Factors associated with hospital admissions among registered diabetes mellitus patients in Guruve and Mazowe districts, Mashonaland Central province, Zimbabwe.

Abstract

Introduction Diabetes mellitus is among the top five chronic conditions contributing to Out Patients Department attendance in Mazowe and Guruve Districts. This study sought to identify the contributory factors that are associated with the increase in hospital admissions among diabetes mellitus patients in Guruve and Mazowe Districts so as to inform interventions. Methods: The study was an analytic cross-sectional study. A census of all the 202 registered patients attending diabetes mellitus review appointments at Guruve, Howard, Concession and Mvurwi hospitals was done. Interviewer-administered pretested questionnaires were used to collect data. Epi info version 3.5.1 was used to create frequencies, proportions and prevalence odds ratios to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables. Ethical approval was sought from all relevant authorities while informed consent was obtained from all study participants. Results: Of the 202 study sample, 43.6% had an admission history due to diabetes mellitus. Being female [POR 2.43 (95%CI: 1.25-4.73)], being unemployed [POR 1.97 (95%CI: 1.09-3.56)] and being less educated (primary level and below)[POR 2.56 (95%CI: 1.38-4.77) were statistically significant risk factors for hospitalisation due to diabetes mellitus. Those patients on insulin [POR 2.93 (95%CI: 1.33-6.48)], those resident in communities where diabetes was not discussed at public meetings and gatherings [POR 3.73 (95%CI: 1.68-8.28)], those with longer duration on treatment for diabetes (4+ years) [POR 2.30 (95% CI: 1.30-4.41)], older cases (>1 year) [POR 3.04 (95%CI: 1.47-6.28)] and support group members [POR 4.77 (95% CI: 1.50-15.18)] had a higher likelihood of getting hospitalised and this was statistically significant. Insulin medication [AOR 2.74 (95% CI: 1.22-7.27) p= 0.0168], low educational level (primary and below) [AOR 2.74 (95% CI: 1.34-5.58) p= 0.00570], having long been diagnosed with diabetes (1year+) [AOR 3.06 (95% CI: 1.38- 6.79) p=0.00570] and residing in areas where there is no diabetes mellitus education at community level [AOR 3.86(95% CI: (1.60-9.32) p=0.00260], were independent factors associated with hospital admissions due to diabetes iii mellitus in Guruve and Mazowe districts that remained statistically significant after logistic regression analysis. Conclusion and Recommendations Independent predictors of hospitalisation due to diabetes were type of treatment, level of education, community based health education and time lapse after diabetes diagnosis. In addition to provision of adequate services and supplies to diabetes mellitus clients, the District Health Executive needs to take an ecological approach towards the inclusion of the wider family and community support structure in effecting lifestyle modifications among diabetes mellitus clients that is conducive to sustain control measures.