Background. The prevalence and distribution of endocrine disorders in children in Africa are not well known because most cases are often undiagnosed or diagnosed too late. The awareness of this led to the launch of the Paediatric Endocrinology Training Center for Africa (PETCA) designed to improve quality and access to health care by training paediatricians from Africa in paediatric endocrinology. Methods. The fellowship is undertaken over an 18-month period: six months of clinical and theoretical training in Kenya, nine months of project research at the fellow's home country, and three months of consolidation in Kenya. Upon completion, certified paediatricians are expected to set up centers of excellence. Results. There have been two phases, phase I from January 2008 to October 2012 and phase II from January 2012 to April 2015. Fifty-four fellows from 12 African countries have been certified, 34 (phase I) and 20 (phase II). Over 1,000 patients with wide ranging diabetes and endocrine disorders have been diagnosed and treated and are being followed up at the centers of excellence. Conclusion. The successes of the PETCA initiative demonstrate the impact a capacity building and knowledge transfer model can have on people in resource-poor settings using limited resources.
The prevalence of disorders linked to paediatric endocrinology-including diabetes, obesity, endocrine cancers, and disorders of growth, thyroid function, adrenal glands, and sexual development-is increasing worldwide. More than 42 million children under age 5 years are obese, 1 and more than half a million children under age 14 years have type 1 diabetes. 2 At present, disorders of sexual development are reported in one in every 4500 births. 3 The number of children with these disorders who do not access care is unavailable, since few studies on paediatric endocrine disorders have been done. But in Africa, and elsewhere in the world, the number of paediatric subspecialists is inadequate. To remedy this, concerted eff orts are focused on capacity building of child health subspecialists, including endocrinologists. As of January, 2016, Kenya has eight boardcertifi ed paediatric endocrinologists, compared with only one before 2007, and seven of them are graduates of the Paediatric Endocrinology Training Centre for Africa (PETCA). Launched in 2007, PETCA is a capacity-building initiative developed to fi ll the urgent need for paediatric endocrinology subspecialists across sub-Saharan Africa.Although PETCA is the fi rst of its kind in Africa, similar programmes exist elsewhere-eg, the British Society for Paediatric Endocrinology and Diabetes, Australasia Paediatric Endocrine Group, Canadian Pediatric Endocrine Group, and the Certifi cate Course in Evidence Based Diabetes Management (CCEBDM) in India. These organisations run fellowship programmes that typically include 6-12 months of clinical and theoretical training, followed by
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