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Effect of Noncommunicable Disease Screening on Diabetes Detection among Adults in Nigeria

Abstract

Diabetes mellitus is an important noncommunicable disease and a growing public health concern in Nigeria. The condition can remain undiagnosed for a considerable period because some individuals may experience few or no noticeable symptoms during its early stages. Undiagnosed diabetes may result in delayed treatment and increase the risk of complications affecting the cardiovascular system, kidneys, eyes, nerves, and other organs. Noncommunicable disease screening provides an opportunity to identify individuals with previously undetected diabetes and other metabolic risk factors through systematic health assessments. Noncommunicable disease screening refers to the organized assessment of individuals for selected chronic disease risk factors and conditions using appropriate clinical measurements, laboratory tests, and standardized screening procedures. Diabetes detection refers to the identification of individuals with elevated blood glucose or other findings suggestive of diabetes through appropriate screening and subsequent clinical assessment. In Nigeria, limited access to preventive healthcare, low awareness of diabetes, financial constraints, inadequate screening services, and poor utilization of routine health assessments may contribute to delayed detection. Strengthening noncommunicable disease screening may increase opportunities for identifying diabetes at an earlier stage and facilitate timely referral, diagnosis, and management. Against this background, this study investigates the effect of noncommunicable disease screening on diabetes detection among adults in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Health Systems Framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Andersen's Behavioral Model emphasizes predisposing, enabling, and need-related factors that influence the utilization of healthcare services. The Health Systems Framework recognizes service delivery, health workforce, health information, medical technologies, and access to essential healthcare services as important components of an effective health system. Collectively, these theoretical perspectives provide a suitable framework for explaining how noncommunicable disease screening may influence diabetes detection among adults in Nigeria. The study will adopt a quantitative cross-sectional community-based research design. Data will be collected from adults participating in selected noncommunicable disease screening programmes across selected locations in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, screening sites, and eligible participants. Noncommunicable disease screening will be assessed using indicators such as availability of screening services, screening frequency, accessibility of screening sites, blood glucose testing, blood pressure measurement, body mass index assessment, waist circumference measurement, assessment of family history and behavioural risk factors, availability of trained healthcare personnel, and use of standardized screening procedures. Diabetes detection will be assessed using indicators such as identification of elevated blood glucose, identification of individuals with suspected diabetes, identification of previously undiagnosed diabetes, and appropriate referral for confirmatory diagnostic assessment. Where available, screening records and laboratory results will be reviewed to validate findings. Descriptive statistics will be used to summarize participants' characteristics, screening participation, and diabetes detection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple regression analysis, will be used to determine the effect of noncommunicable disease screening on diabetes detection. Diagnostic tests will also be conducted to assess the reliability of research instruments, model assumptions, goodness of fit, multicollinearity, and robustness of the findings. The study is expected to find that noncommunicable disease screening has a significant positive effect on diabetes detection among adults in Nigeria. Adults who participate in systematic screening are expected to have a greater likelihood of having previously undetected diabetes or elevated blood glucose identified than adults with limited access to screening services. Routine blood glucose assessment, combined with other risk-factor assessments, may facilitate early identification of individuals who require further diagnostic evaluation. Screening may also increase awareness of diabetes risk factors and encourage individuals with abnormal findings to seek appropriate healthcare services. Conversely, inadequate access to noncommunicable disease screening may contribute to missed opportunities for early diabetes detection and increase the likelihood of delayed diagnosis. However, screening alone may not guarantee definitive diagnosis because confirmatory testing, availability of trained healthcare professionals, laboratory capacity, affordability, referral systems, and continuity of care may also influence diabetes diagnosis. Therefore, screening programmes should be integrated with appropriate referral and follow-up services. The study is expected to contribute to the literature on noncommunicable disease screening, diabetes detection, chronic disease prevention, community health, epidemiology, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, primary healthcare authorities, healthcare facilities, public health practitioners, community health workers, development partners, and policymakers regarding strategies for strengthening early diabetes detection. The study will also provide evidence-based recommendations for expanding community-based noncommunicable disease screening, improving access to blood glucose testing, strengthening healthcare worker capacity, increasing public awareness of diabetes risk factors, improving referral systems, and integrating diabetes screening into routine primary healthcare and other preventive health programmes in Nigeria.

Keywords: Noncommunicable disease screening, diabetes detection, adults, Nigeria, diabetes mellitus, blood glucose screening, chronic diseases, primary healthcare, epidemiology, health promotion, public health.