Type 1 diabetes in low and middle-income countries - Tanzania a streak of hope

Ludvigsson, Johnny; Edna, Majaliwa; Ramaiya, Kaushik

doi:10.3389/fendo.2023.1043370

Cited by 3 publications

(1 citation statement)

References 40 publications

(36 reference statements)

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“…This finding is lower than a study conducted Tanzania, 38.3% of DKA prevalence in 2022 despite the fact that the nation DKA trend was decreased over time, from 89.9% in 2005. 30 Another retrospective study conducted in Benin teaching hospital found the frequency of DKA in newly diagnosed adults to be 77.1%. 31 This frequency is higher relatives to our study, and this might be due to the Benin study, included adults b/n 15–35 years of age and because the study period was 15 years.…”

Section: Discussionmentioning

confidence: 99%

Burden of diabetic ketoacidosis among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis

Abera,

Yesho,

Erega

et al. 2024

BMJ Open

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ObjectivesThis systematic review and meta-analysis aimed to assess the magnitude and determinants of diabetic ketoacidosis (DKA) among patients with diabetes mellitus (DM) in Ethiopia.DesignSystematic review and meta-analysis.ParticipantsAge 15 and above all patients with diabetes with the diagnosis of DKA in EthiopiaData sourcePubMed/MEDLINE, Cochrane Library, Science Direct, HINARI, Google Scholar and grey literatures were accessed to find relevant articles. Studies that have been conducted and reported in English language, articles with an available full-text, and observational studies were included. The task of searching sources was carried out from all stated electronic databases performed during 15 April–29 April 2023.Primary and secondary outcome measuresEligible studies were critically appraised by three independent reviewers for methodological quality in the review using standardised critical appraisal instruments from Joanna Briggs Institute (JBI) for observational studies. After the finally extracted studies were exported, systematic review and meta-analysis were conducted using Unified Management, Assessment and Review of Information (JBI SUMARI) (JBI, Adelaide, Australia) and STATA V.17 software. Sensitivity tests were done, and funnel plot inspections with Egger’s test were used to check for publication bias.ResultFrom a total of 19 studies with 6498 study participants, the pooled prevalence of DKA among patients with DM in Ethiopia was 30.92% (95% CI 29.96 to 31.89) with a significant statistical heterogeneity (I2=99.2, p=<0.001). Sensitivity analysis suggested that three studies showed deviations from the estimated pooled prevalence. A funnel plot inspection and Egger’s test indicated the absence of a publication bias.ConclusionThis systematic review and meta-analysis revealed that the prevalence of DKA among patients with DM in Ethiopia was 30.92%. Besides, different behavioural and clinical determinants of DKA among patients with DM were identified. However, further studies should be conducted, particularly on the possible determinants of DKA, and different stakeholders should be engaged to minimise its burden.

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Section: Discussionmentioning

confidence: 99%

Burden of diabetic ketoacidosis among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis

Abera,

Yesho,

Erega

et al. 2024

BMJ Open

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Mid-level healthcare workers knowledge on non-communicable diseases in Tanzania: a district-level pre-and post-training assessment

Karoli,

Mayige,

Kagaruki

et al. 2024

BMC Health Serv Res

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Introduction Over the past two decades, Tanzania’s burden of non-communicable diseases has grown disproportionately, but limited resources are still prioritized. A trained human resource for health is urgently needed to combat these diseases. However, continuous medical education for NCDs is scarce. This paper reports on the mid-level healthcare workers knowledge on NCDs. We assessed the knowledge to measure the effectiveness of the training conducted during the initiation of a Package for Essential Management of Severe NCDs (PEN Plus) in rural district hospitals in Tanzania. Methods The training was given to 48 healthcare employees from Dodoma Region’s Kondoa Town Council District Hospital. For a total of five (5) days, a fundamental course on NCDs featured in-depth interactive lectures and practical workshops. Physicians from Tanzania’s higher education institutions, tertiary university hospitals, research institutes, and medical organizations served as trainers. Before and after the training, a knowledge assessment comprising 28 questions was administered. Descriptive data analysis to describe the characteristics of the specific knowledge on physiology, diagnosis and therapy of diabetes mellitus, rheumatic fever, heart disease, and sickle cell disease was done using Stata version 17 (STATA Corp Inc., TX, USA). Results Complete assessment data for 42 out of the 48 participants was available. Six participants did not complete the training and the assessment. The mean age of participants was 36.9 years, and slightly above half (52%) were above 35 years. Two-thirds (61.9%) were female, and about half (45%) were nurses. The majority had the experience of working for more than 5 years, and the average was 9.4 years (+/- 8.4 years). Overall, the trainees’ average scores improved after the training (12.79 vs. 16.05, p < 0.0001) out of 28 possible scores. Specifically, trainees’ average scores were better in treatment than in diagnosis, except for sickle cell disease (1.26 vs. 1.83). Most were not able to diagnose rheumatic heart disease (47.6% able) compared to diabetes mellitus (54.8% able) or sickle cell disease (64.3% able) at baseline. The proportion of trainees with adequate knowledge of the treatment of sickle cell disease and diabetes mellitus was 35% and 38.1%, respectively, and there was a non-statistical difference after training. Those working for less than 5 years had a higher proportion of adequate knowledge (30.8%) compared to their more experienced colleagues (6.9%). After the training, participants’ knowledge of NCDs increased by three times (i.e., aPR 3, 95% CI = 1.1, 1.5, and 6.0). Conclusion and recommendations PEN Plus training improved the knowledge of healthcare workers at Kondoa Town Council District Hospital. Training is especially needed among nurses and those with a longer duration of work. Continuing education for human resources for health on the management of NCDs is highly recommended in this setting.

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Range of Disabilities

2024

Discussions of Inclusive Education Within African Contexts

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As previously discussed in chapter one, there are a range of disabilities that educators may be faced with. Therefore, it is crucial for educators in Africa to understand the different types of disabilities that are there so they may know the best practices to use. This chapter provides an overview of the different types of disabilities that teachers might encounter. The disabilities may be categorized as high incidence disabilities and low incidence disabilities. High incidence disabilities are disabilities that are likely to be seen in regular or mainstream classrooms or those that are common among the student population (i.e., learning disabilities, ADHD, EBD). Conversely, low incidence disabilities are less likely to occur in a student population (i.e., hearing impairments, significant intellectual disabilities, deaf blindness).

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Type 1 diabetes in low and middle-income countries - Tanzania a streak of hope

Cited by 3 publications

References 40 publications

Burden of diabetic ketoacidosis among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis

Burden of diabetic ketoacidosis among patients with diabetes mellitus in Ethiopia: a systematic review and meta-analysis

Mid-level healthcare workers knowledge on non-communicable diseases in Tanzania: a district-level pre-and post-training assessment

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