Prevalence of prediabetes and associated risk factors among peri-urban dwelling adults in Blantyre, Malawi

Grace Mukoka-Bwezani¹*, Ndaziona Kwanjo Banda², Thom Kaledzera¹, Adamson Muula³, Enock Chisati^1,4

1. Department of Rehabilitation Sciences, School of Life Sciences and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre, Malawi
2. Department of Medicine, School of Medicine and Oral Health, Kamuzu University of Health Sciences and Queen Elizabeth Central Hospital, Blantyre, Malawi
3. Department of Public Health, School of Public and Global Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
4. Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya

*Corresponding Author: Grace Mukoka-Bwezani; E-mail:gracebwezani@gmail.com

Abstract
Introduction
Prediabetes is a high-risk state for developing diabetes, yet its prevalence in Malawi remains understudied. This study was conducted to determine the prevalence of prediabetes and its associated risk factors in peri-urban communities of Blantyre, Malawi.
Method
A quantitative cross-sectional study design was employed, enrolling 204 participants from South Lunzu, Nkolokoti, and Misesa. Systematic probability sampling was conducted to recruit study participants. Data were collected using the WHO STEP-wise questionnaire. The following data were collected: demographic characteristics (age, sex, education, employment), lifestyle behaviours (smoking, alcohol consumption, physical activity), anthropometric measures (body mass index, waist circumference, waist-hip ratio), blood pressure, and Fasting Plasma Glucose (FPG) levels. Prediabetes was defined as an FPG level of 110-125 mg/dl. Bivariate and multivariate logistic regression analyses were performed to examine relationships between prediabetes and independent factors.
Results
The mean age of participants was 39±13.40 years (range: 18 – 76 years). Female participants constituted 76% (n=155) of the sample. The prevalence of prediabetes was 9.8% (n=20). Participants’ characteristics included 3.4% active smokers, 18.6% alcohol consumers, 67.6% engaging in vigorous physical activity, and 81.9% in daily moderate physical activities. Additionally, 24.5% were obese, 53.9% had high waist circumference, and 23.0% had a high waist-hip ratio. Obesity was significantly associated with prediabetes (AOR=8.850 95% CI=1.172 – 29.208). All other variables were not significantly associated with prediabetes.
Conclusion
Results from this study reveal a significant association between obesity and prediabetes, highlighting the importance of maintaining a healthy weight to prevent prediabetes.

Keywords: Prediabetes, modifiable risk factors, non-communicable diseases, diabetes, WHO-STEPs tool