Desalegn Tsegaw | South Ethiopia Network of Universities in Public Health (Senuph

Publications

Hibstu, D. T., et al. (2026). “Prevalence of diabetes mellitus among adults aged 45 years and above in rural Sidama, Ethiopia: a two-step community-based cross-sectional study.” BMJ Open 16(1): e109628.

Objective To determine the prevalence of undiagnosed diabetes and identify associated factors using a two-step diagnostic method combining fasting blood sugar with confirmatory glycated haemoglobin A1c (HbA1c) testing among adults 45 years and above in rural Sidama, Ethiopia.

Design A community-based cross-sectional design was conducted from 1 April to 31 July 2024. Data were collected through a census of adults aged 45 years and above using a pretested WHO-STEPwise questionnaire. Physical and biochemical tests were performed following standard protocols. Data were analysed using Stata V.17.

Setting Selected rural kebeles of Shebedino district, Sidama, Ethiopia.Participants 2875 adults aged 45 years and above.Primary outcome measures Undiagnosed diabetes confirmed by HbA1c levels (≥48 mmol/mol or ≥6.5%).

Results The prevalence of undiagnosed diabetes confirmed by HbA1c was 1.2% (35 of 2871; 95% CI: 0.9% to 1.7%). Previously diagnosed diabetes was found in 0.5% (14 of 2875; 95% CI: 0.3% to 0.8%). The total diabetes prevalence, confirmed by HbA1c or prior diagnosis, was 1.7% (49 of 2871; 95% CI: 1.3% to 2.3%). A total of 1327 out of 2875 (46%) participants were undernourished. Advanced age (β=0.21; 95% CI: 0.08 to 0.32, p=0.001), and estimated annual income (β=0.15; 95% CI: 0.02 to 0.28; p=0.029) were significantly associated with elevated fasting blood sugar levels.

Conclusion The prevalence of undiagnosed diabetes among rural adult population was low. Older age and higher income were significantly associated with elevated fasting blood sugar. Routine community-based diabetes screening among older population, health education and nutrition-focused interventions are recommended to sustain the low burden and address undernutrition.All data relevant to the study are included in the article or uploaded as supplementary information.