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Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review

BACKGROUND: Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health p...

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Autores principales: Hall, Victoria, Thomsen, Reimar W, Henriksen, Ole, Lohse, Nicolai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156766/
https://www.ncbi.nlm.nih.gov/pubmed/21756350
http://dx.doi.org/10.1186/1471-2458-11-564
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author Hall, Victoria
Thomsen, Reimar W
Henriksen, Ole
Lohse, Nicolai
author_facet Hall, Victoria
Thomsen, Reimar W
Henriksen, Ole
Lohse, Nicolai
author_sort Hall, Victoria
collection PubMed
description BACKGROUND: Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. METHODS: We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality), access to diagnosis and care and economic impact. RESULTS: Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40%) with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. CONCLUSION: Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.
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spelling pubmed-31567662011-08-17 Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review Hall, Victoria Thomsen, Reimar W Henriksen, Ole Lohse, Nicolai BMC Public Health Research Article BACKGROUND: Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. METHODS: We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality), access to diagnosis and care and economic impact. RESULTS: Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40%) with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. CONCLUSION: Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases. BioMed Central 2011-07-14 /pmc/articles/PMC3156766/ /pubmed/21756350 http://dx.doi.org/10.1186/1471-2458-11-564 Text en Copyright ©2011 Hall et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hall, Victoria
Thomsen, Reimar W
Henriksen, Ole
Lohse, Nicolai
Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title_full Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title_fullStr Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title_full_unstemmed Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title_short Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review
title_sort diabetes in sub saharan africa 1999-2011: epidemiology and public health implications. a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156766/
https://www.ncbi.nlm.nih.gov/pubmed/21756350
http://dx.doi.org/10.1186/1471-2458-11-564
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