Glycemic control among People living with HIV and diabetes in Eastern Uganda: A cross-sectional study

Poor glycemic control remains a significant Public Health problem among people living with HIV(PLWH) and diabetes in Africa and Uganda specifically. Dual diagnosis of HIV and diabetes is associated with high costs of management and poor prognosis. This study aimed to determine the baseline glycemic control of PLWH and diabetes and associated factors in Eastern Uganda.

This study employed quantitative methods along with a cross-sectional analytical study design. A total of 257 participants (ten didn't participate) from Mbale and Soroti Regional Referral Hospitals participated in this study from May 1 to July 30th, 2024. The sample size was determined using the modified Cochrane formula, and participants were selected using simple random sampling. An electronic questionnaire was used to collect socio-demographic and clinical data. An automated Finecare HbA1c analyser was used to determine the HbA1c levels of participants. The data was analysed using Stata version 15. Multivariable logistic regression analyses were conducted to identify associated factors. At p<0.05, statistical significance was established.

The median age was 51(44, 60). The female participants comprised 152 (59.1%), and 52 (20.2%) of the total participants had a tertiary education. More than half, 136 (52.9%), had HbA1c above 7%. The age group above 50 years, having more than three children, and tertiary education were positively associated; however, only the tertiary level of education was statistically significant after adjusting for confounders, aPOR 3.9(95% CI:1.1-14.2), p=0.037.

The prevalence of poor glycemic control among people living with HIV and diabetes at Mbale and Soroti Hospitals in Uganda is high at 52.90%. The age group above 50 years, having children and tertiary education were positively associated with poor glycemic control. Routine HbA1c testing and immediate evidence-based management by health workers are encouraged among clients over 50, those with children, and those with tertiary education.