Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future

Frontiers in Pharmacology

Julius C. Mwita¹  Enos M. Rampamba²  Olayinka O. Ogunleye⁴  Nyasha Masuka⁵  Larry A. Distiller⁶  Janney Wale⁷  Loveline Lum Niba⁸  Patrick Mbah Okwen⁸  Ruaraidh Hill^1,11  Justice Nonvignon^1,13  Amanj Kurdi^1,15  Debjani Mueller^1,16  Israel Sefah^1,17  Abubakr Alfadl^1,18  Angela Timoney^1,19  Margaret Oluka^2,20  Anastasia N. Guantai^2,21  Stephen Campbell^2,22  Adefolarin A. Amu^2,23  Johanna C. Meyer^2,24  Francis Kalemeera^2,25  Mwangana Mubita^2,25  Dan Kibuule^2,25  Zinhle Matsebula^2,26  Joseph Fadare^2,27  Aubrey Kalungia^2,28  Trust Zaranyika^3,30  Godfrey Mutashambara Rwegerera^3,31  Bene D. Anand Paramadhas^3,32  Celda Tiroyakgosi^3,33  Debashis Basu^3,34  Jeffrey Wing^3,36  Yogan Pillay^3,37  Brian Godman^3,38 

[1] AIDS, TB and Maternal, Child and Women’s Health, National Department of Health, Pretoria, South Africa;Endocrinology (Pty) Ltd, Johannesburg, South Africa;0Botswana Essential Drugs Action Program, Ministry of Health and Wellness, Gaborone, Botswana;0Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos, Nigeria;0Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia;1Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria;1Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe;1Effective Basic Services (eBASE) Africa, Bamenda, Cameroon;;2Centre for Diabetes &2Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia;2Independent Health Systems Consultant, Harare, Zimbabwe;3Department of Pharmacy, Tshilidzini Regional Hospital, Limpopo Department Of Health, Shayandima, South Africa;3Department of Public Health, University of Bamenda, Bambili, Cameroon;3Independent Consumer Advocate, Brunswick, VIC, Australia;4Liverpool Reviews and Implementation Group, Liverpool University, Liverpool, United Kingdom;4School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa;4School of Public Health, University of Ghana, Legon, Ghana;5Charlotte Maxeke Medical Research Cluster, Johannesburg, South Africa;5Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq;5Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service, Keta, Ghana;6Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya;6NHS Lothian Director of Pharmacy, NHS Lothian, Edinburgh, United Kingdom;6National Medicines Board, Federal Ministry of Health, Khartoum, Sudan;7Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom;7Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia;7Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia;8Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria;8Eswatini Medical Christian University, Mbabane, Swaziland;9Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria;9Raleigh Fitkin Memorial Hospital, Manzini, Swaziland;Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana;Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;Department of Pharmacy, Nyangabgwe Hospital, Francistown, Botswana;Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa;Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden;Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa;;HIV &Health Economics Centre, University of Liverpool Management School, Liverpool, United Kingdom;Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom;

关键词: Type 2 diabetes;    Africa;    national initiatives;    diagnosis;    medicines;    adherence;   

DOI  :  10.3389/fphar.2020.00108

来源: DOAJ

【 摘 要 】

BackgroundThere has been an appreciable increase in the number of people in Africa with metabolic syndrome and Type 2 diabetes (T2DM) in recent years as a result of a number of factors. Factors include lifestyle changes, urbanisation, and the growing consumption of processed foods coupled with increasing levels of obesity. Currently there are 19 million adults in Africa with diabetes, mainly T2DM (95%), estimated to grow to 47 million people by 2045 unless controlled. This has a considerable impact on morbidity, mortality and costs in the region. There are a number of issues to address to reduce the impact of T2DM including improving detection rates and current access to services alongside addressing issues of adherence to prescribed medicines. There are also high rates of co-morbidities with infectious diseases such as HIV and tuberculosis in patients in Africa with T2DM that require attention.ObjectiveDocument ongoing activities across Africa to improve the care of patients with T2DM especially around issues of identification, access, and adherence to changing lifestyles and prescribed medicines. In addition, discussing potential ways forward to improve the care of patients with T2DM based on ongoing activities and experiences including addressing key issues associated with co-morbidities with infectious diseases.Our ApproachContextualise the findings from a wide range of publications including internet based publications of national approaches coupled with input from senior level government, academic and other professionals from across Africa to provide future guidance.Ongoing ActivitiesA number of African countries are actively instigating programmes to improve the care of patients with T2DM starting with improved diagnosis. This recognises the growing burden of non-communicable diseases across Africa, which has been neglected in the past. Planned activities include programmes to improve detection rates and address key issues with diet and lifestyle changes, alongside improving monitoring of care and activities to enhance adherence to prescribed medicines. In addition, addressing potential complexities involving diabetes patients with infectious disease co-morbidities. It is too early to fully assess the impact of such activities,ConclusionThere are a number of ongoing activities across Africa to improve the management of patients with diabetes including co-morbidities. However, more needs to be done considering the high and growing burden of T2DM in Africa. Ongoing research will help further benefit resource allocation and subsequent care.

【 授权许可】

Unknown