Journal des maladies infectieuses et de la médecine préventive
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Incidence and Risk Factors of Diabetes in People Living with HIV in Bobo-Dioulasso, Burkina Faso

Armel Poda* , Arsène Héma, Adrien Sawadogo, Ibrahim Sawadogo, Issouf Yaméogo, Jacques Zoungrana, Ziemlé Clément Méda, Firmin Kaboré, Boly Rainataou, Inès Da, Chérileila Thiombiano, Hervé Kpoda, Abdoul Salam Ouédraogo, Guillaume Bado, Ismael Diallo, DiendéréEric, Apoline Sondo, Mamoudou Savadogo, Téné Marceline Yaméogo

Background: in sub-Saharan Africa, the co-morbidity of diabetes mellitus and HIV is still poorly assessed. This study aimed to determine the incidence and risk factors of diabetes mellitus among PHAs with HIV followed on an outpatient basis at the adult day hospital (HDJ) in Bobo-Dioulasso, Burkina Faso.

Methods: A retrospective cohort study was conducted and concerning period from January 2008 to December 2015 at the adult HDJ. The diagnosis of diabetes mellitus was based on the basis of 2 blood glucose levels >7 mmol/l or patient having a status of diabetes mellitus confirmed. The Cox proportional risk method was used to identify risk factors for the development of diabetes mellitus. The significance level was set at p value < 5% for all statistical tests. Data were analyzed by STATA13 software.

Results: we included 4,500 patients. The incidence of diabetes mellitus was 4.7 per 1000 person-years. Diabetic subjects were predominantly infected with HIV1 (89.4%); the age group 36-45 years was the most represented (34.6%). We observed a predominance of females (61.5%) and an abnormal body mass index (BMI) for 42.9% of cases.

The majority of diabetics were detected at WHO stage 3 (42.5%), had arterial hypertension (38.0%), had abnormal glomerular filtration rate (30.0%) and had CD4 counts of less than 350 cells/μl for 70.0% of the cases. among them 38% had hypertension; 30% had abnormal glomerular filtration rate and 70% had a low CD4 count of less than 350 cells/μl. In multivariate analysis only age >55 years was identified as an independent risk factor for the occurrence of diabetes mellitus during follow-up.

Conclusion: Diabetes mellitus was found among PLWHIV from the day hospital cohort in Bobo Dioulasso. Age was the risk factor found for the onset of diabetes. Integrated approach for patient’s management in different units in sub-Saharan Africa is suitable facing double epidemiological burden.