Feasibility of Managing Diabetes Patients Identified Through Community Screening in Rural Ethiopia
Abstract
ABSTRACT:
Objective: To assess the feasibility of diagnosing, enrolling, and managing adults with type 2 diabetes at the primary healthcare level using the WHO Package of Essential Non-communicable Disease Interventions (WHO-PEN) approach, following identification through community – based screening in rural Ethiopia.
Design: Single-arm, pre-post clinical feasibility study.
Setting: Primary healthcare facility in Shebedino district, Sidama National Regional State, rural Ethiopia, between September 2024 and February 2025.
Participants: 35 adults with newly diagnosed type 2 diabetes, identified through community-based screening and diagnosed according to the WHO and American Diabetes Association criteria.
Interventions: A six-month WHO-PEN based intervention comprising metformin based pharmacologic treatment, lifestyle counselling, and health system strengthening.
Outcome measures: Feasibility across four domains (acceptability, implementation fidelity, practicality, and preliminary clinical signal); HbA1c change from baseline to six months, analysed using the Wilcoxon signed-rank test and McNemar’s test.
Results: All 35 patients completed the six-month follow-up. At baseline, 6(17 %) had comorbid hypertension, 5 (14%) had elevated total cholesterol, 14 (40%) had low HDL cholesterol, 24 (69%) were underweight. Median HbA1c decreased from 52.0 mmol/mol (IQR: 50-56.0) at baseline to 43.0 mmol/mol (IQR: 42.0-46.0) at six months (reduction of 9.0 mmol/mol; p <0.001). By six…
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