Determinants Influencing Awareness and Healthy Practices among a Sample of Insulin-dependent Diabetic Egyptian Patients: A Rural Community-based Study
DOI:
https://doi.org/10.3889/oamjms.2021.6017Keywords:
Diabetes mellitus, Awareness, Practice, Community-based-ruralAbstract
BACKGROUND: The prevalence of diabetes mellitus (DM) is predicted to increase over the coming years.
AIM: The objectives of the study were to measure the level of awareness and healthy practices related to five healthy domains and assess the effect of different demographic characteristics, glycated hemoglobin (HbA1c) level, and body mass index (BMI) on these levels among diabetic patients in a rural Egyptian village.
METHODS: A cross-sectional study was done on 300 selected insulin-dependent diabetic patients resident in an Egyptian village. Data were collected using a questionnaire covering five domains: General disease awareness and management compliance practice, check-up, foot care, diet, and physical activity. HbA1c and BMI were also measured as an impact of the management adherence.
RESULTS: The study found that more than three quarters of the participants (82.0%) were uncontrolled or poorly uncontrolled (HbA1c >8) diabetics and 76.0% were either obese or morbidly obese. Total awareness and practices percentage scores were low (42.4 ± 16.8% and 40.5 ± 12.3%, respectively). The linear regression model showed that high educational level had significantly positive effects on both the total awareness and practice scores as well as their domains. The study found that female participants and those having relatives with DM had significantly higher diet awareness and practice scores (p < 0.05). Younger age had significantly higher scores on foot care and diet awareness scores, physical activity, general disease awareness, and management compliance practices domains.
CONCLUSION: The studied awareness and practice domains were inadequate. Their improvement is cornerstones to impact glycemic control of diabetics and control their health risks, especially in rural communities.Downloads
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Khan Y, Hamdy O. Type 2 diabetes in the Middle East and North Africa (MENA). In: Diabetes Mellitus in Developing Countries and Underserved Communities. Cham: Springer; 2017. p. 49-61. https://doi.org/10.1007/978-3-319-41559-8_4 DOI: https://doi.org/10.1007/978-3-319-41559-8_4
Cho N, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018;138:271-81. https://doi.org/10.1016/j.diabres.2018.02.023 PMid:29496507 DOI: https://doi.org/10.1016/j.diabres.2018.02.023
Jayawardene W, Youssefagha A, Matter S, Mokhtar A. Characteristics of Diabetes Epidemic in the Arabian Peninsula and other Muslim Countries. Ch. 1-18. Contemporary Issues in Public Health in North Africa and the Middle East; 2014.
WHO Egypt STEPS Survey; 2018. Available from: https://www.who.int/ncds/surveillance/steps/Egypt_STEPS_Survey_2017_Fact_Sheet.pdf?ua=1. [Last accessed on 2020 Dec 01].
Hwang CK, Han PV, Zabetian A, Ali MK, Narayan KV. Rural diabetes prevalence quintuples over twenty-five years in lowand middle-income countries: A systematic review and metaanalysis. Diabetes Res Clin Pract. 2012;96(3):271-85. https://doi.org/10.1016/j.diabres.2011.12.001 PMid:22261096 DOI: https://doi.org/10.1016/j.diabres.2011.12.001
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137-49. https://doi.org/10.1016/j.diabres.2013.11.002 PMid:24630390 DOI: https://doi.org/10.1016/j.diabres.2013.11.002
Muninarayana C, Balachandra G, Hiremath SG, Iyengar K, Anil NS. Prevalence and awareness regarding diabetes mellitus in rural Tamaka, Kolar. Int J Diabetes Dev Ctries. 2010;30(1):18-21. https://doi.org/10.4103/0973-3930.60005 PMid:20431801 DOI: https://doi.org/10.4103/0973-3930.60005
Singh A, Milton PE, Nanaiah A, Samuel P, Thomas N. Awareness and attitude toward diabetes in the rural population of Arunachal Pradesh, Northeast India. Indian J Endocrinol Metab 2012;16(Suppl 1):S83. https://doi.org/10.4103/2230-8210.94269 PMid:22701853 DOI: https://doi.org/10.4103/2230-8210.94269
Deepa M, Bhansali A, Anjana R, Pradeepa R, Joshi SR, Joshi PP, et al. Knowledge and awareness of diabetes in urban and rural India: The Indian council of medical research India diabetes study (phase I): Indian council of medical research India diabetes 4. Indian J Endocrinol Metab. 2014;18(3):379-85. https://doi.org/10.4103/2230-8210.131191 PMid:24944935 DOI: https://doi.org/10.4103/2230-8210.131191
Sabri AA, Qayyum MA, Saigol NU, Zafar K, Aslam F. Comparing knowledge of diabetes mellitus among rural and urban diabetics. Mcgill J Med. 2007;10(2):87-9. https://doi.org/10.26443/mjm.v10i2.741 PMid:18523544 DOI: https://doi.org/10.26443/mjm.v10i2.741
Norris SL, Engelgau MM, Narayan KM. Effectiveness of selfmanagement training in Type 2 diabetes: A systematic review of randomized controlled trials. Diabetes Care. 2001;24(3):561-87. https://doi.org/10.2337/diacare.24.3.561 PMid:11289485 DOI: https://doi.org/10.2337/diacare.24.3.561
Duke SA, Colagiuri S, Colagiuri R. Individual patient education for people with Type 2 diabetes mellitus. Cochrane Database Syst Rev. 2009;2009(1):CD005268. https://doi.org/10.1002/14651858.cd005268.pub2 PMid:19160249 DOI: https://doi.org/10.1002/14651858.CD005268.pub2
Metwally AM, Soliman M, Abdelmohsen AM, Kandeel WA, Saber M, Elmosalami DM, et al. Effect of counteracting lifestyle barriers through health education in Egyptian Type 2 diabetic patients. Open Access Maced J Med Sci. 2019;7(17):2886-94. https://doi.org/10.3889/oamjms.2019.624 PMid:31844454 DOI: https://doi.org/10.3889/oamjms.2019.624
El-Khawaga G, Abdel-Wahab F. Knowledge, attitudes, practice and compliance of diabetic patients in Dakahlia, Egypt. Eur J Res Med Sci. 2015;3(1):40-53.
Bayumi HE, Saleh HA. Knowledge, attitude and practice of diabetic patients (type II) regarding life style modification at Qena University Hospital in Upper Egypt. J Health Med Nurs. 2016;27:56-62.
Abdo NM, Mohamed ME. Effectiveness of health education program for Type 2 diabetes mellitus patients attending Zagazig university diabetes clinic, Egypt. J Egypt Public Health Assoc. 2010;85(3-4):113-30. PMid:21244813
Hintze J. PASS 11. NCSS, LLC. Kaysville, Utah, USA. Available from: https://www.core.ac.uk/download/pdf/328824124.pdf. [Last accessed on 2019 Mar 25].
Fatema K, Hossain S, Natasha K, Chowdhury HA, Akter J, Khan T, et al. Knowledge attitude and practice regarding diabetes mellitus among Nondiabetic and diabetic study participants in Bangladesh. BMC Public Health. 2017;17(1):364. https://doi.org/10.1186/s12889-017-4285-9 PMid:28446194 DOI: https://doi.org/10.1186/s12889-017-4285-9
American Diabetes Association. 4. Lifestyle Management: Standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S38-50. https://doi.org/10.2337/dc18-s004 PMid:29222375 DOI: https://doi.org/10.2337/dc18-S004
World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373-4. https://doi.org/10.1001/jama.2013.281053 PMid:11357217 DOI: https://doi.org/10.1001/jama.2013.281053
Roux ML, Walsh C, Reid M, Raubenheimer J. Diabetes-related knowledge, attitude and practices (KAP) of adult patients with Type 2 diabetes mellitus in the Free State province, South Africa. South Afr J Clin Nutr. 2019;32(4):83-90. https://doi.org/10.1080/16070658.2018.1468536 DOI: https://doi.org/10.1080/16070658.2018.1468536
Al-Maskari F, El-Sadig M, Al-Kaabi JM, Afandi B, Nagelkerke N, Yeatts KB. Knowledge, attitude and practices of diabetic patients in the United Arab Emirates. PLoS One. 2013;8(1):e52857. https://doi.org/10.1371/journal.pone.0052857 PMid:23341913 DOI: https://doi.org/10.1371/journal.pone.0052857
Chen CC, Chen CL, Ko Y. The Misconceptions and determinants of diabetes knowledge in patients with diabetes in Taiwan. J Diabetes Res. 2020;2020:2953521. https://doi.org/10.1155/2020/2953521 PMid:32656263 DOI: https://doi.org/10.1155/2020/2953521
Balla SA, Ahmed HA, Awadelkareem MA. Prevalence of diabetes, knowledge, and attitude of rural, population towards diabetes and hypoglycaemic event, Sudan 2013. Am J Health Res. 2014;2(6):356-60. https://doi.org/10.11648/j.ajhr.20140206.16 DOI: https://doi.org/10.11648/j.ajhr.20140206.16
Rahaman KS, Majdzadeh R, Naieni KH, Raza O. Knowledge, attitude and practices (KAP) regarding chronic complications of diabetes among patients with Type 2 diabetes in Dhaka. Int J Endocrinol Metab. 2017;15(3):e12555. https://doi.org/10.5812/ijem.12555 PMid:29201069 DOI: https://doi.org/10.5812/ijem.12555
Abouammoh NA, Alshamrani MA. Knowledge about diabetes and glycemic control among diabetic patients in Saudi Arabia. J Diabetes Res. 2020;2020:1239735. https://doi.org/10.1155/2020/1239735 PMid:32215269 DOI: https://doi.org/10.1155/2020/1239735
Niroomand M, Ghasemi SN, Karimi-Sari H, Kazempour-Ardebili S, Amiri P, Khosravi MH. Diabetes knowledge, attitude and practice (KAP) study among Iranian in-patients with Type-2 diabetes: A cross-sectional study. Diabetes Metab Syndr. 2016;10(1):S114-9. https://doi.org/10.1016/j.dsx.2015.10.006 PMid:26610404 DOI: https://doi.org/10.1016/j.dsx.2015.10.006
Ahmed AM, Allam MF, Habil ES, Metwally AM, Ibrahiem NA, Radwan M, et al. Development of practice guidelines for hemodialysis in Egypt. Indian J Nephrol. 2010;20(4):193-202. https://doi.org/10.4103/0971-4065.73450 PMid:21206681 DOI: https://doi.org/10.4103/0971-4065.73450
Kandeel WA, Rabah TM, Zeid DA, El-Din EM, Metwally AM, Shaalan A, et al. Determinants of exclusive breastfeeding in a sample of Egyptian infants. Open Access Maced J Med Sci. 2018;6(10):1818-23. https://doi.org/10.3889/oamjms.2018.359 PMid:30455755 DOI: https://doi.org/10.3889/oamjms.2018.359
El-Din EM, Elabd MA, Nassar MS, Metwally AM, Abdellatif GA, Rabah TM, et al. The interaction of social, physical and nutritive factors in triggering early developmental language delay in a sample of Egyptian children. Open Access Maced J Med Sci. 2019;7(17):2767-74. https://doi.org/10.3889/oamjms.2019.642 PMid:31844434 DOI: https://doi.org/10.3889/oamjms.2019.642
Metwally AM, Salah El-Din EM, Shehata MA, Shaalan A, El Etreby LA, Kandeel WA, et al. Early life predictors of socioemotional development in a sample of Egyptian infants. PLoS One. 2016;11(7):e0158086. https://doi.org/10.1371/journal.pone.0158086 PMid:27379907 DOI: https://doi.org/10.1371/journal.pone.0158086
El Din EM, Rabah TM, Metwally AM, Nassar MS, Elabd MA, Shalaan A, et al. Potential risk factors of developmental cognitive delay in the first two years of life. Open Access Maced J Med Sci. 2019;7(12):2024-30. https://doi.org/10.3889/oamjms.2019.566 PMid:31406549 DOI: https://doi.org/10.3889/oamjms.2019.566
Metwally AM, El-Sonbaty MM, El Etreby LA, Salah El-Din EM, Hamid NA, Hussien HA, et al. Impact of National Egyptian school feeding program on growth, development, and school achievement of school children. World J Pediatr. 2020;16(4):393-400. https://doi.org/10.1007/s12519-020-00342-8 PMid:32056148 DOI: https://doi.org/10.1007/s12519-020-00342-8
Metwally AM, Hanna C, Galal YS, Saleh RM, Ibrahim NA, Labib NA. Impact of nutritional health education on knowledge and practices of mothers of anemic children in El Othmanyia village-Egypt. Open Access Maced J Med Sci. 2020;8(E):458-65. https://doi.org/10.3889/oamjms.2020.4570 DOI: https://doi.org/10.3889/oamjms.2020.4570
Metwally AM, El-Sonbaty M, El Etreby LA, El-Din EM, Hamid NA, Hussien HA, et al. Stunting and its determinants among governmental primary school children in Egypt: A school-based cross-sectional study. Open Access Maced J Med Sci. 2020;8:650-7. https://doi.org/10.3889/oamjms.2020.4757 DOI: https://doi.org/10.3889/oamjms.2020.4757
Metwally AM, Abdel-Latif GA, Mohsen A, El Etreby L, Elmosalami DM, Saleh RM, et al. Strengths of community and health facilities based interventions in improving women and adolescents’ care seeking behaviors as approaches for reducing maternal mortality and improving birth outcome among low income communities of Egypt. BMC Health Serv Res. 2020;20(1):592. https://doi.org/10.1186/s12913-020-05412-1 PMid:32600377 DOI: https://doi.org/10.1186/s12913-020-05412-1
Metwally AM, Saleh RM, El-Etreby LA, Salama SI, Aboulghate A, Amer HA, et al. Enhancing the value of women’s reproductive rights through community based interventions in upper Egypt governorates: A randomized interventional study. Int J Equity Health. 2019;18(1):146. https://doi.org/10.1186/s12939-019-1042-y PMid:31533741 DOI: https://doi.org/10.1186/s12939-019-1042-y
Metwally AM, Saad A, Ibrahim NA, Emam HM, El-Etreby LA. Monitoring progress of the role of integration of environmental health education with water and sanitation services in changing community behaviours. Int J Environ Health Res. 2007;17(1):61-74. https://doi.org/10.1080/09603120600937856 PMid:17365081 DOI: https://doi.org/10.1080/09603120600937856
Metwally AM, Ibrahim NA, Saad A, Abu el-Ela MH. Improving the roles of rural women in health and environmental issues. Int J Environ Health Res. 2006;16(2):133-44. https://doi.org/10.1080/09603120500539208 PMid:16546806 DOI: https://doi.org/10.1080/09603120500539208
Shiha G, Metwally AM, Soliman R, Elbasiony M, Mikhail NN, Easterbrook P. An educate, test, and treat programme to reduce hepatitis C in Egypt: Results from a communitybased demonstration project. Lancet Gastroenterol Hepatol. 2018;3(11):778-89. https://doi.org/10.1016/s2468-1253(18)30139-0 PMid:30030068 DOI: https://doi.org/10.1016/S2468-1253(18)30139-0
Metwally A, Mohsen A, Saleh R, Foaud W, Ibrahim N, Rabaah T, et al. Prioritizing high-risk practices and exploring new emerging ones associated with hepatitis C virus infection in Egypt. Iran J Public Health. 2014;43(10):1385094. PMid:26060701
Salama II, Sami SM, Said ZN, Salama SI, Rabah TM, Abdel-Latif GA, et al. Early and long term anamnestic response to HBV booster dose among fully vaccinated Egyptian children during infancy. Vaccine. 2018;36(15):2005-11. https://doi.org/10.1016/j.vaccine.2018.02.103 PMid:29530634 DOI: https://doi.org/10.1016/j.vaccine.2018.02.103
Salama II, Sami SM, Said ZN, El-Sayed MH, El Etreby LA, Rabah TM, et al. Effectiveness of hepatitis B virus vaccination program in Egypt: Multicenter national project. World J Hepatol. 2015;7(22):2418-26. https://doi.org/10.4254/wjh.v7.i22.2418 PMid:26464758 DOI: https://doi.org/10.4254/wjh.v7.i22.2418
Sulistyo AH, Sae-Sia W, Maneewat K. Diabetic foot care knowledge and behaviors of individuals with diabetes mellitus in Indonesia. GSTF J Nurs Health Care. 2020;5(1):1-15. https://doi.org/10.5176/2345-7198_5.1.4 DOI: https://doi.org/10.5176/2345-7198_5.1.4
Islam FM, Chakrabarti R, Dirani M, Islam MT, Ormsby G, Wahab M, et al. Knowledge, attitudes and practice of diabetes in rural Bangladesh: The Bangladesh population based diabetes and eye study (BPDES). PLoS One. 2014;9(10):e110368. https://doi.org/10.1371/journal.pone.0110368 PMid:25313643 DOI: https://doi.org/10.1371/journal.pone.0110368
Horng WB, Lee CP, Chen CW. Classification of age groups based on facial features. Tamkang J Sci Eng. 2001;4(3):183-92.
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Copyright (c) 2021 Ammal M. Metwally, Hanaa Yousof, Monira M. Elkholy, Lobna A. Eletreby, Abeer A. Barakat, Soha M. Abd El Dayem, Mohamed Abdelrahman, Sherif M. Eldeeb (Author)
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