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

被引：92

作者：

Godman, Brian ^{[1
,2
,3
,4
]}

Basu, Debashis ^{[5
]}

Pillay, Yogan ^{[6
]}

Mwita, Julius C. ^{[7
]}

Rwegerera, Godfrey Mutashambara ^{[7
,8
]}

Paramadhas, Bene D. Anand ^{[9
]}

Tiroyakgosi, Celda ^{[10
]}

Okwen, Patrick Mbah ^{[11
,12
]}

Niba, Loveline Lum ^{[11
,13
]}

Nonvignon, Justice ^{[14
]}

Sefah, Israel ^{[15
]}

Oluka, Margaret ^{[16
]}

Guantai, Anastasia N. ^{[17
]}

Kibuule, Dan ^{[17
]}

Kalemeera, Francis ^{[17
]}

Mubita, Mwangana ^{[17
]}

Fadare, Joseph ^{[18
,19
]}

Ogunleye, Olayinka O. ^{[20
,21
]}

Distiller, Larry A. ^{[22
]}

Rampamba, Enos M. ^{[2
,23
]}

Wing, Jeffrey ^{[24
]}

Mueller, Debjani ^{[5
,25
]}

Alfadl, Abubakr ^{[26
,27
]}

Amu, Adefolarin A. ^{[28
]}

Matsebula, Zinhle ^{[29
]}

Kalungia, Aubrey ^{[30
]}

Zaranyika, Trust ^{[31
]}

Masuka, Nyasha ^{[32
]}

Wale, Janney ^{[33
]}

Hill, Ruaraidh ^{[34
]}

Kurdi, Amanj ^{[1
,35
]}

Timoney, Angela ^{[1
,36
]}

Campbell, Stephen ^{[37
,38
]}

Meyer, Johanna C. ^{[2
]}

机构：

[1] Univ Strathclyde, Strathclyde Inst Pharm & Biomed Sci, Glasgow, Lanark, Scotland

[2] Sefako Makgatho Hlth Sci Univ, Sch Pharm, Div Publ Hlth Pharm & Management, Pretoria, South Africa

[3] Karolinska Univ Hosp Huddinge, Karolinska Inst, Div Clin Pharmacol, Stockholm, Sweden

[4] Univ Liverpool, Hlth Econ Ctr, Management Sch, Liverpool, Merseyside, England

[5] Univ Pretoria, Steve Biko Acad Hosp, Dept Publ Hlth Med, Pretoria, South Africa

[6] Natl Dept Hlth, HIV & AIDS TB & Maternal Child & Womens Hlth, Pretoria, South Africa

[7] Univ Botswana, Fac Med, Dept Internal Med, Gaborone, Botswana

[8] Princess Marina Hosp, Dept Med, Gaborone, Botswana

[9] Nyangabgwe Hosp, Dept Pharm, Francistown, Botswana

[10] Minist Hlth & Wellness, Botswana Essential Drugs Act Program, Gaborone, Botswana

[11] Effect Basic Serv eBASE Africa, Bamenda, Cameroon

[12] Univ Adelaide, Fac Hlth & Med Sci, Adelaide, SA, Australia

[13] Univ Bamenda, Dept Publ Hlth, Bambili, Cameroon

[14] Univ Ghana, Sch Publ Hlth, Legon, Ghana

[15] Ghana Hlth Serv, Dept Pharm, Keta Municipal Hosp, Keta, Ghana

[16] Univ Nairobi, Sch Pharm, Dept Pharmacol & Pharmacognosy, Nairobi, Kenya

[17] Univ Namibia, Fac Hlth Sci, Dept Pharm Practice & Policy, Windhoek, Namibia

[18] Ekiti State Univ, Dept Pharmacol & Therapeut, Ado Ekiti, Nigeria

[19] Ekiti State Univ Teaching Hosp, Dept Med, Ado Ekiti, Nigeria

[20] Lagos State Univ, Dept Pharmacol Therapeut & Toxicol, Coll Med, Lagos, Nigeria

[21] Lagos State Univ Teaching Hosp, Dept Med, Lagos, Nigeria

[22] Ctr Diabet & Endocrinol Pty Ltd, Johannesburg, South Africa

[23] Tshilidzini Reg Hosp, Dept Pharm, Limpopo Dept Hlth, Shayandima, South Africa

[24] Univ Witwatersrand, Sch Clin Med, Johannesburg, South Africa

[25] Charlotte Maxeke Med Res Cluster, Johannesburg, South Africa

[26] Fed Minist Hlth, Natl Med Board, Khartoum, Sudan

[27] Qassim Univ, Unaizah Coll Pharm, Unaizah, Saudi Arabia

[28] Eswatini Med Christian Univ, Mbabane, Eswatini

[29] Raleigh Fitkin Mem Hosp, Manzini, Eswatini

[30] Univ Zambia, Sch Hlth Sci, Dept Pharm, Lusaka, Zambia

[31] Univ Zimbabwe, Dept Med, Coll Hlth Sci, Harare, Zimbabwe

[32] Independent Hlth Syst Consultant, Harare, Zimbabwe

[33] Independent Consumer Advocate, Brunswick, Vic, Australia

[34] Univ Liverpool, Liverpool Reviews & Implementat Grp, Liverpool, Merseyside, England

[35] Hawler Med Univ, Coll Pharm, Dept Pharmacol, Erbil, Iraq

[36] NHS Lothian, Pharm, Edinburgh, Midlothian, Scotland

[37] Univ Manchester, Ctr Primary Care, Hlth Serv Res & Primary Care, Div Populat Hlth, Manchester, Lancs, England

[38] Univ Manchester, NIHR Greater Manchester Patient Safety Translat R, Sch Hlth Sci, Manchester, Lancs, England

来源：

FRONTIERS IN PHARMACOLOGY | 2020年 / 11卷

关键词：

Type; 2; diabetes; Africa; national initiatives; diagnosis; medicines; adherence; patient groups; SUB-SAHARAN AFRICA; BLOOD-PRESSURE CONTROL; PRIMARY-HEALTH-CARE; QUALITY-OF-LIFE; SOUTH-AFRICA; CARDIOVASCULAR-DISEASE; SUDANESE INDIVIDUALS; MEDICATION ADHERENCE; MIDDLE-INCOME; RISK-FACTORS;

D O I：

10.3389/fphar.2020.00108

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background There 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. Objective Document 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 Approach Contextualise 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 Activities A 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, Conclusion There 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.

引用

页数：21

共 236 条

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