PREVALENCE OF CONCORDANT DIABETES COMORBIDITIES AND ASSOCIATED FACTORS AMONG ADULT DIABETIC OUT-PATIENTS AT HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background. Comorbidities among diabetes mellitus (DM) constitute a major public health problem that significantly increases the morbidity, mortality, and complications of DM. Additionally, comorbidity among DM patients reduces productivity and contribute to the economic burden. Identifying the magnitude of DM comorbidities can help to develop interventions that reduce risks of diabetic related complications and death. Despite increments in the prevalence of diabetes and its complications, there are limited studies on the prevalence and their associated factors of concordant comorbidities among diabetic patient in Ethiopia including the current study area, although some of the comorbidities are studied separately. Objective: This study was conducted to determine the prevalence of concordant DM comorbidities and associated factors among diabetic out- patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia, from September 30,2019 to September 30,2020 Methodology: A hospital-based cross-sectional study was conducted by reviewing medical record charts of diabetic outpatients, who has been on follow up at HFSUH. The data was cleaned and entered in to Epi data version 3.1 and exported to STATA version 16.0 for analysis. Descriptive analysis was employed to describe the independent and outcome variables. Binary logistic regression was carried out to identify factors associated with DM comorbidities. Adjusted Odds Ratio with 95% CI was used to measure strength of association and variables with p ≤ 0.05 was considered as statistically being significant. Result: A total of 319 adult diabetic patents were reviewed with response rate of 86.7%. The overall prevalence of concordant comorbidity among adult diabetic out-patients was 55.8% at 95% CI (50.3-61.3). Mean age of respondents was about 45 years. A larger proportion of patients 232 (72.73%) were diagnosed for type II DM. Hypertension (42.32%), CVD (8.15%), Overweight/Obesity (21.63%), dyslipidemia (4.08%) and CKD (10.66%) were reported comorbidity among DM patients. The odds of having concordant comorbidity among adult diabetic out-patients who were 55 or more years old was 7.52 times greater than those in the age group of 18-24 years old. In general, most of the cases of comorbidities were observed amongst elder people {AOR: 7.52, 95% CI (1.24, 45.75)}. Adult diabetic out-patients of type II DM diagnosis were 9.01 times more likely develop concordant comorbidity as compared to those of Type I DM {AOR: 9.01, 95% CI (1.50, 54.04) . Respondents who had 2-5years duration of DM XII treatments were 77% less likely develop comorbidities as compared to those more than10 years {AOR: 0.23, 95 CI (.078, .691)}. Likewise, an odd of having concordant comorbidity among adult diabetic out-patients of poor glycemic control was 4.41 times greater than those of good glycemic control {AOR: 4.4 1, 95% CI (2.34, 8.32). Age, Types of DM, duration of treatment of DM and glycemic control were acknowledged as independent predictors significantly associated with experience of comorbidity. Conclusion: Consistent with previous studies, the current findings show that patients with diabetes have a high prevalence of comorbidity, therefore multiple demands on the health care providers. Age, types of DM, glycemic control and duration of treatment of DM were acknowledged as independent predictors of experiences of comorbidity. Further studies are required in to search and produce extra suggestion.