Ongoing and planned activities to improve the management of patients with Type 1 diabetes across Africa; implications for the future.


Journal

Hospital practice (1995)
ISSN: 2154-8331
Titre abrégé: Hosp Pract (1995)
Pays: England
ID NLM: 101268948

Informations de publication

Date de publication:
14 Mar 2020
Historique:
pubmed: 21 3 2020
medline: 17 6 2020
entrez: 21 3 2020
Statut: ppublish

Résumé

Currently about 19 million people in Africa are known to be living with diabetes, mainly Type 2 diabetes (T2DM) (95%), estimated to grow to 47 million people by 2045. However, there are concerns with early diagnosis of patients with Type 1 diabetes (T1DM) as often patients present late with complications. There are also challenges with access and affordability of insulin, monitoring equipment and test strips with typically high patient co-payments, which can be catastrophic for families. These challenges negatively impact on the quality of care of patients with T1DM increasing morbidity and mortality. There are also issues of patient education and psychosocial support adversely affecting patients' quality of life. These challenges need to be debated and potential future activities discussed to improve the future care of patients with T1DM across Africa. Documentation of the current situation across Africa for patients with T1DM including the epidemiology, economics, and available treatments within public healthcare systems as well as ongoing activities to improve their future care. Subsequently, provide guidance to all key stakeholder groups going forward utilizing input from senior-level government, academic and other professionals from across Africa. Whilst prevalence rates for T1DM are considerably lower than T2DM, there are concerns with late diagnosis as well as the routine provision of insulin and monitoring equipment across Africa. High patient co-payments exacerbate the situation. However, there are ongoing developments to address the multiple challenges including the instigation of universal health care and partnerships with non-governmental organizations, patient organizations, and pharmaceutical companies. Their impact though remains to be seen. In the meantime, a range of activities has been documented for all key stakeholder groups to improve future care. There are concerns with the management of patients with T1DM across Africa. A number of activities has been suggested to address this and will be monitored.

Sections du résumé

BACKGROUND BACKGROUND
Currently about 19 million people in Africa are known to be living with diabetes, mainly Type 2 diabetes (T2DM) (95%), estimated to grow to 47 million people by 2045. However, there are concerns with early diagnosis of patients with Type 1 diabetes (T1DM) as often patients present late with complications. There are also challenges with access and affordability of insulin, monitoring equipment and test strips with typically high patient co-payments, which can be catastrophic for families. These challenges negatively impact on the quality of care of patients with T1DM increasing morbidity and mortality. There are also issues of patient education and psychosocial support adversely affecting patients' quality of life. These challenges need to be debated and potential future activities discussed to improve the future care of patients with T1DM across Africa.
METHODOLOGY METHODS
Documentation of the current situation across Africa for patients with T1DM including the epidemiology, economics, and available treatments within public healthcare systems as well as ongoing activities to improve their future care. Subsequently, provide guidance to all key stakeholder groups going forward utilizing input from senior-level government, academic and other professionals from across Africa.
RESULTS RESULTS
Whilst prevalence rates for T1DM are considerably lower than T2DM, there are concerns with late diagnosis as well as the routine provision of insulin and monitoring equipment across Africa. High patient co-payments exacerbate the situation. However, there are ongoing developments to address the multiple challenges including the instigation of universal health care and partnerships with non-governmental organizations, patient organizations, and pharmaceutical companies. Their impact though remains to be seen. In the meantime, a range of activities has been documented for all key stakeholder groups to improve future care.
CONCLUSION CONCLUSIONS
There are concerns with the management of patients with T1DM across Africa. A number of activities has been suggested to address this and will be monitored.

Identifiants

pubmed: 32196395
doi: 10.1080/21548331.2020.1745509
doi:

Substances chimiques

Hypoglycemic Agents 0
Insulin 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

51-67

Auteurs

Brian Godman (B)

Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK.
Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa.
Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge , Stockholm, Sweden.
Health Economics Centre, University of Liverpool Management School , Liverpool, UK.

Debashis Basu (D)

Department of Public Health Medicine, Steve Biko Academic Hospital and the University of Pretoria , Pretoria, South Africa.

Yogan Pillay (Y)

National Department of Health, Pretoria, South Africa.

Paulo H R F Almeida (PHRF)

School of Pharmacy, Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais (UFMG) , Belo Horizonte, Brazil.
Departamento de Gestão e Incorporação de Tecnologias e Inovação em Saúde, Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde, Ministry of Health , Brasília, Brazil.

Julius C Mwita (JC)

Department of Internal Medicine, Faculty of Medicine, University of Botswana , Gaborone, Botswana.

Godfrey Mutashambara Rwegerera (GM)

Faculty of Medicine, Department of Internal Medicine, University of Botswana and Department of Medicine, Princess Marina Hospital , Gaborone, Botswana.

Bene D Anand Paramadhas (BD)

Department of Pharmacy, Central Medical Stores, Ministry of Health and Wellness , Gaborone, Botswana.

Celda Tiroyakgosi (C)

Botswana Essential Drugs Action Program, Ministry of Health and Wellness , Gaborone, Botswana.

Okwen Patrick (O)

Effective Basic Services (Ebase) Africa , Bamenda, Africa.
Adelaide University , Adelaide, Australia.

Loveline Lum Niba (LL)

Effective Basic Services (Ebase) Africa , Bamenda, Africa.
Department of Public Health, University of Bamenda , Bambili, Cameroon.

Israel Sefah (I)

Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service , Keta, Ghana; Department of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Ghana.

Margaret Oluka (M)

Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi , Nairobi, Kenya.

Anastasia N Guantai (AN)

Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi , Nairobi, Kenya.

Dan Kibuule (D)

Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia.

Francis Kalemeera (F)

Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia.

Mwangana Mubita (M)

Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia.

Joseph Fadare (J)

Department of Pharmacology and Therapeutics, Ekiti State University , Ado-Ekiti, Nigeria.
Department of Medicine, Ekiti State University Teaching Hospital , Ado-Ekiti, Nigeria.

Olayinka O Ogunleye (OO)

Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine , Ikeja, Nigeria.
Department of Medicine, Lagos State University Teaching Hospital , Ikeja, Nigeria.

Enos M Rampamba (EM)

Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa.
Department of Health, Tshilidzini Hospital, Department of Pharmacy , Shayandima, South Africa.

Jeffrey Wing (J)

Charlotte Maxeke Medical Research Cluster , Johannesburg, South Africa.

Debjani Mueller (D)

Department of Public Health Medicine, Steve Biko Academic Hospital and the University of Pretoria , Pretoria, South Africa.
Charlotte Maxeke Medical Research Cluster , Johannesburg, South Africa.

Abubakr Alfadl (A)

National Medicines Board, Federal Ministry of Health , Khartoum, Sudan.
Unaizah College of Pharmacy, Qassim University , Unaizah, Saudi Arabia.

Adefolarin A Amu (AA)

Eswatini Medical Christian University , Swazi Plaza, Kingdom of Eswatini.

Zinhle Matsebula (Z)

Raleigh Fitkin Memorial Hospital , Manzini, Kingdom of Eswatini.

Aubrey C Kalungia (AC)

Department of Pharmacy, University of Zambia , Lusaka, Zambia.

Trust Zaranyika (T)

Department Of Medicine, University of Zimbabwe College of Health Sciences , Harare, Zimbabwe.

Nyasha Masuka (N)

Independent Health Systems Consultant , Harare, Zimbabwe.

Janney Wale (J)

Independent Consumer Advocate , Brunswick, Australia.

Ruaraidh Hill (R)

Liverpool Reviews and Implementation Group, Whelan Building, University of Liverpool , Liverpool, UK.

Amanj Kurdi (A)

Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK.
Department of Pharmacology, College of Pharmacy, Hawler Medical University , Erbil, Iraq.

Angela Timoney (A)

Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK.
NHS Lothian Director of Pharmacy, NHS Lothian , Edinburgh, UK.

Stephen Campbell (S)

Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester , Manchester, UK.
NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester , Manchester, UK.

Johanna C Meyer (JC)

Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa.

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