PROSPECTIVE-STUDY OF INCIDENCE OF JUVENILE DIABETES-MELLITUS OVER 10 YEARS IN DAR-ES-SALAAM, TANZANIA

Objective-To ascertain the annual incidence of diabetes requiring trea tment with insulin in children and adolescents aged 0-19 years in Dar es Salaam, Tanzania, during a 10 year period from 1 january 1982 to 31 December 1991. Design-Prospective registration at a major urban hospi tal of all patients with newly diagnosed diabetes who were resident in Dar es Salaam. Setting-Muhimbili Medical Centre, Dar es Salaam, Tanza nia. Patients-86 patients: 45 male, 41 female. Results-The annual inci dence of juvenile diabetes for both sexes was 1.5 per 100000 populatio n aged 0-19 years (95% confidence interval 1.3 to 1.7). Incidence per 100 000 population per year increased with age: 0.6 (0.0 to 0.13) in t he age group 0-4 years, 0.5 (0.3 to 0.7) at 5-9 years, 2.2 (1.8 to 2.6 ) at 10-14 years, and 3.4 (2.9 to 3.9) at 15-19 years. Conclusion-Juve nile diabetes mellitus is fairly rare in sub-Saharan Africa. If enviro nmental factors such as infection and material deprivation were import ant determinants of insulin dependent diabetes in Africans, as they ma y be in Europeans, much higher rates would have been expected unless g enetic factors possibly exert a protective role. The eightfold greater incidence in African Americans than in Tanzanians may be related to g reater genetic admixture in African Americans with people from countri es in Europe with a high incidence.