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Effect of Community-Based Diabetes Screening on Diabetes Detection among Adults in Nigeria

Abstract

Diabetes mellitus remains an important public health concern among adults in Nigeria and contributes substantially to morbidity, disability, healthcare expenditure, and premature mortality. The condition is associated with serious complications, including cardiovascular disease, kidney disease, visual impairment, nerve damage, and other long-term health problems. Many adults living with diabetes may remain undiagnosed because diabetes can develop gradually without obvious symptoms, while limited awareness, financial constraints, geographical barriers, inadequate access to healthcare facilities, and low utilization of preventive health services may delay diagnosis. Early detection of diabetes is essential for timely treatment, lifestyle modification, regular monitoring, and prevention or reduction of diabetes-related complications. Community-based diabetes screening provides an opportunity to bring diabetes detection services closer to adults through community outreach programmes, primary healthcare centres, mobile health services, workplaces, markets, religious institutions, and other community platforms. However, inadequate screening coverage, limited diagnostic equipment, shortages of trained healthcare personnel, low awareness, fear of diagnosis, financial barriers, and weak referral and follow-up systems may limit the effectiveness of community-based diabetes screening programmes in Nigeria. Against this background, this study investigates the effect of community-based diabetes screening on diabetes detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Community Health Theory, and the Health Systems Framework. The Health Belief Model explains how adults' perceptions of susceptibility to diabetes, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in community-based diabetes screening. Community Health Theory emphasizes the delivery of accessible health services through community structures and the involvement of communities in disease prevention, health promotion, and early detection activities. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective diabetes screening and healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based diabetes screening may influence diabetes detection among adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 18 years and above residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, households, and eligible adults. Community-based diabetes screening will be measured using indicators such as availability of screening services, screening coverage, frequency of community screening activities, accessibility of screening locations, number of adults screened, blood glucose testing, diabetes risk assessment, availability of trained healthcare personnel, availability of screening equipment, health education, and referral arrangements. Diabetes detection will be assessed using indicators such as abnormal blood glucose results, newly identified suspected diabetes cases, confirmed diabetes diagnoses following appropriate clinical or laboratory assessment, identification of previously undiagnosed diabetes, impaired glucose regulation where applicable, referrals for further assessment, and linkage to appropriate treatment and follow-up care. Data will be collected using structured questionnaires, community screening registers, blood glucose testing records, laboratory reports, healthcare facility records, referral registers, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, blood glucose findings, and patterns of diabetes detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based diabetes screening on diabetes detection. Where appropriate, diabetes detection rates before and after implementation of community-based screening activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based diabetes screening has a significant positive effect on diabetes detection among adults in Nigeria. Adults who participate in community-based diabetes screening are expected to have a higher likelihood of having previously undiagnosed diabetes or abnormal blood glucose levels identified than adults without access to such services. Community-based screening may facilitate early identification of elevated blood glucose and provide opportunities for confirmatory assessment, medical evaluation, lifestyle modification, nutritional counselling, treatment, and continuous monitoring. Bringing diabetes screening services closer to adults may reduce geographical, financial, and time-related barriers and encourage greater utilization of preventive healthcare services. Early detection may also increase awareness of diabetes risk factors and encourage individuals to adopt healthier dietary and physical activity practices. Conversely, inadequate screening coverage, limited diagnostic capacity, shortage of trained healthcare personnel, low awareness, fear of diagnosis, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based diabetes screening. The study therefore expects accessible and well-organized community-based diabetes screening to contribute significantly to improved detection and early management of diabetes among adults in Nigeria. The study is expected to contribute to the literature on community-based diabetes screening, diabetes detection, adult health, non-communicable disease prevention, community health services, preventive healthcare, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, community health workers, diabetes care providers, development partners, and policymakers regarding strategies for improving early detection of diabetes among adults. The study will also provide evidence-based recommendations for expanding community-based diabetes screening programmes, improving access to affordable blood glucose testing, strengthening community health education, increasing availability of trained healthcare personnel and screening equipment, integrating diabetes screening into primary healthcare and community outreach services, strengthening referral and follow-up systems, improving access to appropriate treatment, and promoting early detection and management of diabetes among adults across Nigeria.

Keywords: Community-based diabetes screening, diabetes detection, adults, diabetes mellitus, blood glucose screening, non-communicable diseases, community health services, preventive healthcare, health promotion, early detection, Nigeria, public health.