COVID-19 exposes Africa diabetes danger
Manage your diabetes situation or
pay the price.
And according to the World Health
Organisation (WHO), COVID-19 is more fatal to Africans who have diabetes.
In a preliminary analysis
presented by WHO in advance of the World Diabetes Day on November 14, Africa’s
death rates from COVID-19 infections are significantly higher in patients with
diabetes.
“COVID-19 is delivering a clear
message: fighting the diabetes epidemic in Africa is in many ways as critical
as the battle against the current pandemic. The COVID-19 pandemic will
eventually subside, but Africa is projected in the coming years to experience
the highest increase in diabetes globally. We must act now to prevent new
cases, vaccinate people who have this condition and equally importantly,
identify and support the millions of Africans unaware they are suffering from
this silent killer,” Dr Matshidiso Moeti, WHO Regional Director for Africa,
said.
Diabetes impairs the body’s
ability to produce or process insulin, a substance essential to counteracting a
dangerous rise in blood sugar. The disease causes inflammation and poor blood
circulation, both of which increase the risk of complications, including death,
from COVID-19.
A recent WHO analysis evaluated
data from 13 countries on underlying conditions or comorbidities in Africans
who tested positive for COVID-19. It revealed a 10.2% case fatality rate in
patients with diabetes, compared with 2.5% for COVID-19 patients overall. The
case fatality rate for people with diabetes was also twice as high as the
fatality rate among patients suffering any comorbidity. In addition to people
with diabetes, the three most frequent underlying conditions included patients
with HIV and hypertension.
The countries contributing data
to the analysis were Burkina Faso, Chad, Cote d’Ivoire, Democratic Republic of
the Congo, Eswatini, Guinea, Namibia, Niger, Rwanda, Senegal, Seychelles, Sao
Tome and Principe and Uganda.
An estimated 24 million people
are living with diabetes in Africa in 2021 according to the International
Diabetes Federation and the continent is expected to experience the highest
increase in diabetes globally, with the number of Africans suffering from the
disease predicted to rise to 55 million by 2045, an increase of 134% compared
with 2021. Africa is the region with the highest number of people who do not
know their diagnosis – an estimated 70% of people with diabetes do not know
they have the disease.
“Health officials in Africa
should take advantage of the growing availability of low-cost rapid diagnostic
tests to routinely test patients in diabetes centres to ensure early detection
and proper care,” said Dr Benido Impouma, Director, Communicable and
Noncommunicable Diseases Cluster at WHO Regional Office for Africa. “These
centres also can be key venues for vaccination.”
Since the early days of the
pandemic, people with diabetes in countries around the world have been
prioritized to receive COVID-19 vaccinations. Africa has faced challenges in
this strategy.
Access to vaccines remains poor.
Thus far, only 6.6% of the African population is fully vaccinated against
COVID-19, compared with about 40% globally. Data from 37 countries indicates
that since March 2021, over 6.5 million COVID-19 vaccine doses have gone to
Africans with comorbidities, representing 14% of all doses administered so far.
Efforts to prioritize people with comorbidities, like diabetes, are
accelerating with about half of those 6.5 million doses administered in just
the last couple of months. However, there is still a lot more work to be done
to ensure people at high risk receive the vaccines they need.
“Nine months since COVID-19
vaccination campaigns began in Africa, we are still nowhere near where we need
to be with protecting our most vulnerable,” Dr Moeti said. “There is an urgent
need to step up vaccination and other key services to people at high risk, including
those with diabetes.”
There are two main types of
diabetes: type 1 caused by a condition early in life that damages the pancreas
and impairs insulin production; and type 2—which is linked to poor diet,
obesity and lack of exercise—where the body struggles to process insulin. About
90% of diabetes cases globally, and the vast majority in Africa, are type 2,
with rising rates in Africa attributed to the same poor diets and sedentary
lifestyles causing a surge in type 2 diabetes around the world. In addition to
COVID-19 risks, diabetes can also increase risk of heart attack, stroke, kidney
failure, lower limb amputation, visual impairment, blindness and nerve damage, including
erectile dysfunction.
“All Africans at risk of diabetes
must have access to testing,” Dr Moeti said. “We can also stop diabetes from
claiming more lives by promoting healthy, affordable diets and regular
exercise.”
During the COVID-19 pandemic,
access to diabetes care has been severely disrupted in the African Region.
Lockdowns to limit the spread of COVID-19, for example, have impeded access to
health care and the basic elements of proper disease management, such as
routine glucose monitoring and eating a healthy diet.
To improve equitable access to
quality diabetes care, WHO launched the Global Diabetes Compact in April 2021.
This builds on work in recent years to rollout the WHO Package of Essential
Noncommunicable Disease (WHO PEN) interventions for primary health care in
low-resource settings. So far 21 African countries have started using this
package. Benin, Eritrea, Eswatini, Lesotho and Togo have achieved national
expansion covering all primary health care facilities.
WHO held a virtual press
conference today facilitated by APO Group. Dr Impouma was joined by Professor
Maïmouna Ndour Mbaye, Head of the Internal Medicine unit, Cheikh Anta Diop
University of Dakar and Director, National Diabetes Centre, Senegal, and Mr
Greg Tracz, Chief Executive Officer, Diabetes Africa.
Also on hand to respond to
questions were Dr Phionah Atuhebwe, New Vaccines Introduction Officer, WHO
Regional Office for Africa, Dr Thierno Balde, Regional COVID-19 Incident
Manager, WHO Regional Office for Africa, and Dr Jean-Marie Dangou, Coordinator,
Noncommunicable Diseases Programme, WHO Regional Office for Africa.
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