Rural and urban differences in diabetes prevalence in Tanzania: the role of obesity, physical inactivity and urban living

A population-based survey in 1996 and 1997 of 770 adults (aged greater than or equal to 15 years) from an urban district of Dares Salaam and 928 from a village in rural Kilimanjaro district (Tanzania) revealed that the preval ence of diabetes, impaired fasting glucose (IFG), overweight, obesity, and physical inactivity was higher in the urban area for men and women. The dif ference between urban and rural prevalence of diabetes was 38 [1.1-6.5] % f or men and 2.9 [0.8-4.9]% for women. For IFG, the difference was 2.8 [0.3-5 .3]% for men and 3.9 [1.4-6.4]% for women; for overweight and obesity, the difference was 21.5 [15.8-27.1]% and 6.2 [3.5-8.9]% formenand 17.4 [11.5-23 .3]% and 12.7 [8.5-16.8]% for women, respectively. The difference in preval ence of physical inactivity was 12.5[7.0-18.3]% for men and 37.6[31.9-43.3] % for women. For men with diabetes, the odds for being overweight, obese an d having a large waist:hip ratio were 14.1, 5.3 and 12.5, respectively; for women the corresponding values were 9.0, 10.5 and 2.4 (the last not signif icant) with an attributable fraction for overweight between 64% and 69%. We conclude that diabetes prevalence is higher in the urban Tanzanian communi ty and that this can be explained by differences in the prevalence of overw eight. The avoidance of obesity in the adult population is likely to preven t increases in diabetes incidence in this population.