Prevalence and factors associated with adult diabetes mellitus in the adult population of Bunia, Democratic Republic of Congo: a cross-sectional study.

INTRODUCTION

diabetes mellitus is a global public health emergency, with a worldwide prevalence of 11.1% and a 77.6% increase in mortality over the past decade. In Bunia, Ituri Province, persistent armed conflict and reliance on commercially imported foods may influence diabetes risk, warranting an assessment of its prevalence and associated factors.

METHODS

a community-based cross-sectional study was conducted in Bunia from March to July 2024 using multistage stratified random sampling. Adults aged ≥18 years who had lived in Bunia for at least six months were included. Data were collected through structured questionnaires and anthropometric, physical, and biochemical measurements following the WHO STEPwise approach. Descriptive, bivariate, and multivariate analyses were performed.

RESULTS

a total of 1,808 participants were enrolled, including 1,086 women (60.07%), with a mean age of 39.95 ± 17.01 years. Secondary education was reported by 54% of participants, 54.81% were married, and 25.66% were engaged in commercial activities. Monthly income below USD 100 was reported by 43.53%. The prevalence of diabetes was 6.31% (95% CI: 5.2-7.5), and prediabetes was 12.17% (95% CI: 10.7-13.8). Diabetes prevalence was higher among women (4.03%) than men (2.27%). Factors independently associated with diabetes included advanced age (aOR = 1.029; 95% CI: 1.011-1.047), abdominal obesity (aOR = 1.035; 95% CI: 1.015-1.056), prolonged sedentary behavior (aOR = 1.002; 95% CI: 1.001-1.003), low-intensity physical activity (aOR = 2.002; 95% CI: 1.053-3.813), semi-urban residence (aOR = 2.655; 95% CI: 1.381-5.106), and occupations such as farming or mason´s assistant (aOR = 2.718; 95% CI: 1.084-6.814). Protective factors included family history of diabetes (aOR = 0.337; 95% CI: 0.204-0.558), appropriate salt intake (aOR = 0.527; 95% CI: 0.295-0.943), and low stress levels.

CONCLUSION

diabetes prevalence in Bunia is shaped by demographic, behavioral, occupational, and environmental factors, underscoring the need for targeted prevention, health promotion, and management strategies for high-risk populations.