Frontiers in Pharmacology (Mar 2020)
Review of Ongoing Activities and Challenges to Improve the Care of Patients With Type 2 Diabetes Across Africa and the Implications for the Future
- Brian Godman,
- Brian Godman,
- Brian Godman,
- Brian Godman,
- Debashis Basu,
- Yogan Pillay,
- Julius C. Mwita,
- Godfrey Mutashambara Rwegerera,
- Godfrey Mutashambara Rwegerera,
- Bene D. Anand Paramadhas,
- Celda Tiroyakgosi,
- Patrick Mbah Okwen,
- Patrick Mbah Okwen,
- Loveline Lum Niba,
- Loveline Lum Niba,
- Justice Nonvignon,
- Israel Sefah,
- Margaret Oluka,
- Anastasia N. Guantai,
- Dan Kibuule,
- Francis Kalemeera,
- Mwangana Mubita,
- Joseph Fadare,
- Joseph Fadare,
- Olayinka O. Ogunleye,
- Olayinka O. Ogunleye,
- Larry A. Distiller,
- Enos M. Rampamba,
- Enos M. Rampamba,
- Jeffrey Wing,
- Debjani Mueller,
- Debjani Mueller,
- Abubakr Alfadl,
- Abubakr Alfadl,
- Adefolarin A. Amu,
- Zinhle Matsebula,
- Aubrey Kalungia,
- Trust Zaranyika,
- Nyasha Masuka,
- Janney Wale,
- Ruaraidh Hill,
- Amanj Kurdi,
- Amanj Kurdi,
- Angela Timoney,
- Angela Timoney,
- Stephen Campbell,
- Stephen Campbell,
- Johanna C. Meyer
Affiliations
- Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Brian Godman
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Brian Godman
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Brian Godman
- Health Economics Centre, University of Liverpool Management School, Liverpool, United Kingdom
- Debashis Basu
- Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
- Yogan Pillay
- HIV & AIDS, TB and Maternal, Child and Women’s Health, National Department of Health, Pretoria, South Africa
- Julius C. Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Godfrey Mutashambara Rwegerera
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Godfrey Mutashambara Rwegerera
- Department of Medicine, Princess Marina Hospital, Gaborone, Botswana
- Bene D. Anand Paramadhas
- Department of Pharmacy, Nyangabgwe Hospital, Francistown, Botswana
- Celda Tiroyakgosi
- 0Botswana Essential Drugs Action Program, Ministry of Health and Wellness, Gaborone, Botswana
- Patrick Mbah Okwen
- 1Effective Basic Services (eBASE) Africa, Bamenda, Cameroon
- Patrick Mbah Okwen
- 2Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
- Loveline Lum Niba
- 1Effective Basic Services (eBASE) Africa, Bamenda, Cameroon
- Loveline Lum Niba
- 3Department of Public Health, University of Bamenda, Bambili, Cameroon
- Justice Nonvignon
- 4School of Public Health, University of Ghana, Legon, Ghana
- Israel Sefah
- 5Department of Pharmacy, Keta Municipal Hospital, Ghana Health Service, Keta, Ghana
- Margaret Oluka
- 6Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya
- Anastasia N. Guantai
- 7Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
- Dan Kibuule
- 7Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
- Francis Kalemeera
- 7Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
- Mwangana Mubita
- 7Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
- Joseph Fadare
- 8Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria
- Joseph Fadare
- 9Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
- Olayinka O. Ogunleye
- 0Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Lagos, Nigeria
- Olayinka O. Ogunleye
- 1Department of Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria
- Larry A. Distiller
- 2Centre for Diabetes & Endocrinology (Pty) Ltd, Johannesburg, South Africa
- Enos M. Rampamba
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Enos M. Rampamba
- 3Department of Pharmacy, Tshilidzini Regional Hospital, Limpopo Department Of Health, Shayandima, South Africa
- Jeffrey Wing
- 4School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Debjani Mueller
- Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
- Debjani Mueller
- 5Charlotte Maxeke Medical Research Cluster, Johannesburg, South Africa
- Abubakr Alfadl
- 6National Medicines Board, Federal Ministry of Health, Khartoum, Sudan
- Abubakr Alfadl
- 7Unaizah College of Pharmacy, Qassim University, Unaizah, Saudi Arabia
- Adefolarin A. Amu
- 8Eswatini Medical Christian University, Mbabane, Swaziland
- Zinhle Matsebula
- 9Raleigh Fitkin Memorial Hospital, Manzini, Swaziland
- Aubrey Kalungia
- 0Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
- Trust Zaranyika
- 1Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
- Nyasha Masuka
- 2Independent Health Systems Consultant, Harare, Zimbabwe
- Janney Wale
- 3Independent Consumer Advocate, Brunswick, VIC, Australia
- Ruaraidh Hill
- 4Liverpool Reviews and Implementation Group, Liverpool University, Liverpool, United Kingdom
- Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Amanj Kurdi
- 5Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
- Angela Timoney
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Angela Timoney
- 6NHS Lothian Director of Pharmacy, NHS Lothian, Edinburgh, United Kingdom
- Stephen Campbell
- 7Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
- Stephen Campbell
- 8NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Johanna C. Meyer
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- DOI
- https://doi.org/10.3389/fphar.2020.00108
- Journal volume & issue
-
Vol. 11
Abstract
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.
Keywords