Screening for hypertension, diabetes, and cervical cancer in the democratic Republic of Congo: insights from a nationally representative survey
摘要
Non-communicable diseases are the leading global cause of death, disproportionately affecting low- and middle-income countries like the Democratic Republic of Congo. Despite their growing prevalence, non-communicable diseases remain underdiagnosed and undertreated due to limited screening, poor awareness, and health systems focused on infectious diseases. This study uses data from the 2023–2024 Demographic and Health Survey to assess non-communicable diseases screening prevalence among women in the Democratic Republic of Congo and identify key determinants. This cross-sectional study utilized data from the nationally representative DHS-DRC 2023–2024. The analysis focused on a weighted sample of 11,368 women aged 30–49 years. The DHS employed a stratified, multistage sampling design. Data were analyzed using STATA/SE 17.0, applying multilevel logistic regression to account for hierarchical data structure. Model fit was evaluated using deviance, ICC, and PCV, with statistical significance determined at p < 0.05 and AORs reported with 95% confidence intervals. Among 11,368 Congolese women aged 30–49 years, 53.42% were screened for at least one non-communicable disease. Hypertension screening was most common (52.18%), followed by diabetes (14.25%) and cervical cancer (0.69%). Significant disparities in screening uptake were observed across communities, with multilevel modeling confirming substantial between-cluster variation. Key individual-level factors associated with increased screening included older age, higher education, employment, media exposure, wealth status, health insurance coverage, recent healthcare visits, and alcohol consumption. Community-level factors such as high media exposure, lower poverty levels, urban residence, and higher contraceptive utilization also positively influenced screening rates. Although over half of Congolese women aged 30–49 were screened for at least one non-communicable disease, screening rates for diabetes and cervical cancer remain low. Both individual-level factors (age, education, health insurance, facility visits) and community-level determinants (media exposure, poverty, and contraceptive use) significantly influence screening uptake. To enhance non-communicable disease prevention, targeted interventions are needed, such as expanding health insurance, strengthening media outreach, integrating screening into reproductive health services, and investing in education and economic empowerment.