Boosting diabetes and pre-diabetes screening in rural Ghana

Background: Diabetes is a growing worldwide disease with serious consequences to health and with a high financial burden. Ghana is one of the developing African countries where the prevalence of diabetes is increasing. Moreover, many cases remain undiagnosed, when along with pre-diabetic cases they can be easily detected. Pre-diabetes condition occurs when blood sugar levels are higher than normal but are not high enough to be classified as diabetes, and it is still reversible. The main objective of this study is to propose a novel method to increase diabetes and pre-diabetes early detection in rural areas. A secondary aim is to look for new related behavioral determinants specific to rural Ghana, by comparing subjects at risk with those already diagnosed as diabetic. Methods: The screening approach was based on tests performed pro-actively by community nurses using glucometers and mobile phone apps. As a pilot for future policies, glycemic tests were carried out on 101 subjects from rural communities in Ghana deemed at risk and unaware of their diabetic/pre-diabetic status. A comparison of dietary and lifestyle habits of the screened people was conducted in regards to a cohort of 103 diabetic patients from the same rural communities. Results: The pilot screening detected 2 diabetic subjects (2% of the cohort) showing WHO diabetic glycemic values, and 20 pre-diabetic subjects (19.8% of the cohort) which showed the effectiveness of the user-friendly approach. The need for further campaigns on alcohol consumption and physical activity has emerged, even in rural areas. Conclusions: Policies based on prevention screening as reported in the manuscript have the potential to reduce diabetes incidence, if actions are taken while patients are pre-diabetic, reduce complication related to late diagnosis and indirectly related health-care costs in the country.