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4. Diabetes Management in Latin America

Author

Carrillo-Larco, Rodrigo M., Bracco, Paula A., Bernabe-Ortiz, Antonio, Lazo-Porras, Maria, Zafra-Tanaka, Jessica H., Tenorio-Mucha, Janeth, Bello-Chavolla, Omar Yaxmehen, Beran, David, and Rodriguez-Saldana, Joel, editor

Published
2023
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8. Burden of non-communicable diseases among adolescents aged 10–24 years in the EU, 1990–2019: a systematic analysis of the Global Burden of Diseases Study 2019

Author

Armocida, Benedetta, Monasta, Lorenzo, Sawyer, Susan M, Bustreo, Flavia, Segafredo, Giulia, Castelpietra, Giulio, Ronfani, Luca, Pasovic, Maja, Hay, Simon I, Abila, Derrick Bary, Abolhassani, Hassan, Accrombessi, Manfred Mario Kokou, Adekanmbi, Victor, Ahmadi, Keivan, Al Hamad, Hanadi, Aldeyab, Mamoon A, Al-Jumaily, Adel, Ancuceanu, Robert, Andrei, Catalina Liliana, Andrei, Tudorel, Arumugam, Ashokan, Attia, Sameh, Aujayeb, Avinash, Ausloos, Marcel, Baker, Jennifer L, Barone-Adesi, Francesco, Barra, Fabio, Barteit, Sandra, Basu, Sanjay, Baune, Bernhard T, Béjot, Yannick, Belo, Luis, Bennett, Derrick A, Bikbov, Boris, Bikov, Andras, Blyuss, Oleg, Breitner, Susanne, Brenner, Hermann, Carreras, Giulia, Carvalho, Márcia, Catapano, Alberico L, Chandan, Joht Singh, Charalampous, Periklis, Chen, Simiao, Conde, Joao, Cruz-Martins, Natália, Damiani, Giovanni, Dastiridou, Anna, de la Torre-Luque, Alejandro, Dianatinasab, Mostafa, Dias da Silva, Diana, Douiri, Abdel, Dragioti, Elena, Engelbert Bain, Luchuo, Fagbamigbe, Adeniyi Francis, Fereshtehnejad, Seyed-Mohammad, Ferrara, Pietro, Ferreira de Oliveira, José Miguel P, Ferrero, Simone, Ferro Desideri, Lorenzo, Fischer, Florian, Fonseca, Diogo A, Gaewkhiew, Piyada, Gaihre, Santosh, Gallus, Silvano, Gaspar Fonseca, Mariana, Gill, Paramjit Singh, Glasbey, James C, Gorini, Giuseppe, Gupta, Vijai Kumar, Gurara, Mekdes Kondale, Haro, Josep Maria, Hasan, M Tasdik, Havmoeller, Rasmus J, Heibati, Behzad, Hellemons, Merel E, Herteliu, Claudiu, Hussain, Salman, Isola, Gaetano, Johnson, Olatunji, Jonas, Jost B, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Zubair, Karch, André, Kauppila, Joonas H, Kayode, Gbenga A, Khan, Moien AB, Khatab, Khaled, Kivimäki, Mika, Klugar, Miloslav, Klugarová, Jitka, Koly, Kamrun Nahar, Koyanagi, Ai, Kurmi, Om P, Kusuma, Dian, La Vecchia, Carlo, Lacey, Ben, Lallukka, Tea, Lamnisos, Demetris, Langguth, Berthold, Larsson, Anders O, Lauriola, Paolo, Lee, Paul H, Leonardi, Matilde, Li, An, Linehan, Christine, López-Bueno, Rubén, Lorkowski, Stefan, Loureiro, Joana A, Lunevicius, Raimundas, Magee, Laura A, Magnani, Francesca Giulia, Majeed, Azeem, Makris, Konstantinos Christos, Mathioudakis, Alexander G, Mathur, Manu Raj, McGrath, John J, Menezes, Ritesh G, Mentis, Alexios-Fotios A, Meretoja, Atte, Mestrovic, Tomislav, Miao Jonasson, Junmei, Miazgowski, Tomasz, Mirica, Andreea, Moccia, Marcello, Mohammed, Shafiu, Molokhia, Mariam, Mondello, Stefania, Mueller, Ulrich Otto, Mulita, Francesk, Munblit, Daniel, Negoi, Ionut, Negoi, Ruxandra Irina, Nena, Evangelia, Noor, Nurulamin M, Nowak, Christoph, Ntaios, George, Nwatah, Vincent Ebuka, Oancea, Bogdan, Oguntade, Ayodipupo Sikiru, Ortiz, Alberto, Otoiu, Adrian, Padron-Monedero, Alicia, Palladino, Raffaele, Pana, Adrian, Panagiotakos, Demosthenes, Panda-Jonas, Songhomitra, Pardhan, Shahina, Patel, Jay, Pedersini, Paolo, Peñalvo, José L, Pensato, Umberto, Pereira, Renato B, Perico, Norberto, Petcu, Ionela-Roxana, Polinder, Suzanne, Postma, Maarten J, Rabiee, Mohammad, Rabiee, Navid, Raggi, Alberto, Rahimzadeh, Shadi, Rawaf, David Laith, Rawaf, Salman, Rehman, Faizan Ur, Remuzzi, Giuseppe, Riad, Abanoub, Rodriguez, Alina, Sacco, Simona, Saeb, Mohammad Reza, Safdarian, Mahdi, Sathian, Brijesh, Sattin, Davide, Saxena, Sonia, Scarmeas, Nikolaos, Schlee, Winfried, Schwendicke, Falk, Shamsizadeh, Morteza, Sharew, Nigussie Tadesse, Shiri, Rahman, Shivalli, Siddharudha, Shivarov, Velizar, Silva, João Pedro, Simpson, Colin R, Skou, Søren T, Socea, Bogdan, Soyiri, Ireneous N, Steiropoulos, Paschalis, Straif, Kurt, Sun, Xiaohui, Tabarés-Seisdedos, Rafael, Thiyagarajan, Arulmani, Topouzis, Fotis, Tovani-Palone, Marcos Roberto, Truelsen, Thomas Clement, Unim, Brigid, Van den Eynde, Jef, Vasankari, Tommi Juhani, Veroux, Massimiliano, Villafaina, Santos, Vinko, Matej, Violante, Francesco S, Volovici, Victor, Wang, Yanzhong, Westerman, Ronny, Yadegarfar, Mohammad Esmaeil, Yaya, Sanni, Zadnik, Vesna, Zumla, Alimuddin, Perel, Pablo, Beran, David, Sawyer, Susan, and Hay, Simon

Published
2022
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10. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019

Author

Cousin, Ewerton, Duncan, Bruce B, Stein, Caroline, Ong, Kanyin Liane, Vos, Theo, Abbafati, Cristiana, Abbasi-Kangevari, Mohsen, Abdelmasseh, Michael, Abdoli, Amir, Abd-Rabu, Rami, Abolhassani, Hassan, Abu-Gharbieh, Eman, Accrombessi, Manfred Mario Kokou, Adnani, Qorinah Estiningtyas Sakilah, Afzal, Muhammad Sohail, Agarwal, Gina, Agrawaal, Krishna K, Agudelo-Botero, Marcela, Ahinkorah, Bright Opoku, Ahmad, Sajjad, Ahmad, Tauseef, Ahmadi, Keivan, Ahmadi, Sepideh, Ahmadi, Ali, Ahmed, Ali, Ahmed Salih, Yusra, Akande-Sholabi, Wuraola, Akram, Tayyaba, Al Hamad, Hanadi, Al-Aly, Ziyad, Alcalde-Rabanal, Jacqueline Elizabeth, Alipour, Vahid, Aljunid, Syed Mohamed, Al-Raddadi, Rajaa M, Alvis-Guzman, Nelson, Amini, Saeed, Ancuceanu, Robert, Andrei, Tudorel, Andrei, Catalina Liliana, Anjana, Ranjit Mohan, Ansar, Adnan, Antonazzo, Ippazio Cosimo, Antony, Benny, Anyasodor, Anayochukwu Edward, Arabloo, Jalal, Arizmendi, Damian, Armocida, Benedetta, Artamonov, Anton A, Arulappan, Judie, Aryan, Zahra, Asgari, Samaneh, Ashraf, Tahira, Astell-Burt, Thomas, Atorkey, Prince, Atout, Maha Moh'd Wahbi, Ayanore, Martin Amogre, Badiye, Ashish D, Baig, Atif Amin, Bairwa, Mohan, Baker, Jennifer L, Baltatu, Ovidiu Constantin, Banik, Palash Chandra, Barnett, Anthony, Barone, Mark Thomaz Ugliara, Barone-Adesi, Francesco, Barrow, Amadou, Bedi, Neeraj, Belete, Rebuma, Belgaumi, Uzma Iqbal, Bell, Arielle Wilder, Bennett, Derrick A, Bensenor, Isabela M, Beran, David, Bhagavathula, Akshaya Srikanth, Bhaskar, Sonu, Bhattacharyya, Krittika, Bhojaraja, Vijayalakshmi S, Bijani, Ali, Bikbov, Boris, Birara, Setognal, Bodolica, Virginia, Bonny, Aime, Brenner, Hermann, Briko, Nikolay Ivanovich, Butt, Zahid A, Caetano dos Santos, Florentino Luciano, Cámera, Luis Alberto, Campos-Nonato, Ismael R, Cao, Yin, Cao, Chao, Cerin, Ester, Chakraborty, Promit Ananyo, Chandan, Joht Singh, Chattu, Vijay Kumar, Chen, Simiao, Choi, Jee-Young Jasmine, Choudhari, Sonali Gajanan, Chowdhury, Enayet Karim, Chu, Dinh-Toi, Corso, Barbara, Dadras, Omid, Dai, Xiaochen, Damasceno, Albertino Antonio Moura, Dandona, Lalit, Dandona, Rakhi, Dávila-Cervantes, Claudio Alberto, De Neve, Jan-Walter, Denova-Gutiérrez, Edgar, Dhamnetiya, Deepak, Diaz, Daniel, Ebtehaj, Sanam, Edinur, Hisham Atan, Eftekharzadeh, Sahar, El Sayed, Iman, Elgendy, Islam Y, Elhadi, Muhammed, Elmonem, Mohamed A, Faisaluddin, Mohammed, Farooque, Umar, Feng, Xiaoqi, Fernandes, Eduarda, Fischer, Florian, Flood, David, Freitas, Marisa, Gaal, Peter Andras, Gad, Mohamed M, Gaewkhiew, Piyada, Getacher, Lemma, Ghafourifard, Mansour, Ghanei Gheshlagh, Reza, Ghashghaee, Ahmad, Ghith, Nermin, Ghozali, Ghozali, Gill, Paramjit Singh, Ginawi, Ibrahim Abdelmageed, Glushkova, Ekaterina Vladimirovna, Golechha, Mahaveer, Gopalani, Sameer Vali, Guimarães, Rafael Alves, Gupta, Rajat Das, Gupta, Rajeev, Gupta, Vivek Kumar, Gupta, Veer Bala, Gupta, Sapna, Habtewold, Tesfa Dejenie, Hafezi-Nejad, Nima, Halwani, Rabih, Hanif, Asif, Hankey, Graeme J, Haque, Shafiul, Hasaballah, Ahmed I, Hasan, Syed Shahzad, Hashi, Abdiwahab, Hassanipour, Soheil, Hay, Simon I, Hayat, Khezar, Heidari, Mohammad, Hossain, Mohammad Bellal Hossain, Hossain, Sahadat, Hosseini, Mostafa, Hoveidamanesh, Soodabeh, Huang, Junjie, Humayun, Ayesha, Hussain, Rabia, Hwang, Bing-Fang, Ibitoye, Segun Emmanuel, Ikuta, Kevin S, Inbaraj, Leeberk Raja, Iqbal, Usman, Islam, Md Shariful, Islam, Sheikh Mohammed Shariful, Islam, Rakibul M, Ismail, Nahlah Elkudssiah, Isola, Gaetano, Itumalla, Ramaiah, Iwagami, Masao, Iyamu, Ihoghosa Osamuyi, Jahani, Mohammad Ali, Jakovljevic, Mihajlo, Jayawardena, Ranil, Jha, Ravi Prakash, John, Oommen, Jonas, Jost B, Joo, Tamas, Kabir, Ali, Kalhor, Rohollah, Kamath, Ashwin, Kanchan, Tanuj, Kandel, Himal, Kapoor, Neeti, Kayode, Gbenga A, Kebede, Sewnet Adem, Keshavarz, Pedram, Keykhaei, Mohammad, Khader, Yousef Saleh, Khajuria, Himanshu, Khan, Moien AB, Khan, Md Nuruzzaman, Khan, Maseer, Khater, Amir M, Khoja, Tawfik Ahmed Muthafer, Khubchandani, Jagdish, Kim, Min Seo, Kim, Yun Jin, Kimokoti, Ruth W, Kisa, Sezer, Kisa, Adnan, Kivimäki, Mika, Korshunov, Vladimir Andreevich, Korzh, Oleksii, Koyanagi, Ai, Krishan, Kewal, Kuate Defo, Barthelemy, Kumar, G Anil, Kumar, Nithin, Kusuma, Dian, La Vecchia, Carlo, Lacey, Ben, Larsson, Anders O, Lasrado, Savita, Lee, Wei-Chen, Lee, Chiachi Bonnie, Lee, Paul H, Lee, Shaun Wen Huey, Li, Ming-Chieh, Lim, Stephen S, Lim, Lee-Ling, Lucchetti, Giancarlo, Majeed, Azeem, Malik, Ahmad Azam, Mansouri, Borhan, Mantovani, Lorenzo Giovanni, Martini, Santi, Mathur, Prashant, McAlinden, Colm, Mehedi, Nafiul, Mekonnen, Teferi, Menezes, Ritesh G, Mersha, Amanual Getnet, Miao Jonasson, Junmei, Miazgowski, Tomasz, Michalek, Irmina Maria, Mirica, Andreea, Mirrakhimov, Erkin M, Mirza, Agha Zeeshan, Mithra, Prasanna, Mohammadian-Hafshejani, Abdollah, Mohammadpourhodki, Reza, Mohammed, Arif, Mokdad, Ali H, Molokhia, Mariam, Monasta, Lorenzo, Moni, Mohammad Ali, Moradpour, Farhad, Moradzadeh, Rahmatollah, Mostafavi, Ebrahim, Mueller, Ulrich Otto, Murray, Christopher J L, Mustafa, Ahmad, Nagel, Gabriele, Nangia, Vinay, Naqvi, Atta Abbas, Nayak, Biswa Prakash, Nazari, Javad, Ndejjo, Rawlance, Negoi, Ruxandra Irina, Neupane Kandel, Sandhya, Nguyen, Cuong Tat, Nguyen, Huong Lan Thi, Noubiap, Jean Jacques, Nowak, Christoph, Oancea, Bogdan, Odukoya, Oluwakemi Ololade, Oguntade, Ayodipupo Sikiru, Ojo, Temitope T, Olagunju, Andrew T, Onwujekwe, Obinna E, Ortiz, Alberto, Owolabi, Mayowa O, Palladino, Raffaele, Panda-Jonas, Songhomitra, Pandi-Perumal, Seithikurippu R, Pardhan, Shahina, Parekh, Tarang, Parvizi, Mojtaba, Pepito, Veincent Christian Filipino, Perianayagam, Arokiasamy, Petcu, Ionela-Roxana, Pilania, Manju, Podder, Vivek, Polibin, Roman V, Postma, Maarten J, Prashant, Akila, Rabiee, Navid, Rabiee, Mohammad, Rahimi-Movaghar, Vafa, Rahman, Muhammad Aziz, Rahman, Md. Mosfequr, Rahman, Mosiur, Rahmawaty, Setyaningrum, Rajai, Nazanin, Ram, Pradhum, Rana, Juwel, Ranabhat, Kamal, Ranasinghe, Priyanga, Rao, Chythra R, Rao, Satish, Rawaf, Salman, Rawaf, David Laith, Rawal, Lal, Renzaho, Andre M N, Rezaei, Nima, Rezapour, Aziz, Riahi, Seyed Mohammad, Ribeiro, Daniela, Rodriguez, Jefferson Antonio Buendia, Roever, Leonardo, Rohloff, Peter, Rwegerera, Godfrey M, Ryan, Paul MacDaragh, Saber-Ayad, Maha Mohamed, Sabour, Siamak, Saddik, Basema, Saeedi Moghaddam, Sahar, Sahebkar, Amirhossein, Sahoo, Harihar, Saif-Ur-Rahman, KM, Salimzadeh, Hamideh, Samaei, Mehrnoosh, Sanabria, Juan, Santric-Milicevic, Milena M, Sathian, Brijesh, Sathish, Thirunavukkarasu, Schlaich, Markus P, Seidu, Abdul-Aziz, Šekerija, Mario, Senthil Kumar, Nachimuthu, Seylani, Allen, Shaikh, Masood Ali, Shamshad, Hina, Shawon, Md Shajedur Rahman, Sheikhbahaei, Sara, Shetty, Jeevan K, Shiri, Rahman, Shivakumar, K M, Shuval, Kerem, Singh, Jasvinder A, Singh, Ambrish, Skryabin, Valentin Yurievich, Skryabina, Anna Aleksandrovna, Sofi-Mahmudi, Ahmad, Soheili, Amin, Sun, Jing, Szerencsés, Viktória, Szócska, Miklós, Tabarés-Seisdedos, Rafael, Tadbiri, Hooman, Tadesse, Eyayou Girma, Tariqujjaman, Md., Thankappan, Kavumpurathu Raman, Thapar, Rekha, Thomas, Nihal, Timalsina, Binod, Tobe-Gai, Ruoyan, Tonelli, Marcello, Tovani-Palone, Marcos Roberto, Tran, Bach Xuan, Tripathy, Jaya Prasad, Tudor Car, Lorainne, Tusa, Biruk Shalmeno, Uddin, Riaz, Upadhyay, Era, Valadan Tahbaz, Sahel, Valdez, Pascual R, Vasankari, Tommi Juhani, Verma, Madhur, Villalobos-Daniel, Victor E, Vladimirov, Sergey Konstantinovitch, Vo, Bay, Vu, Giang Thu, Vukovic, Rade, Waheed, Yasir, Wamai, Richard G, Werdecker, Andrea, Wickramasinghe, Nuwan Darshana, Winkler, Andrea Sylvia, Wubishet, Befikadu Legesse, Xu, Xiaoyue, Xu, Suowen, Yahyazadeh Jabbari, Seyed Hossein, Yatsuya, Hiroshi, Yaya, Sanni, Yazie, Taklo Simeneh Yazie, Yi, Siyan, Yonemoto, Naohiro, Yunusa, Ismaeel, Zadey, Siddhesh, Zaman, Sojib Bin, Zamanian, Maryam, Zamora, Nelson, Zastrozhin, Mikhail Sergeevich, Zastrozhina, Anasthasia, Zhang, Zhi-Jiang, Zhong, Chenwen, Zmaili, Mohammad, Zumla, Alimuddin, Naghavi, Mohsen, and Schmidt, Maria Inês

Published
2022
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14. Access to antivenoms in the developing world: A multidisciplinary analysis

Author

Potet, Julien, Beran, David, Ray, Nicolas, Alcoba, Gabriel, Habib, Abdulrazaq Garba, Iliyasu, Garba, Waldmann, Benjamin, Ralph, Ravikar, Faiz, Mohammad Abul, Monteiro, Wuelton Marcelo, de Almeida Gonçalves Sachett, Jacqueline, di Fabio, Jose Luis, Cortés, María de los Ángeles, Brown, Nicholas I., and Williams, David J.

Published
2021
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16. Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia.

Author

Ramadaniati, Hesty Utami, Anggriani, Yusi, Lepeska, Molly, Beran, David, and Ewen, Margaret

Subjects
PRICES, TYPE 1 diabetes, TYPE 2 diabetes, PEOPLE with diabetes, ONLINE marketplaces
Abstract

Insulin is essential for the survival of people with type 1 diabetes and for better management of people with type 2 diabetes. People with diabetes using insulin also require self-monitoring blood glucose (SMBG) devices (e.g., meters, strips, continuous monitoring systems) for day-to-day management. It is essential to ensure that insulin and these devices are available and affordable. This study aimed to evaluate the availability, price, and affordability of insulin and SMBG devices in Indonesia using an adaptation of the World Health Organization/Health Action International (WHO/HAI) price survey. A total of 34 public health facilities (hospitals, primary healthcare centres/Puskesmas) and 37 private pharmacies were sampled. Information from three major online marketplaces was also collected. Prices were expressed as median patient prices (US$). Affordability was defined as the number of days' wages needed by the lowest paid unskilled government worker (LPGW) to purchase 30 days' supply of insulin, delivery devices and SMBGs. Availability of analogue insulin was slightly higher in public facilities (63.6%) than in the private sector (43.2%), with no human insulin available in both sectors. Conversely, better availability was observed in private facilities for SMBG devices as public sector facilities did not supply devices for self-testing. Median prices for 1000IU analogues varied between the public sector (US$ 5.26) and the private sector (US$11.24). The highest median price of analogues was seen in online marketplaces (US$ 28.65). The least costly median price of SMBG devices were observed in online platforms (meter: US$ 18.37, test strip: US$ 0.27, lancet: US$ 0.02). A low-income person had to work 2–3 days to buy 1000IU of analogues. It required 5–7 days' and 4–5 day's wages to purchase a meter and a month's supply of test strips, respectively. The availability and affordability of insulin and SMBG devices remain important issues in Indonesia requiring holistic approaches for further improvement. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Recommendations for the use of mathematical modelling to support decision-making on integration of non-communicable diseases into HIV care

Author

Kibachio, Joseph, Mwenda, Valerian, Ombiro, Oren, Kamano, Jamima H., Perez-Guzman, Pablo N., Mutai, Kennedy K., Guessous, Idris, Beran, David, Kasaie, Paratsu, Weir, Brian, Beecroft, Blythe, Kilonzo, Nduku, Kupfer, Linda, and Smit, Mikaela

Subjects
World Health Organization -- Human resource management, Analysis, Usage, Human resource management, Company personnel management, Communicable diseases -- Usage -- Analysis, HIV -- Usage -- Analysis, Medical research -- Analysis -- Usage
Abstract

1 | INTRODUCTION The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries calls for concerted efforts at prevention, early detection and optimization of health systems for effective [...], Introduction: Integrating services for non-communicable diseases (NCDs) into existing primary care platforms such as HIV programmes has been recommended as a way of strengthening health systems, reducing redundancies and leveraging existing systems to rapidly scale-up underdeveloped programmes. Mathematical modelling provides a powerful tool to address questions around priorities, optimization and implementation of such programmes. In this study, we examine the case for NCD-HIV integration, use Kenya as a case-study to highlight how modelling has supported wider policy formulation and decision-making in healthcare and to collate stakeholders' recommendations on use of models for NCD-HIV integration decisionmaking. Discussion: Across Africa, NCDs are increasingly posing challenges for health systems, which historically focused on the care of acute and infectious conditions. Pilot programmes using integrated care services have generated advantages for both provider and user, been cost-effective, practical and achieve rapid coverage scale-up. The shared chronic nature of NCDs and HIV means that many operational approaches and infrastructure developed for HIV programmes apply to NCDs, suggesting this to be a cost-effective and sustainable policy option for countries with large HIV programmes and small, un-resourced NCD programmes. However, the vertical nature of current disease programmes, policy financing and operations operate as barriers to NCD-HIV integration. Modelling has successfully been used to inform health decision-making across a number of disease areas and in a number of ways. Examples from Kenya include (i) estimating current and future disease burden to set priorities for public health interventions, (ii) forecasting the requisite investments by government, (iii) comparing the impact of different integration approaches, (iv) performing cost-benefit analysis for integration and (v) evaluating health system capacity needs. Conclusions: Modelling can and should play an integral part in the decision-making processes for health in general and NCD-HIV integration specifically. It is especially useful where little data is available. The successful use of modelling to inform decision-making will depend on several factors including policy makers' comfort with and understanding of models and their uncertainties, modellers understanding of national priorities, funding opportunities and building local modelling capacity to ensure sustainability Keywords: policy; integration; modelling; Kenya; non-communicable diseases; HIV

Published
2020
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21. The Burden of Type 1 and Type 2 Diabetes Among Adolescents and Young Adults in 24 Western European Countries, 1990–2019: Results From the Global Burden of Disease Study 2019

Author

Armocida, Benedetta, Monasta, Lorenzo, Sawyer, Susan M., Bustreo, Flavia, Onder, Graziano, Castelpietra, Giulio, Pricci, Flavia, Minardi, Valentina, Giacomozzi, Claudia, Abbafati, Cristiana, Stafford, Lauryn K., Pasovic, Maja, Hay, Simon I., Ong, Kanyin Lian, Perel, Pablo, Larsson, Anders, Beran, David, Armocida, Benedetta, Monasta, Lorenzo, Sawyer, Susan M., Bustreo, Flavia, Onder, Graziano, Castelpietra, Giulio, Pricci, Flavia, Minardi, Valentina, Giacomozzi, Claudia, Abbafati, Cristiana, Stafford, Lauryn K., Pasovic, Maja, Hay, Simon I., Ong, Kanyin Lian, Perel, Pablo, Larsson, Anders, and Beran, David

Published
2024
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22. The Burden of Type 1 and Type 2 Diabetes Among Adolescents and Young Adults in 24 Western European Countries, 1990–2019:Results From the Global Burden of Disease Study 2019

Author

Armocida, Benedetta, Monasta, Lorenzo, Sawyer, Susan M., Bustreo, Flavia, Onder, Graziano, Castelpietra, Giulio, Pricci, Flavia, Minardi, Valentina, Giacomozzi, Claudia, Abbafati, Cristiana, Stafford, Lauryn K., Pasovic, Maja, Hay, Simon I., Ong, Kanyin Lian, Perel, Pablo, Beran, David, Abolhassani, Hassan, Adane, Tigist Demssew, Ahmed, Ayman, Ali Al-Ahdal, Tareq Mohammed, Andrei, Catalina Liliana, Artamonov, Anton A., Arumugam, Ashokan, Asaduzzaman, Muhammad, Banach, Maciej, Barchitta, Martina, Bärnighausen, Till Winfried, Barone-Adesi, Francesco, Belo, Luis, Bikbov, Boris, Bonny, Aime, Briko, Nikolay Ivanovich, Calina, Daniela, Charalampous, Periklis, Chen, Simiao, Chowdhury, Rajiv, Cruz-Martins, Natália, Dadras, Omid, Dianatinasab, Mostafa, Dinu, Monica, Dziedzic, Arkadiusz Marian, Fischer, Florian, Gaal, Peter Andras, Gyawali, Bishal, Hammoud, Ahmad, Haubold, Johannes, Herteliu, Claudiu, Hussain, Salman, Ilic, Irena M., Ilic, Milena D., Armocida, Benedetta, Monasta, Lorenzo, Sawyer, Susan M., Bustreo, Flavia, Onder, Graziano, Castelpietra, Giulio, Pricci, Flavia, Minardi, Valentina, Giacomozzi, Claudia, Abbafati, Cristiana, Stafford, Lauryn K., Pasovic, Maja, Hay, Simon I., Ong, Kanyin Lian, Perel, Pablo, Beran, David, Abolhassani, Hassan, Adane, Tigist Demssew, Ahmed, Ayman, Ali Al-Ahdal, Tareq Mohammed, Andrei, Catalina Liliana, Artamonov, Anton A., Arumugam, Ashokan, Asaduzzaman, Muhammad, Banach, Maciej, Barchitta, Martina, Bärnighausen, Till Winfried, Barone-Adesi, Francesco, Belo, Luis, Bikbov, Boris, Bonny, Aime, Briko, Nikolay Ivanovich, Calina, Daniela, Charalampous, Periklis, Chen, Simiao, Chowdhury, Rajiv, Cruz-Martins, Natália, Dadras, Omid, Dianatinasab, Mostafa, Dinu, Monica, Dziedzic, Arkadiusz Marian, Fischer, Florian, Gaal, Peter Andras, Gyawali, Bishal, Hammoud, Ahmad, Haubold, Johannes, Herteliu, Claudiu, Hussain, Salman, Ilic, Irena M., and Ilic, Milena D.

Abstract

Objectives: As little is known about the burden of type 1 (T1DM) and type 2 diabetes (T2DM) in adolescents in Western Europe (WE), we aimed to explore their epidemiology among 10–24 year-olds. Methods: Estimates were retrieved from the Global Burden of Diseases Study (GBD) 2019. We reported counts, rates per 100,000 population, and percentage changes from 1990 to 2019 for prevalence, incidence and years lived with disability (YLDs) of T1DM and T2DM, and the burden of T2DM in YLDs attributable to high body mass index (HBMI), for 24 WE countries. Results: In 2019, prevalence and disability estimates were higher for T1DM than T2DM among 10–24 years old adolescents in WE. However, T2DM showed a greater increase in prevalence and disability than T1DM in the 30 years observation period in all WE countries. Prevalence increased with age, while only minor differences were observed between sexes. Conclusion: Our findings highlight the substantial burden posed by DM in WE among adolescents. Health system responses are needed for transition services, data collection systems, education, and obesity prevention.

Published
2024

28. User requirements for non-invasive and minimally invasive glucose self-monitoring devices in low-income and middle-income countries: a qualitative study in Kyrgyzstan, Mali, Peru and Tanzania

Author

Safary, Elvis, primary, Beran, David, additional, Vetter, Beatrice, additional, Lepeska, Molly, additional, Abdraimova, Aida, additional, Dunganova, Asel, additional, Besançon, Stéphane, additional, Lazo-Porras, Maria, additional, Portocarrero Mazanett, Jill, additional, Pérez-León, Silvana, additional, Maixenchs, Maria, additional, Nchimbi, Happy, additional, Ramaiya, Kaushik, additional, Munishi, Castory, additional, and Martínez-Pérez, Guillermo Z, additional

Published
2024
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29. Development of a target product profile for new glucose self-monitoring technologies for use in low- and middle-income countries.

Author

Safary, Elvis, Lepeska, Molly, Beran, David, Ewen, Margaret, Zhaparova, Aigerim, Rukare, Jackie, Boulle, Philippa, Aebischer Perone, Sigiriya, Makohliso, Solomzi, Pleus, Stefan, and Vetter, Beatrice

Subjects
MIDDLE-income countries, PEOPLE with diabetes, HIGH-income countries, PRICES, GLUCOSE
Abstract

Aims: Most glucose self-monitoring devices have been developed with high-income countries in mind. We developed a target product profile (TPP) for new glucose self-monitoring technologies for users in low- and middle-income countries (LMICs). Methods: A draft TPP including 39 characteristics was developed by an expert group including diabetes specialists, device specialists, and people with diabetes, incorporating findings from qualitative research in LMICs. Each characteristic had minimal and optimal requirements for two use cases, frequent and sporadic use. Characteristics requiring refinement were identified via online survey. Characteristics with agreement level <90% for any requirement were reviewed by the expert group and amended as appropriate. Results: One characteristic (shelf life) had agreement <75% (both requirements for both use cases). Characteristics with agreement ≥75% and <90% for the frequent use case included infrastructure level, measurement cycle, duration of use before replacement, interchangeability, and calibration (both requirements), and activity log and price per month to end payer (minimal requirement). Intended use (both requirements), accuracy, and price per month to end payer (optimal requirement) had agreement ≥75% and <90% for the sporadic use case. Conclusions: This TPP will inform developers on requirements for glucose self-monitoring technologies for LMICs, and support decision-makers in evaluating existing devices. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Access to insulin: applying the concept of security of supply to medicines/Acces a l'insuline: application du concept de securite d'approvisionnement aux medicaments/Acceso a la insulina: aplicacion del concepto de seguridad en el suministro a los medicamentos

Author

Beran, David, Mirza, Zafar, and Dong, Jicui

Subjects
United Nations. Children's Fund, International economic relations, Intellectual property, Sustainable development, Multinational corporations, World health, Insulin, Business logistics
Abstract

Introduction Improving access to medicines is included in sustainable development goal (SDG) 3, which is to ensure healthy lives and promote well-being for all at all ages. (1) Nonetheless, estimations [...], Security of supply of medicines is fundamental to ensure health for all. Furthermore, improving access to medicines is included in sustainable development goal 3. However, the concept of security of supply has mostly been applied to food, water and energy. Diversity of supply, vulnerability to disruption, expenditure, infrastructure, stability of exporting countries, ownership of production, price stability, access and equity, affordability, intellectual property, safety and reliability of supply, and countries&apos; capacity to adapt to market changes are all elements of security of supply. Based on these elements, we assessed security of supply for insulin, since access to insulin is a global problem. We found that three multinational companies, in Denmark, France and Germany, control 99% of the value of the global insulin market. Prices and affordability of insulin and access to it vary considerably between countries. Some countries are vulnerable to insulin shortage because they import insulin from only one source. Many countries spend large amounts of money on insulin and costs are increasing. Some countries lack an adequate infrastructure for procurement, supply chain management and distribution of insulin. Applying the security of supply concept to insulin showed that diversification of suppliers needs to be fostered. Global health actors should adopt a security of supply approach to identify medicines that are susceptible to supply issues and address this concern by strategic promotion of local production, strengthening regulatory harmonization, and adding local products to the World Health Organization&apos;s programme on prequalification of medicines. [phrase omitted] La securite de l&apos;approvisionnement en medicaments est fondamentale pour garantir une bonne sante pour tous. De plus, l&apos;amelioration de l&apos;acces aux medicaments figure dans l&apos;Objectif de developpement durable no 3. Or, le concept de securite d&apos;approvisionnement a jusqu&apos;a present ete principalement applique aux aliments, aux boissons et a l&apos;energie. La diversite d&apos;approvisionnement, la vulnerabilite face aux perturbations de la chaine d&apos;approvisionnement, les infrastructures, la stabilite des pays exportateurs, la propriete des moyens de production, la stabilite des prix, l&apos;acces et l&apos;equite, l&apos;accessibilite des prix, la propriete intellectuelle, la surete et la fiabilite de l&apos;approvisionnement ainsi que la capacite des pays a s&apos;adapter aux evolutions du marche sont autant de notions inherentes a la securite d&apos;approvisionnement. A partir de ces elements, nous avons evalue la securite d&apos;approvisionnement pour l&apos;insuline, etant donne que l&apos;acces a l&apos;insuline constitue un enjeu mondial. Nous avons constate que trois multinationales (au Danemark, en France et en Allemagne) controlent 99% de la valeur du marche mondial de l&apos;insuline. Les prix, leur accessibilite ainsi que l&apos;acces a l&apos;insuline varient considerablement d&apos;un pays a un autre. Certains pays sont vulnerables face aux penuries d&apos;insuline, car ils n&apos;importent l&apos;insuline qu&apos;aupres d&apos;une seule source. De nombreux pays depensent enormement d&apos;argent pour l&apos;insuline, et les couts sont en augmentation. Certains pays n&apos;ont pas d&apos;infrastructures appropriees pour les achats, la gestion de la chaine d&apos;approvisionnement et la distribution de l&apos;insuline. Lapplication du concept de securite d&apos;approvisionnement a l&apos;insuline nous a montre que la diversification des fournisseurs doit etre encouragee. Les acteurs mondiaux de la sante devraient adopter une approche de securite d&apos;approvisionnement pour identifier les medicaments susceptibles de connaitre des problemes d&apos;approvisionnement et repondre a cet enjeu par la promotion strategique d&apos;une production locale, le renforcement de l&apos;harmonisation reglementaire et l&apos;ajout de produits locaux dans le programme de l&apos;Organisation mondiale de la Sante sur la prequalification des medicaments. [phrase omitted] La seguridad en el suministro de medicamentos es fundamental para garantizar la salud de todos. Ademas, la mejora del acceso a los medicamentos esta incluida en el objetivo de desarrollo sostenible 3. Sin embargo, el concepto de seguridad en el suministro se ha aplicado principalmente a los alimentos, el agua y la energia. La diversidad del suministro, la vulnerabilidad a las perturbaciones, el gasto, la infraestructura, la estabilidad de los paises exportadores, la propiedad de la produccion, la estabilidad de los precios, el acceso y la equidad, la asequibilidad, la propiedad intelectual, la seguridad y la fiabilidad del suministro y la capacidad de los paises para adaptarse a los cambios del mercado son todos elementos que se incluyen en la seguridad en el suministro. Con base en estos elementos, se ha evaluado la seguridad del suministro de insulina, ya que el acceso a esta es un problema mundial. Se ha descubierto que tres empresas multinacionales, en Dinamarca, Francia y Alemania, controlan el 99 % del valor de mercado mundial de insulina. Los precios y la asequibilidad de la insulina y el acceso a ella varian considerablemente de un pais a otro. Algunos paises son vulnerables a la escasez de insulina porque la importan de una sola fuente. Muchos paises gastan grandes cantidades de dinero en insulina y los costes aumentan. Algunos paises carecen de una infraestructura adecuada para la adquisicion, la gestion de la cadena de suministro y la distribucion de insulina. La aplicacion del concepto de seguridad en el suministro a la insulina demostro que es necesario fomentar la diversificacion de los proveedores. Los agentes de la salud mundial deberian adoptar un enfoque de seguridad en el suministro para identificar los medicamentos que son susceptibles de problemas de suministro y abordar esta preocupacion mediante la promocion estrategica de la produccion local, el fortalecimiento de la armonizacion de los reglamentos y la incorporacion de los productos locales al programa de la Organizacion Mundial de la Salud sobre la precalificacion de los medicamentos.

Published
2019
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37. Diabetes in sub-Saharan Africa: from clinical care to health policy

Author

Atun, Rifat, Davies, Justine I, Gale, Edwin A M, Bärnighausen, Till, Beran, David, Kengne, Andre Pascal, Levitt, Naomi S, Mangugu, Florence W, Nyirenda, Moffat J, Ogle, Graham D, Ramaiya, Kaushik, Sewankambo, Nelson K, Sobngwi, Eugene, Tesfaye, Solomon, Yudkin, John S, Basu, Sanjay, Bommer, Christian, Heesemann, Esther, Manne-Goehler, Jennifer, Postolovska, Iryna, Sagalova, Vera, Vollmer, Sebastian, Abbas, Zulfiqarali G, Ammon, Benjamin, Angamo, Mulugeta Terekegn, Annamreddi, Akhila, Awasthi, Ananya, Besançon, Stéphane, Bhadriraju, Sudhamayi, Binagwaho, Agnes, Burgess, Philip I, Burton, Matthew J, Chai, Jeanne, Chilunga, Felix P, Chipendo, Portia, Conn, Anna, Joel, Dipesalema R, Eagan, Arielle W, Gishoma, Crispin, Ho, Julius, Jong, Simcha, Kakarmath, Sujay S, Khan, Yasmin, Kharel, Ramu, Kyle, Michael A, Lee, Seitetz C, Lichtman, Amos, Malm, Carl P, Mbaye, Maïmouna N, Muhimpundu, Marie A, Mwagomba, Beatrice M, Mwangi, Kibachio Joseph, Nair, Mohit, Niyonsenga, Simon P, Njuguna, Benson, Okafor, Obiageli L O, Okunade, Oluwakemi, Park, Paul H, Pastakia, Sonak D, Pekny, Chelsea, Reja, Ahmed, Rotimi, Charles N, Rwunganira, Samuel, Sando, David, Sarriera, Gabriela, Sharma, Anshuman, Sidibe, Assa, Siraj, Elias S, Syed, Azhra S, Van Acker, Kristien, and Werfalli, Mahmoud

Published
2017
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38. Problems and Solutions

Author

Bracken, Paul, Tong, Zengxiang, Nelsen, Roger B., Johnson, Pete, Leach, Dave, Lee, Ho-joo, Sastry, K. R. S., Sedinger, Harry, Schmidt, Frank, Donini, Daniele, Shan, Zun, Patenaude, Robert, Mombelli, Juan Martin, McDougal, Kevin, Muthuvel, Kandasamy, Zimmerman, Seth, and Beran, David

Published
1999
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39. Problems and Solutions

Author

Schmidt, Frank, Zimmerman, Seth, Tudoran, Razvan, Risteski, Ice B., Eynden, Charles Vanden, Mombelli, Juan Martin, Vandergriff, Jim, Mackiw, George, Hsia, Cyrus C., Donini, Daniele, Beran, David, Barbara, Roy, Andreoli, Michael, and Steelman, John Henry

Published
1999
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40. Problems and Solutions

Author

Mombelli, Juan Martin, Mackiw, George, Schmidt, Frank, Beran, David, Andreoli, Michael, Wardlaw, William P., Lewis, Kathleen E., Pan, Yi-Chuan, Doucette, Robert L., Diminnie, Charles R., Smith, Trey, Marquez, Juan-Bosco Romero, Fukuta, Jiro, Donini, Daniele, Stone, A. P., and Burgermeister, P. F.

Published
1998
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45. Teplizumab approval for type 1 diabetes in the USA

Author

Beran, David, Abidha, Carol, Adler, Amanda, de Beaufort, Carine, Lepeska, Molly, Levitt, Naomi, Pfiester, Elizabeth, Zafra Tanaka, Jessica Hanae, and Gale, Edwin Am

Subjects
Diabetes Mellitus, Type 1, Endocrinology, Teplizumab, type 1 diabetes, Endocrinology, Diabetes and Metabolism, Internal Medicine, USA, United States
Abstract

The US Food and Drug Administration's (FDA) approval of teplizumab to delay the onset of type 1 diabetes could be seen as symbolic, because it came a century after the first use of insulin. Teplizumab, an anti-CD3 monoclonal antibody, is now approved in the USA for people at high risk of type 1 diabetes. This approval is a highly welcome development for this population and all those involved in the care and wellbeing of people with type 1 diabetes. However, in our opinion, the approval of teplizumab should be interpreted with caution. A global health perspective must consider evidence, cost, patient preferences, and equity...

Published
2023
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46. Using Clinical Vignettes to Understand the Complexity of Diagnosing Type 1 Diabetes in Sub-Saharan Africa

Author

Le Bec,Enora, Kam,Madibele, Aebischer Perone,Sigiriya, Boulle,Philippa, Cikomola,Justin, Gandur,Maria Eugenia, Gehri,Mario, Kehlenbrink,Sylvia, Beran,David, Le Bec,Enora, Kam,Madibele, Aebischer Perone,Sigiriya, Boulle,Philippa, Cikomola,Justin, Gandur,Maria Eugenia, Gehri,Mario, Kehlenbrink,Sylvia, and Beran,David

Abstract

Enora Le Bec,1 Madibele Kam,2 Sigiriya Aebischer Perone,3,4 Philippa Boulle,5 Justin Cirhuza Cikomola,6 Maria Eugenia Gandur,5 Mario Gehri,7 Sylvia Kehlenbrink,8 David Beran3,9 1Internal Medicine, Etablissements Hospitaliers du Nord Vaudois, Yverdon, Switzerland; 2Pediatric University Hospital Charles de Gaulle, Ouagadougou, Burkina Faso; 3Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland; 4Health Unit, International Committee of the Red Cross, Geneva, Switzerland; 5Médecins sans Frontières, Geneva, Switzerland; 6Faculty of Medicine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo; 7Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; 8Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Boston, MA, USA; 9Faculty of Medicine, University of Geneva, Geneva, SwitzerlandCorrespondence: Enora Le Bec, Hôpital d’Yverdon-les-Bains, Rue d’Entremonts 11, Yverdon-les-Bains, 1400, Switzerland, Tel +41 24 424 44 44, Fax +41 24 424 43 60, Email enora.lebec@gmail.comAbstract: Lack of awareness, access to insulin and diabetes care can result in high levels of morbidity and mortality for children with type 1 diabetes (T1DM) in sub-Saharan Africa (SSA). Improvements in access to insulin and diabetes management have improved outcomes in some settings. However, many people still present in diabetic ketoacidosis (DKA) in parallel to misdiagnosis of children with T1DM in contexts with high rates of communicable diseases. The aim of this study was to highlight the complexity of diagnosing pediatric T1DM in a healthcare environment dominated by infectious diseases and lack of adequate health system resources. This was done by developing clinical vignettes and recreating the hypothetico-deductive process of a clinician confronted with DKA in the absence of identification of pathognomonic elements of diabetes and with limited diagnostic tools. A non-systema

Published
2023

47. An Online Survey of the Perceptions of Clinical Professionals on Healthcare for Non-Communicable Diseases and Covid-19 Measures During the Pandemic in Malaysia

Author

Oris, Michel [0000-0002-6435-9448], Sureshkumar, Sugitha, Mustapha, Feisul, Yusoff, Haironi, Mwangi, Kibachio Joseph, Marcus, Kailing, Kohlbrenner, Bogomil, Issom, David, Benissa, Mohamed-Rida, Aebischer-Perone, Sigiriya, Braha, Nirit, Candela, Egidio, Chhabra, Kumar Gaurav, Desikachari, B. R., Dondi, Arianna, Etchebehere, Marina, Gathecha, Gladwell, Pascal Kengne, Andre, Missoni, Eduardo, Palafox, Benjamin, Pati, Sanghamitra, Madhu, Priyanka Paul, Peer, Nasheeta, Quint, Jennifer, Tabrizi, Reza, Oris, Michel, Beran, David, Balabanova, Dina, Etter, Jean François, Oris, Michel [0000-0002-6435-9448], Sureshkumar, Sugitha, Mustapha, Feisul, Yusoff, Haironi, Mwangi, Kibachio Joseph, Marcus, Kailing, Kohlbrenner, Bogomil, Issom, David, Benissa, Mohamed-Rida, Aebischer-Perone, Sigiriya, Braha, Nirit, Candela, Egidio, Chhabra, Kumar Gaurav, Desikachari, B. R., Dondi, Arianna, Etchebehere, Marina, Gathecha, Gladwell, Pascal Kengne, Andre, Missoni, Eduardo, Palafox, Benjamin, Pati, Sanghamitra, Madhu, Priyanka Paul, Peer, Nasheeta, Quint, Jennifer, Tabrizi, Reza, Oris, Michel, Beran, David, Balabanova, Dina, and Etter, Jean François

Abstract

Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022. Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing. Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation. Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.

Published
2023

48. Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya

Author

Oris, Michel [0000-0002-6435-9448], Sureshkumar, Sugitha, Mwangi, Kibachio Joseph, Gathecha, Gladwell, Marcus, Kailing, Kohlbrenner, Bogomil, Issom, David, Bennissa, Mohamed-Rida, Aebischer-Perone, Sigiriya, Braha, Nirit, Candela, Egidio, Chhabra, Kumar Gaurav, Ramachandran Desikachari, Bava, Dondi, Arianna, Etchebehere, Marina, Pascal Kengne, Andre, Missoni, Eduardo, Mustapha, Feisul, Palafox, Benjamin, Pati, Sanghamitra, Madhu, Priyanka Paul, Peer, Nasheeta, Quint, Jennifer, Tabrizi, Reza, Yusoff, Haironi, Oris, Michel, Beran, David, Balabanova,, Dina, Etter, Jean François, Oris, Michel [0000-0002-6435-9448], Sureshkumar, Sugitha, Mwangi, Kibachio Joseph, Gathecha, Gladwell, Marcus, Kailing, Kohlbrenner, Bogomil, Issom, David, Bennissa, Mohamed-Rida, Aebischer-Perone, Sigiriya, Braha, Nirit, Candela, Egidio, Chhabra, Kumar Gaurav, Ramachandran Desikachari, Bava, Dondi, Arianna, Etchebehere, Marina, Pascal Kengne, Andre, Missoni, Eduardo, Mustapha, Feisul, Palafox, Benjamin, Pati, Sanghamitra, Madhu, Priyanka Paul, Peer, Nasheeta, Quint, Jennifer, Tabrizi, Reza, Yusoff, Haironi, Oris, Michel, Beran, David, Balabanova,, Dina, and Etter, Jean François

Abstract

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption.

Published
2023

49. A plan to improve global type 1 diabetes epidemiology data

Author

Beran, David, Højlund, Kurt, Besançon, Stéphane, Mundt, Mads Loftager, Ogle, Graham D., Ramaiya, Kaushik, Robinson, Tom, Svensson, Jannet, Tuomilehto, Jaakko, Wild, Sarah, Green, Anders, Beran, David, Højlund, Kurt, Besançon, Stéphane, Mundt, Mads Loftager, Ogle, Graham D., Ramaiya, Kaushik, Robinson, Tom, Svensson, Jannet, Tuomilehto, Jaakko, Wild, Sarah, and Green, Anders

Published
2023

50. Outcomes measured in studies assessing health systems interventions for type 1 diabetes management: A scoping review.

Author

Zafra‐Tanaka, Jessica Hanae, del Valle, Adela, Bernabé‐Ortiz, Antonio, Miranda, J. Jaime, and Beran, David

Subjects
GLYCOSYLATED hemoglobin, ONLINE information services, MEDICAL information storage & retrieval systems, SYSTEMATIC reviews, RESEARCH methodology, TYPE 1 diabetes, HEALTH outcome assessment, TREATMENT effectiveness, HYPOGLYCEMIA, DESCRIPTIVE statistics, QUALITY of life, MEDLINE, DIABETIC acidosis
Abstract

Aims: Describe the outcomes reported in research on health systems interventions for type 1 diabetes management in comparison to the outcomes proposed by a core outcome set (COS) for this condition, an essential list of outcomes that studies should measure. Methods: Systematic search of studies published between 2010 and 2021 reporting health systems interventions directed to improve the management of type 1 diabetes using PubMed, EMBASE and CENTRAL. Information on the outcomes was extracted and classified according to a COS: self‐management, level of clinical engagement, perceived control over diabetes, diabetes‐related quality of life, diabetes burden, diabetes ketoacidosis, severe hypoglycemia, and glycated hemoglobin (HbA1C). Results: 187 studies were included. Most of the studies included either children (n = 82/187) or adults (n = 82/187) living with type 1 diabetes. The most common outcome measured was HbA1C (n = 149/187), followed by self‐management (n = 105/187). While the least measured ones were diabetes ketoacidosis (n = 15/187), and clinical engagement (n = 0/187). None of the studies measured all the outcomes recommended in the COS. Additionally, different tools were found to be used in measuring the same outcome. Conclusions: This study provides a description of what researchers are measuring when assessing health systems interventions to improve type 1 diabetes management. In contrast to a COS, it was found that there is a predominance of clinical‐based outcomes over patient‐reported outcome measures. [ABSTRACT FROM AUTHOR]

Published
2024
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