Estimating the burden of disease attributable to diabetes in South Africa in 2000

Abstract

Naomi S Levitt, MB ChB, MD, FCP (SA)Corresponding author : D Bradshaw (Debbie.Bradshaw@mrc.ac.za) Objectives. To estimate the burden of disease attributable to diabetes by sex and age group in South Africa in 2000.

Diabetes mellitus and non-traumatic lower extremity amputations in four public sector hospitals in Cape Town, South Africa, during 2009 and 2010

“…This is in keeping with numerous studies conducted elsewhere that have stated that LEAs represent a considerable cost for such services, not only for the admission and amputation, but also for the additional components of rehabilitation, home care and social services. [6,9,17,18] The human cost is also considerable for the patients, their families and society. The best way to decrease these costs is to decrease the number of foot complications, including LEAs.…”

“…[27] A number of reasons may account for suboptimal foot care: high patient numbers and decreased consultation times leading to infrequent foot examinations, limited opportunities for patient education and therefore non-adherence, as well as inadequate overall treatment at a primary healthcare level. [6,19,28] While preventive diabetes foot care is not the sole preserve of the doctor or a podiatrist, it is important to note that there is a lack of podiatrists to adequately prevent and treat these complications. Nurses, health promoters and community health workers can all contribute to a diabetes foot programme, but would need to receive appropriate training to enable patients to be active participants in their own care, to screen for at-risk feet and to refer appropriately for further management.…”

“…There is a wide range in the proportion of LEAs due to DM, with studies showing that up to 90% of LEAs worldwide are associated with DM and up to 70% of patients who undergo an LEA die within 5 years of the operation. [6,9,10] There are some African data on diabetes-related LEAs, primarily from small tertiary hospital studies. In each, diabetic foot complications were the major indication for non-traumatic LEAs.…”

Risk factors for myocardial infarction and stroke in Africa

“…(6,7) Addressing risk factors through primary and secondary prevention strategies have been shown to reduce mortality and morbidity. (7) Major risk factors for CVD in Africa may be similar to those in the Western world, but because African populations are of wide genetic and ethnic diversity, are heavily burdened by infectious diseases and at different stages of epidemiological health transition, it is uncertain whether information from studies in economically more developed countries can be applied to the African context.…”

Cost-effectiveness analysis for priority-setting in South Africa - what are the possibilities?

“…Key interventions were derived through examining international and local evidence (on cost-effectiveness, among other things) and through consulting with experts. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Importantly, these interventions are not simply biomedical in nature, but extend to interventions aimed at health promotion, social change and development. 31 Given remaining problems with the quality of national mortality data, and difficulties in obtaining disaggregated data on the disease burden faced by poor and marginalised communities, alternative strategies have emerged in South Africa.…”