Abstract:
Objective-To ascertain the annual incidence of
diabetes requiring treatment 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
hospital of all patients with newly diagnosed diabetes
who were resident in Dar es Salaam.
Setting-Muhimbili Medical Centre, Dar es
Salaam, Tanzania.
Patients-86 patients: 45 male, 41 female.
Results-The annual incidence of juvenile diabetes
for both sexes was 1-5 per 100000 population
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 the 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-Juvenile diabetes mellitus is fairly
rare in sub-Saharan Africa. If environmental
factors such as infection and material deprivation
were important determinants of insulin dependent
diabetes in Africans, as they may be in Europeans,
much higher rates would have been expected unless
genetic factors possibly exert a protective role. The
eightfold greater incidence in African Americans
than in Tanzanians may be related to greater genetic
admixture in African Americans with people
