Prevalence and clinical picture of IDDM in Nigerian Igbo schoolchildren

Abstract

OBJECTIVE To evaluate the prevalence and clinical picture of IDDM in Nigerian Igbo schoolchildren born and living in continental Africa. RESEARCH DESIGN AND METHODS In three school districts (Ezza, Ishielu, Ohaukwu), 77,862 schoolchildren aged 5–17 yr answered our questionnaires on age, sex, known disease, drugs being taken, family history, and diabetic symptoms like polyuria, polydipsia, polyphagia, and weight loss. Positive respondents were given glucosuric tests, and glucosuric subjects had hyperglycemic tests. Diagnosis of IDDM was established in hyperglycemic patients by referred hospital clinicians based on insulin requirements. RESULTS Twelve new cases of IDDM were found in addition to 14 previously diagnosed cases, giving a CPR of 0.33/1000. Ishielu had a CPR of 0.46/1000 compared with 0.25 (P < 0.01) for Ohaukwu. Boys had a CPR of 0.38/1000 compared with 0.25/1000 (P < 0.06) for girls. Boy-to-girl prevalence ratio was ∼ 3:1. CONCLUSIONS The relatively high prevalence of IDDM in this poor African population, despite potential deaths caused by minimal medical attention, may be because of long-term protein malnutrition and endemic childhood infections, which have been implicated in the etiology of IDDM in similar malnourished populations.