{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:35:27Z","timestamp":1793504127195,"version":"4.5.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":87,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018822","name":"Western Sydney University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018822","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes screening is vital for the early detection and management of the condition, aiming to improve prognosis and prevent disease progression and complications. However, evidence on population\u2011level uptake of diabetes screening and its determinants in low\u2011 and middle\u2011income countries (LMICs) remains limited. Therefore, this study assessed uptake of diabetes screening and the associated individual\u2011 and community\u2011level factors among adults in LMICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed recent Demographic and Health Surveys from 14 LMICs across Africa, South-East Asia, and the Americas. Weighted prevalence estimates of individuals who have ever undergone diabetes screening were calculated for each included country, by participant characteristics. Multilevel logistic regression models were fitted for each country to examine individual- and community-level determinants of diabetes screening uptake. Community variances, intraclass correlation coefficients, and proportional change in variance were used to measure community-level variability in diabetes screening uptake. Deviance, Akaike information criterion, and Bayesian Information criterion were used to select the best-fitting model for each survey. Adjusted odds ratios were used to estimate the association between covariates and diabetes screening uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of diabetes screening uptake varied widely across countries, ranging from 5.9% in Timor-Leste to 39.8% in the Dominican Republic. In most countries, women had significantly higher screening uptake than men. Older age, higher educational attainment, marital status, health insurance coverage, media exposure, and prior blood pressure measurement were consistently associated with increased likelihood of diabetes screening uptake across multiple surveys. At the community level, higher community media exposure and, in some contexts, higher community educational attainment were associated with greater odds of screening uptake. Substantial between\u2011community heterogeneity was observed, with intraclass correlation coefficients ranging from 6.8% to 40%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diabetes screening uptake remains suboptimal across many LMICs, with pronounced disparities by sex, socioeconomic status, and community characteristics. Strengthening health system performance, expanding health insurance coverage, increasing community\u2011level awareness, and better integrating diabetes screening into routine primary care may improve early detection. Addressing both individual\u2011 and structural\u2011level determinants is essential to enhancing screening uptake, reducing the burden of undiagnosed diabetes, and advancing global targets to mitigate diabetes\u2011related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-28221-3","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:06:23Z","timestamp":1783652783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Individual and community-level factors affecting diabetes screening uptake among adults in 14 low- and middle-income countries: a multilevel mixed-effects analysis of recent demographic and health surveys"],"prefix":"10.1186","volume":"26","author":[{"given":"Kegnie","family":"Shitu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"McBride","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Simmons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freya","family":"MacMillan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"28221_CR1","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1016\/S0140","volume":"379","author":"AG Tab\u00e1k","year":"2012","unstructured":"Tab\u00e1k AG, Brunner EJ, Kivim\u00e4ki M, Tab\u00e1k AG, Herder C, Rathmann W, et al. Diabetes 1 Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379:2279\u201390. https:\/\/doi.org\/10.1016\/S0140.","journal-title":"Lancet"},{"key":"28221_CR2","unstructured":"International Diabetes Federation. Diabetes Atlas , Brussels B. 2025. Available from: http:\/\/www.diabetesatlas.org\/"},{"key":"28221_CR3","unstructured":"World Health Organisation. Diabetes. Geneva, World Health Organization; 2024 . Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes .[cited 2025 Dec 2]."},{"key":"28221_CR4","doi-asserted-by":"publisher","unstructured":"The Lancet Diabetes & Endocrinology. Undiagnosed type 2 diabetes: an invisible risk factor. The Lancet Diabetes and Endocrinology. Elsevier Ltd; 2024. p. 215. https:\/\/doi.org\/10.1016\/S2213-8587. (24)00072-X PubMed PMID: 38460527.","DOI":"10.1016\/S2213-8587"},{"key":"28221_CR5","doi-asserted-by":"publisher","unstructured":"Ogurtsova K, Guariguata L, Barengo NC, Ruiz PLD, Sacre JW, Karuranga S, et al. IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract. 2022;183. https:\/\/doi.org\/10.1016\/j.diabres.2021.109118 . PubMed PMID: 34883189.","DOI":"10.1016\/j.diabres.2021.109118"},{"key":"28221_CR6","doi-asserted-by":"publisher","unstructured":"Kengne AP, Ramachandran A. Feasibility of prevention of type 2 diabetes in low- and middle-income countries. Diabetologia Springer Sci Bus Media Deutschland GmbH. 2024;763\u201372. https:\/\/doi.org\/10.1007\/s00125-023-06085-1 . PubMed PMID: 38355989.","DOI":"10.1007\/s00125-023-06085-1"},{"key":"28221_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2022.155217","volume-title":"Clinical and Experimental","author":"C Boutari","year":"2022","unstructured":"Boutari C, Mantzoros CS. A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Clinical and Experimental. Metabolism: W.B. Saunders; 2022. https:\/\/doi.org\/10.1016\/j.metabol.2022.155217 . PubMed PMID: 35584732."},{"issue":"5","key":"28221_CR8","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1002\/osp4.519","volume":"7","author":"PN Gona","year":"2021","unstructured":"Gona PN, Kimokoti RW, Gona CM, Ballout S, Rao SR, Mapoma CC, et al. Changes in body mass index, obesity, and overweight in Southern Africa development countries, 1990 to 2019: Findings from the Global Burden of Disease, Injuries, and Risk Factors Study. Obes Sci Pract. 2021;7(5):509\u201324. https:\/\/doi.org\/10.1002\/osp4.519.","journal-title":"Obes Sci Pract"},{"key":"28221_CR9","doi-asserted-by":"publisher","unstructured":"Motala AA, Mbanya JC, Ramaiya K, Pirie FJ, Ekoru K. Type 2 diabetes mellitus in sub-Saharan Africa: challenges and opportunities. Nat Reviews Endocrinol Nat Res. 2022;219\u201329. https:\/\/doi.org\/10.1038\/s41574-021-. 00613-y PubMed PMID: 34983969.","DOI":"10.1038\/s41574-021-"},{"key":"28221_CR10","doi-asserted-by":"publisher","unstructured":"Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. The Lancet. Lancet Publishing Group; 2020. pp. 2019\u201382. https:\/\/doi.org\/10.1016\/S0140-6736(. 20)32374-6 PubMed PMID: 33189186.","DOI":"10.1016\/S0140-6736("},{"issue":"10","key":"28221_CR11","doi-asserted-by":"publisher","first-page":"e1576","DOI":"10.1016\/S2214-109X","volume":"11","author":"NE Rahim","year":"2023","unstructured":"Rahim NE, Flood D, Marcus ME, Theilmann M, Aung TN, Agoudavi K, et al. Diabetes risk and provision of diabetes prevention activities in 44 low-income and middle-income countries: a cross-sectional analysis of nationally representative, individual-level survey data. Lancet Glob Health. 2023;11(10):e1576\u201386. https:\/\/doi.org\/10.1016\/S2214-109X. (23)00348-0 PubMed PMID: 37734801.","journal-title":"Lancet Glob Health"},{"key":"28221_CR12","doi-asserted-by":"publisher","unstructured":"Manne-Goehler J, Geldsetzer P, Agoudavi K, Andall-Brereton G, Aryal KK, Bicaba BW, et al. Health system performance for people withdiabetes in 28 low-and middle-incomecountries: A cross-sectional study of nationallyrepresentative surveys. PLoS Med. 2019;16(3). https:\/\/doi.org\/10.1371\/journal.pmed.1002751 . PubMed PMID: 30822339.","DOI":"10.1371\/journal.pmed.1002751"},{"key":"28221_CR13","doi-asserted-by":"publisher","unstructured":"Church D, Simmons D. More evidence of the problems of using HbA1c for diagnosing diabetes? The known knowns, the known unknowns and the unknown unknowns. Journal of Internal Medicine. Blackwell Publishing Ltd; 2014. pp. 171\u20133. https:\/\/doi.org\/10.1111\/joim.12200 PubMed PMID: 24443985.","DOI":"10.1111\/joim.12200"},{"issue":"8","key":"28221_CR14","doi-asserted-by":"publisher","first-page":"358","DOI":"10.4239\/wjd.v11.i8.358","volume":"11","author":"EL Klatman","year":"2020","unstructured":"Klatman EL, Ogle GD. Access to insulin delivery devices and glycated haemoglobin in lower-income countries. World J Diabetes. 2020;11(8):358\u201369. https:\/\/doi.org\/10.4239\/wjd.v11.i8.358.","journal-title":"World J Diabetes"},{"issue":"9","key":"28221_CR15","doi-asserted-by":"publisher","first-page":"e1363","DOI":"10.1016\/S2214-109X","volume":"11","author":"S Ochmann","year":"2023","unstructured":"Ochmann S, von Polenz I, Marcus ME, Theilmann M, Flood D, Agoudavi K, et al. Diagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries: a cross-sectional study of data for 994\u2008185 individuals from 57 nationally representative surveys. Lancet Glob Health. 2023;11(9):e1363\u201371. https:\/\/doi.org\/10.1016\/S2214-109X. (23)00280-2 PubMed PMID: 37591584.","journal-title":"Lancet Glob Health"},{"key":"28221_CR16","doi-asserted-by":"publisher","unstructured":"Grundlingh N, Zewotir TT, Roberts DJ, Manda S. Assessment of prevalence and risk factors of diabetes and pre-diabetes in South Africa. J Health Popul Nutr. 2022;41(1). https:\/\/doi.org\/10.1186\/s41043-022-00281-2 . PubMed PMID: 35236427.","DOI":"10.1186\/s41043-022-00281-2"},{"key":"28221_CR17","unstructured":"The Global Diabetes Compact - progress in supporting its workstreams: technical report. Geneva, World Health Organization. : 2024. Licence: CC BY-NC-SA 3.0 IGO. Available from: https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/b0dec6e7-ccfb-4ee4-9e04-5ebc5ccedc34\/content .[cited 2025 Dec 2]."},{"key":"28221_CR18","unstructured":"The DHS Program. Funded by USAID . Available from: https:\/\/dhsprogram.com\/ .[cited 2025 Dec 2]."},{"key":"28221_CR19","volume-title":"Demographic and Health Survey Sampling and Household Listing Manual","author":"ICF International","year":"2012","unstructured":"ICF International. Demographic and Health Survey Sampling and Household Listing Manual. Maryland, U.S.A.: ICF International. Calverton: MEASURE DHS, Calverton; 2012."},{"key":"28221_CR20","volume-title":"Multilevel Modeling Using DHS Surveys: A Framework to Approximate Level-Weights. DHS Methodological Reports No. 27","author":"R Mahmoud Elkasabi","year":"2020","unstructured":"Mahmoud Elkasabi R, Ren, Pullum TW. Multilevel Modeling Using DHS Surveys: A Framework to Approximate Level-Weights. DHS Methodological Reports No. 27. Maryland, USA: ICF: Rockville; 2020."},{"key":"28221_CR21","unstructured":"The DHS, Program. DHS Questionnaires. Available from: https:\/\/dhsprogram.com\/methodology\/survey-types\/dhs-questionnaires.cfm .[cited 2025 Nov 17]."},{"key":"28221_CR22","unstructured":"Yebyo HG, Gebreselassie MA, Kahsay AB. Individual and Community-Level Predictors of Home Delivery in Ethiopia: A Multilevel Mixed-Effects Analysis of the 2011 Ethiopia National Demographic and Health Survey. 2014."},{"issue":"1","key":"28221_CR23","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/2156587215593656","volume":"21","author":"M Koley","year":"2016","unstructured":"Koley M, Saha S, Arya JS, Choubey G, Ghosh S, Chattopadhyay R, et al. Knowledge, Attitude, and Practice Related to Diabetes Mellitus Among Diabetics and Nondiabetics Visiting Homeopathic Hospitals in West Bengal, India. J Evid Based Complement Altern Med. 2016;21(1):39\u201347. doi:10.1177\/2156587215593656 PubMed PMID: 26156145.","journal-title":"J Evid Based Complement Altern Med"},{"issue":"2","key":"28221_CR24","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.pcd.2018.10.003","volume":"13","author":"JR Nansseu","year":"2019","unstructured":"Nansseu JR, Petnga SJN, Atangana CP, Ossa AS, Sangong SNN, Ebendeng P, et al. The general public\u2019s knowledge of diabetes mellitus: A cross-sectional study in Cameroon. Prim Care Diabetes. 2019;13(2):97\u2013105. https:\/\/doi.org\/10.1016\/j.pcd.2018.10.003 . PubMed PMID: 30472025.","journal-title":"Prim Care Diabetes"},{"key":"28221_CR25","doi-asserted-by":"publisher","unstructured":"AshaRani PV, Devi F, Wang P, Abdin E, Zhang Y, Roystonn K, et al. Factors influencing uptake of diabetes health screening: a mixed methods study in Asian population. BMC Public Health. 2022;22(1). https:\/\/doi.org\/10.1186\/s12889-022-13914-2 . PubMed PMID: 35941579.","DOI":"10.1186\/s12889-022-13914-2"},{"key":"28221_CR26","doi-asserted-by":"publisher","unstructured":"Dozie UW, Diala IM, Dozie KCN, Chukwuocha UM, Nwaokoro CJ, Iwuala CC, et al. Factors affecting the utilization of diabetes screening services among adults in Owerri West, LGA, Imo State South-Eastern Nigeria. Discover public health. 2025;22(1). https:\/\/doi.org\/10.1186\/s12982-025-00860-8.","DOI":"10.1186\/s12982-025-00860-8"},{"key":"28221_CR27","doi-asserted-by":"crossref","unstructured":"Zhen Wong H, Lim WY, Ma SS, Chua LA, Wei-Yen L. Screening in Singaporeans-Hui Zhen Wong H. Health Screening Behaviour among Singaporeans. 44. 2015.","DOI":"10.47102\/annals-acadmedsg.V44N9p326"},{"key":"28221_CR28","doi-asserted-by":"publisher","unstructured":"Marcus ME, Reuter A, Rogge L, Diba F, Marthoenis, Vollmer S. Hypertension and diabetes screening uptake in adults aged 40\u201370 in Indonesia: a knowledge, attitudes, and practices study. BMC Global Public Health. 2025;3(1). https:\/\/doi.org\/10.1186\/s44263-025-00157-7.","DOI":"10.1186\/s44263-025-00157-7"},{"key":"28221_CR29","doi-asserted-by":"publisher","unstructured":"Arevalo-Rios ECE, Layza-Reyes J, Noriega-Ruiz VH. Diabetes Mellitus screening and associated factors in Peru: A cross-sectional analysis of a national health survey. PLOS Global Public Health. 2025;5(9 September). https:\/\/doi.org\/10.1371\/journal.pgph.0005150.","DOI":"10.1371\/journal.pgph.0005150"},{"issue":"2","key":"28221_CR30","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1093\/inthealth\/ihab033","volume":"14","author":"PA Duodu","year":"2022","unstructured":"Duodu PA, Agbadi P, Duah HO, Darkwah E, Nutor JJ. Correlates of blood pressure and blood glucose screenings in Cameroon: Insights from the 2018 Demographic and Health Survey. Int Health. 2022;14(2):201\u201310. https:\/\/doi.org\/10.1093\/inthealth\/ihab033 . PubMed PMID: 34118153.","journal-title":"Int Health"},{"key":"28221_CR31","doi-asserted-by":"publisher","unstructured":"Okyere J, Ayebeng C, Sakyi B, Dickson KS. Place of residence and blood sugar testing practices among men: insights from the 2021 Madagascar demographic and health survey. BMC Public Health. 2024;24(1). https:\/\/doi.org\/10.1186\/s12889-024-19248-5 . PubMed PMID: 38918758.","DOI":"10.1186\/s12889-024-19248-5"},{"key":"28221_CR32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0219731","author":"D Erlangga","year":"2019","unstructured":"Erlangga D, Suhrcke M, Ali S, Bloor K. The impact of public health insurance on health care utilisation, financial protection and health status in low- And middle-income countries: A systematic review. PLoS ONE Public Libr Sci. 2019. https:\/\/doi.org\/10.1371\/journal.pone.0219731 . PubMed PMID: 31461458.","journal-title":"PLoS ONE Public Libr Sci"},{"key":"28221_CR33","unstructured":"WHO. World Health Organisation. Universal health coverage (UHC) 2025. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/universal-health-coverage-%28uhc%29 . [cited 2026 Jan 5]."},{"key":"28221_CR34","doi-asserted-by":"publisher","unstructured":"Kidney RSM, Peacock JM, Smith SA. Blood glucose screening rates among minnesota adults with hypertension, behavioral risk factor surveillance system, 2011. Prev Chronic Dis. 2014;11(11). https:\/\/doi.org\/10.5888\/pcd11. 140204 PubMed PMID: 25427315.","DOI":"10.5888\/pcd11"},{"key":"28221_CR35","unstructured":"WHO Package of Essential Noncommunicable (PEN). Disease Interventions for Primary Health Care. World Health Organization; 2020."},{"issue":"2","key":"28221_CR36","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.anr.2013.04.002","volume":"7","author":"H Kim","year":"2013","unstructured":"Kim H, Lee M, Kim H, Lee K, Chang S, Kim V, et al. Factors affecting diabetic screening behavior of korean adults: A multilevel analysis. Asian Nurs Res (Korean Soc Nurs Sci). 2013;7(2):67\u201373. https:\/\/doi.org\/10.1016\/j.anr.2013.04.002.","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"key":"28221_CR37","unstructured":"Biogaran World 2024. Biogaran. Screening operation in Benin. Available from: https:\/\/biogaran.com\/en\/news\/actions-en\/biogaran-reiterates-its-commitment-to-benin-by-taking-part-in-a-vast-screening-operation-for-hypertension-and-diabetes\/ . [cited 2026 Jan 6]."},{"issue":"1","key":"28221_CR38","doi-asserted-by":"publisher","first-page":"59","DOI":"10.5334\/aogh.4738","volume":"91","author":"TI Lejone","year":"2025","unstructured":"Lejone TI, Gerber F, Gupta R, Belus JM, Tahirsylaj T, Lee T, et al. Feasibility and Acceptability of Diabetes and Hypertension Screening and Diagnosis by Community Health Workers in Rural Lesotho: A Mixed-Methods Pilot Study. Ann Glob Health. 2025;91(1):59. https:\/\/doi.org\/10.5334\/aogh.4738 . PubMed PMID: 40963788.","journal-title":"Ann Glob Health"},{"key":"28221_CR39","doi-asserted-by":"publisher","unstructured":"Konkor I, Bisung E, Soliku O, Ayanore M, Kuuire V. Exposure to mass media chronic health campaign messages and the uptake of non-communicable disease screening in Ghana. PLoS ONE. 2024;19(5 May). https:\/\/doi.org\/10.1371\/journal.pone.0302942 . PubMed PMID: 38820497.","DOI":"10.1371\/journal.pone.0302942"},{"key":"28221_CR40","doi-asserted-by":"publisher","unstructured":"Tabassum R, Froeschl G, Cruz JP, Colet PC, Dey S, Islam SMS. Untapped aspects of mass media campaigns for changing health behaviour towards non-communicable diseases in Bangladesh. Globalization and Health. BioMed Central Ltd.; 2018. https:\/\/doi.org\/10.1186\/s12992-018-0325-1 . PubMed PMID: 29347986.","DOI":"10.1186\/s12992-018-0325-1"},{"issue":"3","key":"28221_CR41","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1093\/pubmed\/fdv070","volume":"38","author":"S Attwood","year":"2016","unstructured":"Attwood S, Morton K, Sutton S. Exploring equity in uptake of the NHS Health Check and a nested physical activity intervention trial. J Public Health (United Kingdom). 2016;38(3):560\u20138. https:\/\/doi.org\/10.1093\/pubmed\/fdv070 . PubMed PMID: 26036701.","journal-title":"J Public Health (United Kingdom)"},{"issue":"3","key":"28221_CR42","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1177\/1077558708330428","volume":"66","author":"K Pitkin Derose","year":"2009","unstructured":"Pitkin Derose K, Varda DM. Social capital and health care access: A systematic review. Med Care Res Rev. 2009;66(3):272\u2013306. doi:10.1177\/1077558708330428 PubMed PMID: 19174538.","journal-title":"Med Care Res Rev"},{"key":"28221_CR43","doi-asserted-by":"publisher","unstructured":"Bender AM, Kawachi I, J\u00f8rgensen T, Pisinger C. Neighborhood social capital is associated with participation in health checks of a general population: A multilevel analysis of a population-based lifestyle intervention- the Inter99 study. BMC Public Health. 2015;15(1). https:\/\/doi.org\/10.1186\/s12889-015-2042-5 . PubMed PMID: 26197982.","DOI":"10.1186\/s12889-015-2042-5"},{"key":"28221_CR44","doi-asserted-by":"publisher","unstructured":"Merlo J, Chaix B, Ohlsson H, Beckman A, Johnell K, Hjerpe P, et al. A brief conceptual tutorial of multilevel analysis in social epidemiology: Using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Commun Health. 2006;290\u20137. https:\/\/doi.org\/10.1136\/jech.2004.029454 . PubMed PMID: 16537344.","DOI":"10.1136\/jech.2004.029454"},{"issue":"9","key":"28221_CR45","doi-asserted-by":"publisher","first-page":"e1543","DOI":"10.1016\/S2214-109X","volume":"13","author":"TV Sekher","year":"2025","unstructured":"Sekher TV, Flood D, Green H, Hu P, Ali MK, Shete A, et al. Prevalence, awareness, treatment, and control of diabetes in India: a nationally representative survey of adults aged 45 years and older. Lancet Glob Health. 2025;13(9):e1543\u201352. https:\/\/doi.org\/10.1016\/S2214-109X. (23)00502-8 PubMed PMID: 40784358.","journal-title":"Lancet Glob Health"},{"key":"28221_CR46","doi-asserted-by":"publisher","unstructured":"Mathias EG, Dhyani VS, Krishnan JB, Rani U, Gudi N, Pattanshetty S. Community based health literacy interventions in India: A scoping review. Clinical Epidemiology and Global Health. Elsevier B.V.; 2023. https:\/\/doi.org\/10.1016\/j.cegh.2023.101310.","DOI":"10.1016\/j.cegh.2023.101310"},{"key":"28221_CR47","doi-asserted-by":"publisher","unstructured":"Kowall B, Girschik C, Stolpe S. Inconsistencies in self-reported diabetes in a large panel study: the Survey of Health, Ageing and Retirement in Europe (SHARE). BMC Med Res Methodol. 2024;24(1). https:\/\/doi.org\/10.1186\/s12874-023-02137-7 . PubMed PMID: 38212700.","DOI":"10.1186\/s12874-023-02137-7"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-026-28221-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-28221-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-026-28221-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:39:30Z","timestamp":1791157170000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-026-28221-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["28221"],"URL":"https:\/\/doi.org\/10.1186\/s12889-026-28221-3","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"26 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All DHS surveys obtained ethical approval from the ICF (originally, the Inner City Fund) Institutional Review Board and from national ethics committees in each participating country, and written informed consent was obtained from all respondents. The datasets used in this study were de-identified and accessed with formal written permission from the DHS program.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"2784"}}