Key result
Urban residence linked to ~7 percentage points lower diabetes prevalence vs. rural residence.
Cross-Sectional (n=2,131)
Yes
Absolute Event Rate: 16.4% vs 23.1%
p-value: p=0.000
This study demonstrates a high prevalence of cardiometabolic risk factors in Haiti and highlights the feasibility of community-based screening with point-of-care testing in remote, resource-limited settings.
Higher rural diabetes prevalence in Haiti may guide localized screening; leaves open drivers and generalizability.
OBJECTIVE: To estimate the prevalence of hypertension, diabetes and chronic kidney disease and their risk factors in a rural and urban region of Haiti. SETTING AND PARTICIPANTS: Community health workers enumerated 2648 households (909 rural and 1739 urban) via a multistage cluster random sampling method from July 2015 to May 2016, completed 705 rural and 1419 urban assessments for adults aged 25-65 years. OUTCOME MEASURES: We performed a WHO STEPS based questionnaire, measured two blood pressure values, weight, height, abdominal circumference and point of care test finger stick blood sample for haemoglobin A1c, creatinine and cholesterol (total, high density lipoprotein (HDL) and triglycerides). RESULTS: After adjusting for age and sex, the overall prevalence rates of hypertension, diabetes and chronic kidney disease were 15.6% (±2.93%), 19.7% (±1.57%) and 12.3% (±2.72%), respectively. Of the three non-communicable diseases (NCDs), only diabetes showed a significant difference between rural and urban sites (p=0.000), with the rural site (23.1%) having a higher prevalence than the urban site (16.4%). When comparing male and female participants, females were significantly more likely than males to have an NCD (p≤0.011). Females had a higher prevalence of most of the risk factors when compared with males. The urban location had a higher prevalence than the rural location for four risk factors that showed a significant difference between location (p≤0.037). CONCLUSIONS: Women in Haiti had significantly higher prevalence rates of most NCDs and risk factors than men, and urban populations frequently, but not always, had higher rates of NCDs risk factors than the rural population. Further, it was shown that using point of care blood tests combined with community health workers, it is feasible to screen for NCDs and risk factors in remote areas which otherwise have limited access to healthcare.
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DeGennaro et al. (2018) conducted a cross-sectional in Non-communicable diseases (hypertension, diabetes, chronic kidney disease) and risk factors (n=2,131). Urban residence vs. Rural residence was evaluated on Prevalence of diabetes (p=0.000). In a community-based cross-sectional study in Haiti, the prevalence of diabetes was significantly lower in the urban population (16.4%) compared to the rural population (23.1%, p=0.000).
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