Use of medical services and medicines attributable to diabetes in Sub-Saharan Africa

Show simple item record Brown, Jonathan Betz Ramaiya, Kaushik Besancon, Stephane Rheeder, Paul Tassou, Clarisse Mapa Mbanya, Jean-Claude Kissimova-Skarbek, Katarzyna Njenga, Eva Wangechi Muchemi, Eva Wangui Wanjiru, Harrison Kiambuthi Schneider, Erin 2014-11-04T07:17:41Z 2014-11-04T07:17:41Z 2014-09-12
dc.description.abstract BACKGROUND: Although the large majority of persons with diabetes and other non-communicable diseases (NCDs) lives and dies in low- and middle-income countries, the prevention and treatment of diabetes and other NCDs is widely neglected in these areas. A contributing reason may be that, unlike the impacts of acute and communicable diseases, the demands on resources imposed by diabetes is not superficially obvious, and studies capable of detecting these impacts have not be done. METHODS: To ascertain recent use of medical services and medicines and other information about the impact of ill-health, we in 2008–2009 conducted structured, personal interviews with 1,780 persons with diagnosed diabetes (DMs) and 1,770 matched comparison subjects (MCs) without diabetes in Cameroon, Mali, Tanzania and South Africa. We sampled DMs from diabetes registries and, in Cameroon and South Africa, from attendees at outpatient diabetes clinics. To recruit MCs, we asked subjects with diabetes to identify five persons living nearest to them who were of the same sex and approximate age. We estimated diabetes impact on medical services use by calculating ratios and differences between DMs and MCs, testing for statistical significance using two-stage multivariable hurdle models. FINDINGS: DMs consumed 12.95 times more days of inpatient treatment, 7.54 times more outpatient visits, and 5.61 times more medications than MCs (all p,0.001). DMs used an estimated 3.44 inpatient days per person per year, made 10.72 outpatient visits per person per year (excluding traditional healers), and were taking an average of 2.49 prescribed medicines when interviewed. CONCLUSIONS: In Sub-Saharan Africa, the relative incremental use of medical care and medicines associated with diagnosed diabetes is much greater than in industrialized countries and in China. Published calculations of the health-system impact of diabetes in Africa are dramatic underestimates. Although non-communicable diseases like diabetes are commonly thought to be minor problems for health systems and patients in Africa, our data demonstrate the opposite. en_US
dc.description.librarian am2014 en_US
dc.description.sponsorship The Economic Study Fund of the International Diabetes Federation (IDF) en_US
dc.description.uri en_US
dc.identifier.citation Brown JB, Ramaiya K, Besanc¸on S, Rheeder P, Tassou CM, et al. (2014) Use of Medical Services and Medicines Attributable to Diabetes in Sub-Saharan Africa. PLoS ONE 9(9): e106716. DOI: 10.1371/journal.pone.0106716. en_US
dc.identifier.issn 1932-6203
dc.identifier.other 10.1371/journal.pone.0106716
dc.language.iso en en_US
dc.publisher Public Library of Science en_US
dc.rights © 2014 Brown et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License. en_US
dc.subject Diabetes en_US
dc.subject Medical services en_US
dc.subject Non-communicable diseases (NCDs) en_US
dc.subject Medicines en_US
dc.title Use of medical services and medicines attributable to diabetes in Sub-Saharan Africa en_US
dc.type Article en_US

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