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Burden of disease among the world’s poorest billion people: An expert-informed secondary analysis of Global Burden of Disease estimates

Coates, M. M., Ezzati, M., Robles Aguilar, G., Kwan, G. F., Vigo, D., Mocumbi, A. O., Becker, A. E., Makani, J., Hyder, A. A., Jain, Y., Stefan, D. C., Gupta, N., Marx, A. & Bukhman, G.

The health of populations living in extreme poverty has been a long-standing focus of global development efforts, and continues to be a priority during the Sustainable Development Goal era. However, there has not been a systematic attempt to quantify the magnitude and causes of the burden in this specific population for almost two decades. We estimated disease rates by cause for the world’s poorest billion and compared these rates to those in high-income populations.

 

Feasibility and effectiveness of self-monitoring of blood glucose among insulin-dependent patients with type 2 diabetes: open randomized control trial in three rural districts in Rwanda

Loise Ng’ang’a, Gedeon Ngoga, Symaque Dusabeyezu, Bethany L. Hedt‐Gauthier, Emmanuel Harerimana, Simon Pierre Niyonsenga, Charlotte M. Bavuma, Gene Bukhman, Alma J. Adler, Fredrick Kateera and Paul H. Park

This study explores the feasibility and effectiveness of implementing self-monitoring of blood glucose among patients diagnosed with insulin‐dependent type 2 diabetes in rural Rwanda.

Our study showed that among patients with insulin‐dependent type 2 diabetes residing in rural Rwanda, SMBG was feasible and demonstrated positive outcomes in improving blood glucose control. However, there is need for strategies to enhance accuracy in recording blood glucose test results in the log‐book.

Feasibility and effectiveness of self-monitoring of blood glucose among insulin-dependent patients with type 2 diabetes: open randomized control trial in three rural districts in Rwanda

 

 

Addressing severe chronic NCDs across Africa: measuring demand for PEN-Plus

Chantelle Boudreaux, Prebo Barango, Alma Adler, Patrick Kaobre, Amy McLaughlin, Mohamed Ould Sidi Mohamed, Paul H. Park, Steven Shongwe, Jean Marie Dangou, Gene Bukhman
Health Policy and Planning 2022

Addressing severe chronic NCDs across Africa:
measuring demand for the Package of Essential Non-communicable Disease Interventions-Plus (PEN-Plus)

Severe chronic non-communicable diseases (NCDs) pose important challenges for health systems across Africa. This study explores the current availability of and demand for decentralization of services for four high-priority conditions: insulin-dependent diabetes, heart failure, sickle cell disease, and chronic pain. Countries reported widespread gaps in service availability at all levels. We found that just under half (49%) of respondents report that services for insulin-dependent diabetes are generally available at the secondary level (district hospital); 32% report the same for heart failure, 27% for chronic pain and 14% for sickle cell disease. Reported gaps are smaller at tertiary level (referral hospital) and larger at primary care level (health centres). Respondents report ambitious plans to introduce and decentralize these services in the coming 5 years. Respondents from 32 countries (86%) hope to make all services available at tertiary hospitals, and 21 countries (57%) expect to make all services available at secondary facilities. These priorities align with the Package of Essential NCD Interventions-Plus. Efforts will require strengthened infrastructure and supply chains, capacity building for staff and new monitoring and evaluation systems for efficient implementation. Many countries will need targeted financial assistance in order to realize these goals. Nearly all (36/37) respondents request technical assistance to organize services for severe chronic NCDs.

Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

Alma J Adler, Celina Trujillo, Leah Schwartz, Laura Drown, Jacquelin Pierre, Christopher Noble, Theophilus Allison, Rebecca Cook, Cyrus Randolph, Gene Bukhman

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Despite the severe nature of T1D and growing burden in sub- Saharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and self-management, and barriers and facilitators for accessing T1D care.

T1D was found to have a significant impact on patients and caregivers, and informants identified several key individual and systems-level barriers to effective T1D care in Liberia. Addressing these concerns is vital for designing sustainable and effective programmes for treating patients living with T1D.