Self-perceived health in urban diabetic patients in Tanzania

Objectives: To compare self-perceived health in a group of urban Tanzanian diabetic patients and the general population and to investigate validity of the Swahili version of the health questionnaire used. Design: A health questionnaire and a symptom check list were filled in:by diabetic patients after informed consent. The results were compared with data from the general population. Setting: The study was carried out at the diabetes out-patient clinic at Muhimbili Medical Centre in Dar es Salaam, Tanzania. Subjects: Adult diabetic patients (n = 518) with a mean diabetes duration of 5.5 years were consecutively included. Thirty one per cent of the patients were on insulin treatment. Outcome measures: The Swahili version of a health questionnaire measuring eight health-domains and a check-list including 29 symptoms were used. Results: Diabetic patients reported significantly poorer health when compared to the general population. Patients on insulin treatment reported poorer health than those on diet/oral treatment and those with less than ten years duration of diabetes had poorer self-perceived health than patients with shorter duration. Satisfactory concurrent and content validity of the Swahili version of the health questionnaire was found. All but the general health domain showed Cronbach's alpha levels exceeding .70. Conclusions: It is important to include validated health measures when assessing diabetes treatment and care. The health questionnaire used here was found to differentiate between diabetic patients and the general population. Underlying cultural factors might explain the unsatisfactory reliability of the general health domain.