Community-Based Screening of Hyperglycemia and Hypoglycemia Among Adult Men in Herat City, Afghanistan

Abstract

Background and Objective: Community-based data on glycemic abnormalities in Afghanistan remain limited. This study assessed the prevalence and district-level distribution of diabetes-range glucose values and hypoglycemia among adult men screened in community health camps in Herat city, Afghanistan. Method: A cross-sectional community-based screening survey was conducted in Herat city from 16 to 19 November 2025. Adult male volunteers aged ≥18 years were recruited through walk-in screening camps advertised via social media and printed posters. Capillary blood glucose was measured using a portable glucometer. Participants were classified according to self-reported fasting status as fasting blood sugar (FBS) or random blood sugar (RBS) groups. Descriptive statistics and appropriate non-parametric tests, including Shapiro–Wilk, Mann–Whitney U, Kruskal–Wallis, Dunn’s post hoc, chi-square, Fisher’s exact, and unadjusted logistic regression analyses, were performed. Findings/ Result: Among 1,009 adult males screened, 418 (41.4%) underwent FBS testing and 591 (58.6%) RBS testing. Glucose values were non-normally distributed in both groups, and RBS values were significantly higher than FBS values (U = 162,552.5, p < 0.001). Diabetes-range glucose values were identified in 10.29% of FBS and 9.14% of RBS participants. Prediabetes/impaired glucose was more common in the FBS group than the RBS group (19.6% vs. 6.8%). Screening method was significantly associated with glycemic category (χ²(2) = 39.90, p < 0.001). District 2 had higher RBS-based hyperglycemia than District 1 (OR = 3.06, 95% CI: 1.76–5.32, p < 0.001), whereas no significant district differences were observed for FBS-defined diabetes-range values. Hypoglycemia occurred in 19 participants (1.9%), exclusively in the fasting group (4.5% vs. 0.0%, p < 0.001), with no significant district variation. Conclusion: Community screening identified a substantial burden of glycemic abnormalities among adult men in Herat, with approximately one in ten showing diabetes-range glucose values. Screening method influenced glycemic classification, and district-level variation was observed for RBS-based hyperglycemia. These findings support targeted community-based screening and follow-up.