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Demographics, clinical measurements, and behavioral predictors of Type 1 Diabetes mortality in Rwandan adults

Phelos, Heather (2017) Demographics, clinical measurements, and behavioral predictors of Type 1 Diabetes mortality in Rwandan adults. Master Essay, University of Pittsburgh.

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Background/Objective: Life for a Child (LFAC) is an international program that provides care and education to needing youth with Type 1 Diabetes in over 42 countries. The program’s approach is to work with local partners, providing necessary insulin, blood glucose testing supplies, and education to all youth (age 26) in need. In Rwanda, LFAC works primarily through the Rwanda Diabetes Association (RDA). The current study is being conducted to serve the need of LFAC to evaluate long-term outcomes, including mortality, and uses a retrospective cohort design to survey 84 participants who ‘aged out’ of the LFAC program in 2012 or 2013, i.e. 4-5 years prior to being surveyed (2017).
Methods: Baseline data were obtained from the 2012/2013 clinical exam records kept by the RDA staff. The mortality status was ascertained in May of 2017, with a censoring date of June 1, 2017, via local hospital consultation. Descriptive statistical evaluation of baseline data and last available LFAC measures was performed by gender and mortality status using Stata. Baseline predictors of mortality status were assessed using logistic regression models.
Results: Out of the 84 participants with a mean baseline age of 24.2 years, 51 (60.7%) were women. The vital status was obtained for 46 out of the 84, or 54.7% of the sample. During the 4.3 years of mean follow-up, there were 10 deaths (6 females (60.0%)), giving an incidence density of 5.4 /100 person-years. In the logistic regression models, higher last visit HbA1c levels (OR=2.7, p=0.03) and lower BMI (OR=0.6 p=0.02) were significantly associated with mortality status.
Conclusion: The results show an alarmingly high mortality rate for these youth. HbA1c and BMI were the sole significant mortality predictors, though the low sample size and the high degree of missing data do not allow for definitive conclusions. Thus, further risk factors may also be important and merit further study. The burden of high mortality, along with annual increases of the disease, show the public health importance of type 1 diabetes research.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairCostacou, Tinacostacout@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberOrchard, Trevororchardt@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberLibman, IngridIngrid.Libman@chp.eduUNSPECIFIEDUNSPECIFIED
Date: 15 December 2017
Date Type: Submission
Submission Date: 24 November 2017
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 43
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Type 1 Diabetes Rwanda
Date Deposited: 17 Jul 2018 16:17
Last Modified: 17 Jul 2018 16:17


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