Morbidity and complications of diabetes mellitus in children and adolescents in Ghana: study design and rationale

Essuman, Vera Adobea; Tagoe, Naa Naamuah; Akpalu, Josephine; Essuman, Akye; Sackey, A.H.; Hayfron-Benjamin, C.F.; Asare, George; Abaidoo, Benjamin; Amoah, A.G.B.; Ndanu, Thomas; Ofori-Adjei, I.D.B.; Barnes, N.A.; Appiah-Thompson, B.L.; Amoaku, Winfried

Abstract

Background:
Diabetes is associated with premature morbidity and mortality from its many complications. There is limited data on the chronic complications of diabetes in children and adolescents in sub-Saharan Africa.

Objective:
The study aims to: i) determine the burden and related factors of chronic diabetes complications, and non-diabetes ocular conditions in children and adolescents and ii) the quality of life (QoL) of the participants compared to healthy controls.

Methods:
After ethics approval from all the participating institutions, and written informed consent or assent, a cohort of children and adolescents (4 – 19 years) with diabetes was recruited from health facilities from two cities in Ghana, Accra (Korle Bu Teaching Hospital) and Cape Coast (Cape-Coast Teaching Hospital). Demographic, medical history, anthropometric measurements and laboratory characteristics were collected, and the participants screened for microvascular and macrovascular complications as well as non-diabetic ocular disease. QoL questionnaires were administered to participants, their care givers and controls. Participants were followed up annually to determine the natural history and trends in the above conditions. The statistical package for social sciences (SPSS Version 25.0) will be used for data analysis. Continuous and categorical data will be presented as mean and standard deviation (SD) and as percentages (%), respectively. T-test and ANOVA will be used to compare means and Chi-square for categorical data. Correlation, regression and logistic regression will be employed to establish linear associations and causal associations as appropriate. Relative risk and Odds ratios will be used to estimate risk. Quality of life (QoL) outcomes in Ghanaian children and adolescents with diabetes mellitus compared with caregivers and healthy controls will be assessed using the PedsQL™ inventory. Significance will be set at α=0.05.

Results:
The study was approved by the Ethical and Protocol Review Committee of the College of Health Sciences, University of Ghana (protocol identification number: MS-Et/M.12-P4.5/2013-2014) and received funding support from University of Ghana Research Fund (large multi-disciplinary grant). Data collection started from August 2017 to September 2019. Currently, patient recruitment, clinical examinations, and some laboratory analysis have been completed. A total of 59 children and adolescents with diabetes mellitus have been recruited. Blood samples are stored at -80 degrees Celsius for analysis. Data has been captured to date and analysis is currently underway. Investigators are planning to submit results for publication by October, 2020.

Conclusions:
The prevalence, natural history, trends in diabetic complications and non-diabetic ocular disease, and quality of life will be provided. Our data may inform policies and interventions to improve care given to children and adolescents with diabetes.

Citation

Essuman, V. A., Tagoe, N. N., Akpalu, J., Essuman, A., Sackey, A., Hayfron-Benjamin, C., …Amoaku, W. Morbidity and complications of diabetes mellitus in children and adolescents in Ghana: study design and rationale

• Deposit Date: Jul 27, 2020
• Public URL: https://nottingham-repository.worktribe.com/output/4693115
• Related Public URLs: https://preprints.jmir.org/preprint/21440