Correlates of diabetic polyneuropathy of the elderly in Sub-Saharan Africa.

BACKGROUND: Diabetic polyneuropathy is associated with significant physical disability among older adults. However, their frequency and correlates are not well known in the older adults in Sub-Saharan-Africa. The objectives were to evaluate the hospital-based prevalence of diabetic polyneuropathy and identify its correlates in older adults. METHODS: Over a period of 5 months, a cross-sectional survey was carried out at Douala Laquintinie Hospital (DLH), a main reference hospital in Douala, the economic capital of Cameroon. Participants in our study group comprised all patients with type 2 diabetes, whatever the reason for their reporting to the hospital. Diabetic Polyneuropathy was defined according to a Diabetic Neuropathy Examination score > 3/16. RESULTS: A total of 159 older adults with diabetes were examined during this recruitment period, among whom 106 (66.7%) were women. The mean age was 68.3 ± 6.5 years. Diabetes median duration was 108 months. For all patients assessed using the Diabetic Neuropathy Examination score, polyneuropathy was reported in 31.4%; among them, polyneuropathy proved symptomatic in 78% of them. Correlates of polyneuropathy were glycated hemoglobin (p = 0.049), HIV infection (p = 0.031) and albuminuria (p< 0.001), even after adjustment for age, gender and duration of diabetes. CONCLUSION: A third of older adults with diabetes who visited our hospital were diagnosed with prevalent diabetes-related polyneuropathy. It shows that early detection is required through routine screening and regular follow-up examinations in order to reduce the risk of disability and improve the quality of life in elderly diabetics.

Prevalence of hypertension in older people in Africa: a systematic review and meta-analysis.

OBJECTIVE: The prevalence of hypertension in older people living on the African continent has not been comprehensively assessed. We aimed to provide accurate estimates of hypertension prevalence and variations by major predictive characteristics in this population to assist prevention and monitoring efforts. METHODS: For this systematic review and meta-analysis, we searched major electronic databases for population-based studies on hypertension prevalence reported from 1 January 2000 to 5 March 2016. Two independent reviewers undertook quality assessment and data extraction. We stabilized the variance of study-specific prevalence with the Freeman-Tukey single arcsine transformation before pooling the data with random-effects models. RESULTS: From the 2864 citations identified via searches, 91 studies providing 156 separate data contributions involving 54 198 individuals met the inclusion criteria. The overall prevalence of hypertension was 55.2% (95% confidence interval 53.1-57.4). Prevalence was higher in urban compared with rural settings [59.0% (55.3-62.6) vs. 48.0% (43.8-52.3), P < 0.001]. Prevalence did not differ significantly between STEPwise approach to surveillance (STEPS) and non-STEPS studies, across age groups, sex, sample size, year of publication, region, or population coverage. In cumulative meta-analysis, no temporal trend was identified over the years considered in this review. In influence analysis, no individual study was found to have a strong effect on the pooled prevalence estimate. There was substantial heterogeneity across studies (all I(2) > 94%, P < 0.001) and no evidence of publication bias. CONCLUSION: Our findings highlight the need to implement timely and aggressive strategies for prevention, detection, and control of hypertension among older people in Africa.Registration: PROSPERO ID CRD42016034003.