Pastakia Sonak D, Pekny Chelsea R, Manyara Simon M, Fischer Lydia
Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN, USA.
Department of Pharmacy, Moi Teaching and Referral Hospital, Eldoret, Kenya.
Diabetes Metab Syndr Obes. 2017 Jun 22;10:247-263. doi: 10.2147/DMSO.S126314. eCollection 2017.
The global prevalence and impact of diabetes has increased dramatically, particularly in sub-Saharan Africa. This region faces unique challenges in combating the disease including lack of funding for noncommunicable diseases, lack of availability of studies and guidelines specific to the population, lack of availability of medications, differences in urban and rural patients, and inequity between public and private sector health care. Because of these challenges, diabetes has a greater impact on morbidity and mortality related to the disease in sub-Saharan Africa than any other region in the world. In order to address these unacceptably poor trends, contextualized strategies for the prevention, identification, management, and financing of diabetes care within this population must be developed. This narrative review provides insights into the policy landscape, epidemiology, pathophysiology, care protocols, medication availability, and health care systems to give readers a comprehensive summary of many factors in these domains as they pertain to diabetes in sub-Saharan Africa. In addition to providing a review of the current evidence available in these domains, potential solutions to address the major gaps in care will be proposed to reverse the negative trends seen with diabetes in sub-Saharan Africa.
糖尿病的全球患病率和影响急剧上升，尤其是在撒哈拉以南非洲地区。该地区在抗击糖尿病方面面临着独特的挑战，包括缺乏用于非传染性疾病的资金、缺乏针对该人群的研究和指南、药物供应不足、城乡患者差异以及公共和私营部门医疗保健之间的不公平。由于这些挑战，糖尿病对撒哈拉以南非洲地区与该疾病相关的发病率和死亡率的影响比世界上任何其他地区都更大。为了应对这些令人无法接受的不良趋势，必须制定针对该人群糖尿病护理的预防、识别、管理和融资的因地制宜的策略。本叙述性综述深入探讨了政策环境、流行病学、病理生理学、护理方案、药物供应和医疗保健系统，以便让读者全面了解这些领域中与撒哈拉以南非洲地区糖尿病相关的诸多因素。除了对这些领域现有证据进行综述外，还将提出解决护理重大差距的潜在解决方案，以扭转撒哈拉以南非洲地区糖尿病的负面趋势。
