Brian Godman1,2,3,4, Debashis Basu5, Yogan Pillay6, Paulo H R F Almeida7,8, Julius C Mwita9, Godfrey Mutashambara Rwegerera10, Bene D Anand Paramadhas11, Celda Tiroyakgosi12, Okwen Patrick13,14, Loveline Lum Niba13,15, Israel Sefah16, Margaret Oluka17, Anastasia N Guantai17, Dan Kibuule18, Francis Kalemeera18, Mwangana Mubita18, Joseph Fadare19,20, Olayinka O Ogunleye21,22, Enos M Rampamba2,23, Jeffrey Wing24, Debjani Mueller5,24, Abubakr Alfadl25,26, Adefolarin A Amu27, Zinhle Matsebula28, Aubrey C Kalungia29, Trust Zaranyika30, Nyasha Masuka31, Janney Wale32, Ruaraidh Hill33, Amanj Kurdi1,34, Angela Timoney1,35, Stephen Campbell36,37, Johanna C Meyer2. 1. Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow, UK. 2. Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa. 3. Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge , Stockholm, Sweden. 4. Health Economics Centre, University of Liverpool Management School , Liverpool, UK. 5. Department of Public Health Medicine, Steve Biko Academic Hospital and the University of Pretoria , Pretoria, South Africa. 6. National Department of Health, Pretoria, South Africa. 7. School of Pharmacy, Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais (UFMG) , Belo Horizonte, Brazil. 8. 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. 9. Department of Internal Medicine, Faculty of Medicine, University of Botswana , Gaborone, Botswana. 10. Faculty of Medicine, Department of Internal Medicine, University of Botswana and Department of Medicine, Princess Marina Hospital , Gaborone, Botswana. 11. Department of Pharmacy, Central Medical Stores, Ministry of Health and Wellness , Gaborone, Botswana. 12. Botswana Essential Drugs Action Program, Ministry of Health and Wellness , Gaborone, Botswana. 13. Effective Basic Services (Ebase) Africa , Bamenda, Africa. 14. Adelaide University , Adelaide, Australia. 15. Department of Public Health, University of Bamenda , Bambili, Cameroon. 16. 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. 17. Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi , Nairobi, Kenya. 18. Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia , Windhoek, Namibia. 19. Department of Pharmacology and Therapeutics, Ekiti State University , Ado-Ekiti, Nigeria. 20. Department of Medicine, Ekiti State University Teaching Hospital , Ado-Ekiti, Nigeria. 21. Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine , Ikeja, Nigeria. 22. Department of Medicine, Lagos State University Teaching Hospital , Ikeja, Nigeria. 23. Department of Health, Tshilidzini Hospital, Department of Pharmacy , Shayandima, South Africa. 24. Charlotte Maxeke Medical Research Cluster , Johannesburg, South Africa. 25. National Medicines Board, Federal Ministry of Health , Khartoum, Sudan. 26. Unaizah College of Pharmacy, Qassim University , Unaizah, Saudi Arabia. 27. Eswatini Medical Christian University , Swazi Plaza, Kingdom of Eswatini. 28. Raleigh Fitkin Memorial Hospital , Manzini, Kingdom of Eswatini. 29. Department of Pharmacy, University of Zambia , Lusaka, Zambia. 30. Department Of Medicine, University of Zimbabwe College of Health Sciences , Harare, Zimbabwe. 31. Independent Health Systems Consultant , Harare, Zimbabwe. 32. Independent Consumer Advocate , Brunswick, Australia. 33. Liverpool Reviews and Implementation Group, Whelan Building, University of Liverpool , Liverpool, UK. 34. Department of Pharmacology, College of Pharmacy, Hawler Medical University , Erbil, Iraq. 35. NHS Lothian Director of Pharmacy, NHS Lothian , Edinburgh, UK. 36. Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester , Manchester, UK. 37. NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester , Manchester, UK.
Abstract
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: 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: 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: 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.
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: 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: 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: 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.
Authors: Paulo H R F Almeida; Brian Godman; Vania Dos Santos Nunes-Nogueira; Lívia L P de Lemos; Francisco de Assis Acúrcio; Augusto A Guerra-Junior; Vânia E de Araújo; Alessandra M Almeida; Juliana Alvares-Teodoro Journal: Clin Diabetes Date: 2022
Authors: Ileana Mardare; Stephen M Campbell; Johanna C Meyer; Israel Abebrese Sefah; Amos Massele; Brian Godman Journal: Front Pharmacol Date: 2022-01-14 Impact factor: 5.810
Authors: Ayukafangha Etando; Adefolarin A Amu; Mainul Haque; Natalie Schellack; Amanj Kurdi; Alian A Alrasheedy; Angela Timoney; Julius C Mwita; Godfrey Mutashambara Rwegerera; Okwen Patrick; Loveline Lum Niba; Baffour Boaten Boahen-Boaten; Felicity Besong Tabi; Olufunke Y Amu; Joseph Acolatse; Robert Incoom; Israel Abebrese Sefah; Anastasia Nkatha Guantai; Sylvia Opanga; Ibrahim Chikowe; Felix Khuluza; Dan Kibuule; Francis Kalemeera; Ester Hango; Jennie Lates; Joseph Fadare; Olayinka O Ogunleye; Zikria Saleem; Frasia Oosthuizen; Werner Cordier; Moliehi Matlala; Johanna C Meyer; Gustav Schellack; Amos Massele; Oliver Ombeva Malande; Aubrey Chichonyi Kalungia; James Sichone; Sekelani S Banda; Trust Zaranyika; Stephen Campbell; Brian Godman Journal: Healthcare (Basel) Date: 2021-12-13