Adherence and associated factors to type 1 diabetes mellitus care among adolescents at Rwanda Diabetes Association

Abstract

Background: Worldwide, many adolescents are suffering from type 1 diabetes. Greater adherence to the recommendations management is associated with better clinical outcomes. In Rwanda, the adherence of adolescents living with T1DM to diabetic care is not well known. Objectives: The study had the purpose to assess the adherence of children suffering from T1DM to Diabetic care and its associated factors. Methods: The quantitative cross-section study was conducted in Rwanda Diabetic Association Centre in Kigali, Rwanda among a convenient sample of 108. The study was conducted from February to April (precise date). A structured questionnaire was used to collect data. Ethical approval was sought and obtained from UR-CMHS-IRB (number of ethics). Participation was voluntary and other ethical principles were observed throughout the study. Descriptive data were entered into the Statistical Package of Social Sciences (SPSS) version 21, and then analyzed using Pearson Chi-square, to determine association between variables. The significance level was set at p-value of < 0.05 The Results: A total of 106 (98%) participants who consisted of 40.6% male and 59.4% female completed the survey. The majority of participants were aged between 15-19 (79.2%) years while 22(20.8%) were between 10-14 years old. 79.2% were adherent to diabetic care while 20.8% were not adherent. (72.6%) had schooling while (27.4%) did not attend school. The majority of the participants (79.2%) were in boarding school and (20.8%) were living out of school. Moreover (63.2%) children were living with both parents and (61.3%) of parents were married. There is no association between adherence and Age, gender , Child in boding school, Duration of medication, or if there are causes delayed respect of nurse‘ instructions but the others factors are associated with adherence: schooling child( p:0.001) , Relationship with guardian p:0.001) Parent status(p:<001) ,Guardian‘ occupation(p:<001), education level of guardian( p:0.017) (p:),Ubudehe category(p:<001), Health insurance(p:0.025) Complication (p:0.001) and Co-morbidities diseases ( p:0.001). Conclusion: Adherence to type 1 diabetes care is still low among the adolescent. The results suggest that reinforcing caretaker involvement could be vital in improving adherence to diabetes care recommendations in this population.