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Sep 19, 2007Article Details
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Main Article Content
Estimating the burden of disease attributable to diabetes in South Africa in 2000
Abstract
Objectives. To estimate the burden of disease attributable to
diabetes by sex and age group in South Africa in 2000.
Design. The framework adopted for the most recent World
Health Organization comparative risk assessment (CRA)
methodology was followed. Small community studies used to
derive the prevalence of diabetes by population group were
weighted proportionately for a national estimate. Populationattributable
fractions were calculated and applied to revised
burden of disease estimates. Monte Carlo simulation-modelling
techniques were used for uncertainty analysis.
Setting. South Africa.
Subjects. Adults 30 years and older.
Outcome measures. Mortality and disability-adjusted life years
(DALYs) for ischaemic heart disease (IHD), stroke, hypertensive
disease and renal failure.
Results. Of South Africans aged ≥ 30 years, 5.5% had diabetes
which increased with age. Overall, about 14% of IHD, 10% of
stroke, 12% of hypertensive disease and 12% of renal disease
burden in adult males and females (30+ years) were attributable
to diabetes. Diabetes was estimated to have caused 22 412 (95%
uncertainty interval 20 755 - 24 872) or 4.3% (95% uncertainty
interval 4.0 - 4.8%) of all deaths in South Africa in 2000. Since
most of these occurred in middle or old age, the loss of healthy
life years comprises a smaller proportion of the total 258 028
DALYs (95% uncertainty interval 236 856 - 290 849) in South
Africa in 2000, accounting for 1.6% (95% uncertainty interval
1.5 - 1.8%) of the total burden.
Conclusions. Diabetes is an important direct and indirect cause
of burden in South Africa. Primary prevention of the disease
through multi-level interventions and improved management
at primary health care level are needed.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 700-706
