• A B Swai, J L Lutale, and D G McLarty.
• Department of Medicine, Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.
• BMJ. 1993 Jun 12; 306 (6892): 1570-2.

ObjectiveTo 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.DesignProspective registration at a major urban hospital of all patients with newly diagnosed diabetes who were resident in Dar es Salaam.SettingMuhimbili Medical Centre, Dar es Salaam, Tanzania.Patients86 patients: 45 male, 41 female.ResultsThe annual incidence of juvenile diabetes for both sexes was 1.5 per 100,000 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.ConclusionJuvenile 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 from countries in Europe with a high incidence.

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