SELF-REPORTED DIABETES SCREENING, CARE CASCADE AND THE BURDEN OF UNDIAGNOSED DIABETES IN KENYA. EVIDENCE FROM THE 2015 KENYA STEPWISE SURVEY.
Author(s)
Catherine Odhiambo, PhD.
PhD Student, University of Sheffield, Sheffield, United Kingdom.
PhD Student, University of Sheffield, Sheffield, United Kingdom.
OBJECTIVES: This study assessed the prevalence and determinants of diabetes screening, quantifiedundiagnosed diabetes, and examined the diabetes care cascade in Kenya.
METHODS: Using data from the 2015 Kenya WHO STEPwise survey, a nationally representative cross-sectional study of adults aged 18-69 years, the analysis included 4,167 participants after excluding those with missing fasting plasma glucose (FPG) measurements or who fell outside the eligible age range. Diabetes screening was defined as self-reported prior blood glucose measurement by a health worker, while diabetes was defined as FPG ≥7 mmol/L, previous diagnosis, or prior treatment for diabetes. Weighted prevalence estimates with 95% confidence intervals were calculated, and both univariable and multivariable logistic regression analyses were conducted to identify factors associated with diabetes screening.
RESULTS: Only 11.9% (95% CI: 9.7-14.5) reported ever being screened. Diabetes prevalence was 2.66% (95% CI: 2.06-3.42), with 53.4% (95% CI: 39.0-67.4) of cases undiagnosed. Screening was highest among older adults, those with tertiary education, obese individuals, and those with hypertension, but lowest among younger adults, those with no formal education, and residents of North Eastern region. Among those with diabetes, 46.9% were aware of their diagnosis, 40.8% of those aware were on treatment, and 26.4% of those treated achieved glycaemic control. Significant screening predictors included older age (60-69 years: aOR=6.29, 95% CI: 3.66-10.79), tertiary education (aOR=2.65, 95% CI: 1.33-5.27), poorest wealth quintile (aOR=8.42, 95% CI: 4.11-17.24), obesity (aOR=2.13, 95% CI: 1.41-3.21), and hypertension (aOR=1.64, 95% CI: 1.21-2.23).
CONCLUSIONS: Diabetes screening coverage in Kenya is critically low, with over half of cases undiagnosed and major losses across the care cascade. Thesefindings highlight critical gaps in early diagnosis, linkage to care, treatment uptake, andglycaemic control. Strengthening integrated diabetes screening and care services, particularlyfor underserved and high-risk populations, is essential to improve early detection andcontinuity of care in Kenya.
METHODS: Using data from the 2015 Kenya WHO STEPwise survey, a nationally representative cross-sectional study of adults aged 18-69 years, the analysis included 4,167 participants after excluding those with missing fasting plasma glucose (FPG) measurements or who fell outside the eligible age range. Diabetes screening was defined as self-reported prior blood glucose measurement by a health worker, while diabetes was defined as FPG ≥7 mmol/L, previous diagnosis, or prior treatment for diabetes. Weighted prevalence estimates with 95% confidence intervals were calculated, and both univariable and multivariable logistic regression analyses were conducted to identify factors associated with diabetes screening.
RESULTS: Only 11.9% (95% CI: 9.7-14.5) reported ever being screened. Diabetes prevalence was 2.66% (95% CI: 2.06-3.42), with 53.4% (95% CI: 39.0-67.4) of cases undiagnosed. Screening was highest among older adults, those with tertiary education, obese individuals, and those with hypertension, but lowest among younger adults, those with no formal education, and residents of North Eastern region. Among those with diabetes, 46.9% were aware of their diagnosis, 40.8% of those aware were on treatment, and 26.4% of those treated achieved glycaemic control. Significant screening predictors included older age (60-69 years: aOR=6.29, 95% CI: 3.66-10.79), tertiary education (aOR=2.65, 95% CI: 1.33-5.27), poorest wealth quintile (aOR=8.42, 95% CI: 4.11-17.24), obesity (aOR=2.13, 95% CI: 1.41-3.21), and hypertension (aOR=1.64, 95% CI: 1.21-2.23).
CONCLUSIONS: Diabetes screening coverage in Kenya is critically low, with over half of cases undiagnosed and major losses across the care cascade. Thesefindings highlight critical gaps in early diagnosis, linkage to care, treatment uptake, andglycaemic control. Strengthening integrated diabetes screening and care services, particularlyfor underserved and high-risk populations, is essential to improve early detection andcontinuity of care in Kenya.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH15
Topic
Epidemiology & Public Health
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)