Fighting non-communicable diseases in East Africa: assessing progress and identifying the next steps

Kraef, Christian; Juma, Pamela A.; Mucumbitsi, Joseph; Ramaiya, Kaushik; Ndikumwenayo, Francois; Kallestrup, Per; Yonga, Gerald

doi:10.1136/bmjgh-2020-003325

Cited by 30 publications

(19 citation statements)

References 18 publications

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“…7 Therefore, healthcare systems strengthening, increased investments and efficient use of resources are needed to counter the double burden of communicable and NCDs in SSA. 8 The established vertical healthcare structures in many countries, in particular those for HIV-care, risk contributing to inefficient use of resources and increased HIV-related stigma. 9 10 Thus, integration of the existing communicable and non-communicable healthcare infrastructure has become a recent policy and research focus to improve care for people living with NCDs (PLWNCDs) and PLWH alike.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

et al. 2021

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IntroductionAntiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy. In this article, we aim to review patient perspectives on integration of healthcare for HIV, type 2 diabetes and hypertension.MethodsThe framework for scoping reviews developed by Arksey and O'Malley and updated by Peter et al was applied for this review. The databases PubMed, Web of Science and Cochrane library were searched. Broad search terms for HIV, NCDs (specifically type 2 diabetes and hypertension) and healthcare integration were used. As the review aimed to identify definitions of patient perspectives, they were not included as an independent term in the search strategy. References of included publications were searched for relevant articles. Titles and abstracts for these papers were screened by two independent reviewers. The full texts for all the publications appearing to meet the inclusion criteria were then read to make the final literature selection.ResultsOf 5502 studies initially identified, 13 articles were included in this review, of which 11 had a geographical origin in sub-Saharan Africa. Nine articles were primarily focused on HIV/diabetes healthcare integration while four articles were focused on HIV/hypertension integration. Patient’s experiences with integrated care were reduced HIV-related stigma, reduced travel and treatment costs and a more holistic person-centred care. Prominent concerns were long waiting times at clinics and a lack of continuity of care in some clinics due to a lack of healthcare workers. Non-integrated care was perceived as time-consuming and more expensive.ConclusionPatient perspectives and experiences on integrated care for HIV, diabetes and hypertension were mostly positive. Integrated services can save resources and allow for a more personalised approach to healthcare. There is a paucity of evidence and further longitudinal and interventional evidence from a more diverse range of healthcare systems are needed.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

et al. 2021

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“…There has been an increased morbidity and mortality rate in Africa due to COVID-19, especially among individuals with comorbidities [14]. In addition, many African countries are burdened by NCDs such as diabetes mellitus, hypertension, heart failure, cancer, and asthma among others [15]. Studies have also shown that most people who succumb to COVID-19 suffer from one or more NCDs [16] [17].…”

Section: Background Informationmentioning

confidence: 99%

“…The upsurge of these NCDs threatens to further stretch the already fragile healthcare systems across the African continent [115] [116]. Previous analysis has projected that the morbidity and mortality due to NCDs such as diabetes and hypertension will likely supersede the scourge inflicted by infectious diseases by 2030 [15]. A major complication with NCDs is that they often co-exist with other diseases [116].…”

Section: Burden Of Communicable and Non-communicable Diseases In Africamentioning

confidence: 99%

Challenges Affecting African Countries in the Fight against the COVID-19 Pandemic: Implications for Interventional Strategies in Low-and Middle-Income Countries

Mudenda¹,

Mwila²,

Hikaambo³

et al. 2022

AID

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The coronavirus disease 2019 (COVID-19) has caused many global challenges, especially in resource-constrained countries. Africa, a continent with a large number of low-and middle-income countries (LMICs), shares this burden disproportionately compared to developed countries. Here we review some of the major challenges African countries face in the fight against COVID-19 and propose some mitigation measures. Studies have reported low adherence to COVID-19 prevention measures in most African countries. Additionally, there has been a shortage of healthcare workers, inadequate surveillance and diagnostic tools, unavailability of drugs in healthcare facilities, increased wrong beliefs, myths, misinformation and misconceptions about COVID-19 and vaccinations, and an already existing burden of infectious and non-infectious diseases across the African continent. Despite being very challenging to implement across African countries, telehealth is a critical solution to offer healthcare services during disease outbreaks. Many African countries have faced challenges in the fight against COVID-19. The training of healthcare workers (HCWs) must be strengthened to help address the shortage.

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“…According to global burden of disease study in 2017, Sub-Saharan Africa has seen a rapid increase of NCDs burden from 19% to 30% of the total diseases burden, between 1990 and 2017[2]. In a recent review of NCDs in the East Africa Community which includes Burundi, it was reported that cardiovascular diseases caused 13% of all NCDs related deaths, followed by malignant neoplasms (5.9%), respiratory diseases (2.1%), and diabetes mellitus (1.9%) according to data reported between 2000-2016[3].…”

Section: Introductionmentioning

confidence: 99%

A leap to non-communicable diseases epidemic in Burundi: overall trends of the disproportionate burden

Niyukuri

Nyandwi

Kamatari

et al. 2022

Preprint

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In developing countries, Noncommunicable diseases (NCDs) are increasing relentlessly. A recent review in East African Community countries showed that much need to be done to improve in prevention of risk factors, monitoring, surveillance, governance, and evaluation of health systems to tackle NCDs. In Burundi, there is no study which has been conducted to give an overview on status of NCDs and their risks factors. We conducted a review on estimations of NCDs statistics and pooled the data of NCDs and associated risk factors together with data available in report on cancer for Burundi. A descriptive analysis was performed, and statistical test was conducted to check the differences among burden distributions between male and female populations. We built linear model for diabetes and hypertension with same predictors (blood pressure, body-mass index, and cholesterol). Overall, data pooled in different studies showed that almost all NCDs have increasing trends in Burundi among male and female populations. The results showed increasing trends of all NCDs, except for hypertension. However, all risk factors are increasing. Although both populations have a very fast increasing trend of obesity, women, girls between 5 and 10 years, and adolescent girls are carrying the highest and fastest increasing burden of obesity compared to their male counterpart with same age categories. Cancer is also increasing with a lot of new types being diagnosed. We conclude that, NCDs are of a lot of concerns in male and female populations in Burundi. Adult men and women are at high risk of developing diabetes and hypertension. The prevalence of obesity among younger children and adolescent is alarming. There is a need of actions to be done in order to be able to prevent NCDs, but interventions targeting children and women should be put in place urgently.

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Fighting non-communicable diseases in East Africa: assessing progress and identifying the next steps

Cited by 30 publications

References 18 publications

Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

Challenges Affecting African Countries in the Fight against the COVID-19 Pandemic: Implications for Interventional Strategies in Low-and Middle-Income Countries

A leap to non-communicable diseases epidemic in Burundi: overall trends of the disproportionate burden

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