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Diabetes prevention, care challenges in Africa

Brazzaville – Africa is expected to experience the highest increase in diabetes globally. The number of people suffering from the disease is predicted to rise to 55 million by 2045—a 134% spike compared with 2021. At 70%, the continent also has the world’s highest number of people who do not know they have diabetes. Dr Bernadette Adeyileka-Tracz, Founder and Chief Operating Officer of Diabetes Africa, a non-profit organization working to improve the health of Africans living with diabetes, explains the challenges in diabetes prevention and care in the continent.

What are the challenges a person living with diabetes faces in Africa?

The number one challenge for a person living with type 1 or type 2 diabetes in Africa is diagnosis: people living with diabetes may not know they have the condition until serious complications develop. That’s because “looking healthy” is not the same as “being healthy.” People with excess blood sugar, particularly in the case of type 2 diabetes, can live without experiencing complications for a long time. However, when these complications do manifest, they present huge problems to livelihoods and add to the burden of already-strained health systems. Blindness, amputation, heart emergencies are not light complications.

In many places across the continent, this challenge is compounded by a lack of testing facilities or training among health workers that would enable them to identify risks early on. The earlier Type 2 diabetes or pre-diabetes can be diagnosed and treated, the better for the person and for the community at large.

The cost and access to medication is of course an acute challenge in Africa. We can add that managing blood glucose levels requires testing blood sugar levels regularly, and this presents challenges on its own: people living with diabetes should receive adequate training on the topic, but also be able to afford it: how can we expect people to test regularly if they must choose between feeding their families and buying test strips?

Diagnosis and testing are the first of a series of cascading challenges. Experts often use what they call the “rule of halves” to describe them: of 100 people living with diabetes, only 50 of them will have been diagnosed. The rest will live with the condition and its consequences without being aware of it. Of the 50 that have been diagnosed, 25 will receive care. The others are unable to seek care, for personal or economic reasons. Finally, among the 25 who receive adequate care, only 12 or 13 will meet their targets in terms of readings or measurements. But in the end, only six of them will have a positive health outcome.

This shows the scale of the challenge in front of us. It’s also possible that in remote and rural areas in Africa a rule of thirds or a rule of fourths applies.

How has COVID-19 made their situation worse?

COVID-19 has certainly increased risks for people living with diabetes. People living with diabetes are more likely to have more severe symptoms of COVID-19. Research is still ongoing, but anecdotal evidence coming from Africa tends to corroborate research done in the United Kingdom and in the United States of America. In the Democratic Republic of the Congo, for example, the analysis of a small sample of 215 people who died of COVID-19 showed that 30% of them had diabetes.

The public response to the pandemic has also had an impact on people living with diabetes. An initial reaction to the pandemic has been to encourage people to stay at home and reduce visits to the hospital. People living with diabetes also chose to stay at home for fear of catching the virus. With the pandemic stretching into 2021, this did not prove to be a sustainable solution.

The sudden global focus on health may have encouraged some people to control their diabetes better and make an extra effort, but in general, COVID-19 and its associated restrictions has meant that people became more sedentary, experienced stress and anxiety and had more difficulties keeping a healthy diet and controlling their diabetes.

Luckily, in most instances, hospitals and healthcare providers acknowledged these challenges and made a special effort to allow people living with chronic conditions to receive face-to-face care. Telemedicine has helped in countries where phone calls and video calls were a workable option, for example in Nigeria and Kenya. However, in other countries, such as Uganda for example, the cost and technical challenges of telemedicine were often prohibitive.

COVID-19 has also been the catalyst for positive changes. Civil society organizations have had an active role in encouraging governments to tackle non-communicable diseases like diabetes to lighten the burden on health systems. In Kenya, the Noncommunicable Diseases Alliance has been actively advocating for essential diabetes medicines to be covered by the National Health Insurance Fund.

How can countries innovate and manage diabetes in a low-resource setting?

It’s difficult to look at diabetes in isolation and ask how we could do more with less. Adequate healthcare demands a basic level of resources and given their impact on the overall system, noncommunicable diseases such as diabetes remain largely underfunded.

This is regrettable because managing health in a low-resource setting would benefit from actions that reduce costly complications, such as early diagnosis and prevention of diabetes. People who stay in the hospital with COVID-19 often have comorbidities. Can we not address these comorbidities at the source?

One of the greatest innovations in a low-resource setting would be to change mindsets: consider investing in keeping people healthy, rather than fixing problems. There will always be emergencies and costly operations that cannot be avoided. But diabetes need not be the cause of them.

This involves an effort to train healthcare professionals, inform and train people who may be at risk, sharing knowledge at a much greater scale, which is what Diabetes Africa aims to do. This would also entail working with commercial organizations, in particular in the food and beverage industry to label products and help people make informed decisions.

Source: World Health Organization. Africa

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World Prematurity Day – Saving every baby born too early

Abuja 17 November 2021 – In November 2019, Ijeoma Uchenna, 25 years old, was rushed to the hospital because she had a premature rupture of the membranes and mild contractions.

The baby was born at 33 weeks of pregnancy through an emergency Cesarean Section at a private hospital in Kubwa, Abuja.

Born prematurely, the baby required specialized care at the neonatal intensive care unit(NICU). A baby is premature if they are born before 37 weeks. Since the hospital had no such facility, they referred the baby to a government tertiary health institution, separating him from his mother. The baby travelled 34.6 kilometers before admitted in the NICU at a tertiary hospital in Abuja.

“Fortunately, there was a vacant incubator at the tertiary hospital. He was in the hospital for about four weeks before we brought him home”, said Ijeoma’s husband, Mr Uchenna.

In Kwali General Hospital, Jeremiah Bulus anxiously waits for his daughter to be attended to by a nurse. He and his wife are using Kangaroo care to keep her alive. (Kangaroo mother care involves infants being carried by the parent, with skin-to-skin contact).

“We constantly hold the newborn baby against our skin to keep her warm. The close body contact help stabilize the baby’s temperature, steady her heartbeat and help her breathe”, said the father carrying the baby on his chest.

Like the Uchennas, many families with premature birth in Nigeria undergo the stress of referral to other health facilities to keep the newborn alive.

Approximately 15 million babies worldwide are born prematurely yearly and need special attention to stay healthy. The World Health Organization commemorates the World Prematurity Day (17 November) to raise awareness of premature birth and the sometimes devastating impacts on families.

Although Nigeria has the highest number of newborn deaths in Africa, the country has made marginal progress in reducing child mortality. An analysis of the Nigeria Demographic Health Survey (NDHS) 2018 shows that the current rate of neonatal deaths in Nigeria is 39 percent. More than 80 per cent of newborn deaths are due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis.

To reduce perinatal deaths in Nigeria, the WHO and development partners, are implementing Quality of Care across 112 health facilities in the country. KMC is one of the interventions under the program to reduce hypothermia (low body temperature) with the ultimate aim of reducing newborn deaths.

I am always happy whenever we save the life of a premature child and prevent perinatal death, says Hannatu Ishiaq, Head of Nursing Unit, Kwali General hospital.

Kwali General Hospital is one of the facilities in the Federal Capital Territory which has been on the WHO Quality, Equity and Dignity (QED) network for QoC since 2019.

“We are grateful for the support and training we received from WHO. We have been able to reduce the referral of preterm babies to the teaching hospital. In the past, we had lost many babies in transit during referrals. But with new scientific evidence and training, we have improved the quality of care provided, and we have seen a lot of good results,” she said.

“The theme for this year world Prematurity day zero Separation Act now! Keep parents and babies born too soon together is the best practice with Kangaroo care, says Dr Olumuyiwa Ojo, Technical officer with WHO.

He said WHO has supported government at national and state level to implement evidence-based interventions to improve quality of care and save more babies from preventable deaths.

“WHO trained over 200 workers in 19 health facilities across FCT, Abuja and Kebbi state in Northwest Nigeria healthcare workers in the labour room, wards and antenatal areas on how to improve their practices to reduce maternal and child mortality.

The country in recent times, developed various evidence-based policies and guidelines to improve management of newborn including management of prematurity. These include, the National Guideline for comprehensive newborn care, Kangaroo mother care operational plan to be launched on 17 November 2021, Nigerian every newborn action plan and child health policy both in final stages of development”, he said.

Nigeria is one of the first countries to subscribe to the WHO-led QED network with support from the Bill and Melinda Gates Foundation, EU, USAID, Merck for Mothers and other donors who directly support partners on the network. The network aims to reduce by half maternal mortality, stillbirths and improve the experience of care as reported by mothers and families by 2030.

Source: World Health Organization. Africa

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AU Sets Up Nairobi Situation Room to Help Africa Mitigate Disasters

With the Earth becoming warmer and weather events more extreme, the African Union has set up a disaster operation center in Nairobi to help monitor major hazards and provide regional early warnings for drought, floods, extreme rainfall, food insecurity, and pests like the desert locust.

Major floods have become more common in Africa and show how vulnerable the continent is to climate change, even though it’s the lowest producer of greenhouse gas emissions in the world.

To cope with such disasters, the African Union has set up a centralized monitoring and early warning system for the continent. The Nairobi Disaster Operation Center for the East African region is the continent’s first weather “situation room.”

“Council of the ministers within the member states sat and said we need to have a disaster operation center in Nairobi, which will focus mainly on early warning systems,” said Jully Ouma, a geographic information system analyst at the Intergovernmental Authority on Development, or IGAD, in Nairobi. “So, that gave birth to the establishment of this office so that we look at broader aspects of different disasters within the region.”

The center — located at the IGAD Climate Prediction and Applications Center — uses East Africa Hazards Watch, a system developed by the center for collecting and sharing multi-hazard data with member countries.

“The system works automatically so that it ingests in the data set,” Ouma said, adding, “We have a super computing system within ICPAC, so there is less human attachment to it. It is also near real time. So, in every 10 days it updates itself and then we see the conditions of drought.”

The center provides climate information and early warnings to 11 East African countries. Officials say local communities must be ready to respond quickly to save lives and minimize damage.

“So, we must equip the communities themselves to be able to respond to a disaster in its first hours at least,” said Amjad Abbashar, regional director for Africa at the U.N. Office for Disaster Risk Reduction. “And so, I think we owe it to them to set up these early warning systems and ensure that it is functional, and that people who are vulnerable to disasters are able to access that information in a timely way, to save lives and property.”

The situation room in Nairobi covers and reports on drought and floods. Another one in Niger, set to open this month, will monitor extreme rains and cyclones. The information collected at both sites will be distributed by the situation room at the AU headquarters in Addis Ababa.

“We are responding to a very complex situation,” said Gatkuoth Kai, technical coordinator for disaster risk reduction at the Africa Union Commission. “Over the years, we have seen disasters increasingly becoming borderless. But even when a hazard is localized, the intensity easily overwhelms the national response. And in this situation, the Pan African solidarity is required. Therefore, having this situation room is going to facilitate that African solidarity.”

As Africa experiences more extreme weather, officials say early warnings and early action will help limit its impact.

Source: Voice of America

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Kenya interested in investing in tourism sector

Malanje- The minister and deputy head of the Commission of the Kenyan Embassy to Angola, Haggai Ouguki, Tuesday expressed the interest of businesspeople from his country in investing and boosting the tourism sector in Malanje province, in order to generate income.

The focus on this segment involves building support infrastructures for tourism and training of staff, with a view to making the sector profitable in the province which, in his opinion, has vast potential and can contribute to the process of diversification of the country’s economy.

According to Haggai Ouguki, who was speaking during a meeting with local businesspeople, there is growing interest from Kenyan businesspeople in tourism in Angola, particularly in Malanje, given its potential.

He said that his country had experience in this area and was willing to transfer capital and knowledge to make tourism in Malanje more competitive, without ruling out the possibility of Malanje businesspeople investing in the same area in Kenya.

Besides tourism, he pointed out agro-livestock as also being an area of interest for his country, judging by the climate and fertile land that Malanje has for the development of agriculture and livestock.

Source: Angola Press News Agency

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Canada Landslides Leave 1 Dead, 2 Missing, Port’s Rail Access Cut

The port of Vancouver, Canada’s largest, said on Tuesday that all rail access had been cut by floods and landslides farther east that killed at least one person and left two others missing.

Two days of torrential rain across the Pacific province of British Columbia touched off major flooding and shut rail routes operated by Canadian Pacific Rail and Canadian National Railway, Canada’s two biggest rail companies.

“All rail service coming to and from the Port of Vancouver is halted because of flooding in the British Columbia interior,” port spokesperson Matti Polychronis said.

At least one person was killed when a mudslide swept cars off Highway 99 near Pemberton, some 100 miles (160 kilometers) to the northeast of Vancouver.

Search and rescue crews were combing through the rubble for signs of survivors or additional casualties, officials said.

Vancouver’s port moves C$550 million ($440 million) worth of cargo each day, ranging from automobiles and finished goods to essential commodities.

The floods temporarily shut down much of the movement of wheat and canola from Canada, one of the world’s biggest grain exporters, during a busy time for trains to haul grain to the port following the harvest.

This year drought has sharply reduced the size of Canada’s crops, meaning a rail disruption of a few days may not create a significant backlog, a grain industry source told Reuters.

Del Dosdall, senior export manager at grain handler Parrish & Heimbecker, said he expected some rail service could be restored by the weekend. Another industry source said he expected the shutdown to last weeks.

Floods have also hampered pipelines. Enbridge shut a segment of a British Columbia natural gas pipeline as a precaution.

The storms also forced the closure of the Trans Mountain pipeline, which carries up to 300,000 barrels per day of crude oil from Alberta to the Pacific Coast.

Copper and coal miner Teck Resources Limited said the floods had disrupted movement of its commodities to its export terminals, while potash exporter Canpotex said it was looking for alternatives to move the crop nutrient overseas.

Directly to the south of British Columbia, in Washington state, heavy rains forced evacuations and cut off electricity for more than 150,000 households on Monday. The U.S. National Weather Service on Tuesday issued a flash flood warning in Mount Vernon, Washington, “due to the potential for a levee failure.”

Some areas of British Columbia received 20 centimeters (8 inches) of rain on Sunday, the amount that usually falls in a month.

Authorities in Merritt, some 200 km (120 miles) northeast of Vancouver, ordered all 8,000 citizens to leave on Monday as river waters rose quickly, but some were still trapped in their homes on Tuesday, said city spokesman Greg Lowis.

Snow blanketed the town on Tuesday and some cars could be seen floating in the flood waters still up to 1.22 meters (4 feet) high. The towns of Chilliwack and Abbotsford ordered partial evacuations.

Rescuers equipped with diggers and body-sniffing dogs started dismantling large mounds of debris that have choked highways.

The landslides and floods come less than six months after wildfires gutted an entire town, as temperatures in the province soared during a record-breaking heat dome.

Source: Voice of America

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Covid-19: Angola reports 218 recoveries, 13 new infections

Luanda – The health authorities on Tuesday reported the recovery of 218 patients, 13 new cases and 2 deaths in the last 24 hours.

Among those recovered, 128 reside in Benguela, 78 in Cabinda, 7 in Malanje, 4 in Huila and 1 in Uige.

Of the new cases, of which 10 are men and 3 women, aged between 7 and 62, 7 were diagnosed in Luanda, 3 in Malanje, 2 in Cabinda and 1 in Benguela.

In the last 24 hours, 1,813 samples were processed by RT-PCR, with a positivity rate of 5.6 percent.

The deaths were registered in the province of Luanda.

The country has a cumulative number of 64,940 confirmed cases, of which 646 are active, 1,729 have died and 62,565 have been recovered. Of the active cases, 4 are in critical state, 5 serious, 14 moderate, 16 light and 607 asymptomatic.

In treatment centres, 39 patients are hospitalised, while in institutional quarantine are 83 people and 93 contacts of positive cases are under epidemiological surveillance.

Source: Angola Press News Agency

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Diabetes- negligence of the disease is very risky

Abubakar Yabagi from Niger State believes negligence made him develop type two diabetes and poor health.

The 65-year-old civil servant and father of four further narrated that “I got diagnosed for Type two diabetes seven years ago when I was 57 years. It all started with frequent headache and I thought it was prevalent Malaria which I kept treating with no little or no improvement. After several months, my sight started deteriorating and that was when I decided to go and see a doctor”.

“I ended up in the hospital with high blood sugar, severe dehydration, fatigue and exhaustion. The doctors were alarmed at my high blood sugar level such that I was admitted immediately. Upon admission, I was referred to the emergency room and that was how I spent two weeks under intensive care. I was given all necessary care ranging from insulin to several medications needed to stabilize me.”

I can say my diabetes was based on negligence as I paid more attention to my job than to my health. I now know that my health comes first and we must take proper leave when due to be able to keep up with my health.

After being discharged from the hospital, Abubakar says he was placed on medication twice daily and was put under monthly observation and after a year of so much improvement his monthly hospital visits reduced to three months till date.

“My wife and children have been very supportive ever since the diagnosis, the food I eat has been changed to low sugar with a lot of vegetables. My children have been supportive with the insurance co-pay for medication. My medication hasn’t been a hassle as I am enrolled on the National Health Insurance Scheme (NHIS) so I get to pay a little out of pocket. The journey hasn’t been easy; some days are great, others—not so great but I thank God and my family that are going through this journey with me”.

“My diabetes journey continues with a renewed focus on prioritizing my health through exercise and instituting healthy eating habits. I am calling on people to please pay attention to their health, visit the hospital whenever they feel something unusual or persistent and make sure they eat healthy food. Many diseases can be prevented with lifestyle modification as it is always better to prevent diseases than manage it. The government also needs to do better on insurance, a lot of people are not able to afford and access diabetic care because of lack of coverage” says Abubakar.

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type two diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn’t make enough insulin. In the past three decades the prevalence of type two diabetes has risen dramatically in countries of all income levels.

Source: World Health Organization. Africa

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Covid-19: Angola receives over 700,000 doses of Pfizer vaccine

Luanda- Angola Tuesday received a batch of 750,000 doses of vaccine from Pfizer, in a donation from the United States of America.

This is the sixth batch of Pfizer vaccine that the United States has donated to Angola since last February.

Over 4.4 million doses of Pfizer’s vaccine have so far been donated to combat the pandemic.

The Secretary of State for Public Health, Franco Mufinda, reiterated his thanks for a gesture that further strengthens the good relations between both countries.

Franco Mufinda took the opportunity to appeal to the citizens to adhere to the vaccination posts.

In his turn, the Chargé d’Affaires of the US Embassy, Gregory Segas, said that the donation shows the commitment of President Joe Biden with Angola and the world.

The official made it known that they will continue with the donation programmes.

Source: Angola Press News Agency

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President João Lourenço receives European champion pilot

Luanda – The President of the Republic, João Lourenço, received Angolan driver Rui Andrade, European champion in Endurance Le Mans 2021 in the LMP2 category.

At the end of the audience, Rui Andrade said he was proud to be received by the Angolan Head of State and to be able to show what he has been doing to represent the country in Europe.

He informed that he offered João Lourenço a replica of the jersey he wore when he became champion, as well as presented the European champion trophy.

“It is a great pride to represent Angola at such a high level,” said the driver, who wears the Angolan flag on his racing suit and helmet, adding that he received congratulations from the President of the Republic for this year’s title.

According to the driver, the Angolan statesman considered it “a source of pride” for Angolans to represent the country in Europe.

Regarding his future, he said that the winter tests to prepare for next year have already started, stressing that his aim is to compete in the world championship with the focus on victory.

Rui Andrade became champion of the European Endurance Le Mans 2021 in the LMP2 category last October, after finishing the four hours race, disputed in the Autodrome of Portimão, in Algarve, Portugal.

The driver, who only needed to finish the race to win the competition, achieved deed by securing the second position of the race, becoming the first Angolan to win the trophy.

Rui Andrade had already reached 13th place (among 33 competitors) in the LMP2 category of the Endurance World Championship, in a race that took place in the SPA-Francorchamps Circuit, in Belgium.

The 22 year-old driver represents the G-Drive Racing team, with the Aurus car, and is the first Angolan driver to participate in a world motorsport championship.

The Angolan, resident in Portugal, started his career in Spain, competing in formula four (F4) in 2018 at the service of Spanish Drivex Racing.

Source: Angola Press News Agency

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Coach Pedro Gonçalves ends contract with FAF

Luanda – The national team’s head-coach, Pedro Gonçalves, ends this Tuesday his contractual tie with the Angolan Football Federation (FAF), two years after being hired to replace the Serbian Srdjan Vasilevic.

Since 2019 at the helm of the Angolan National Team “Palancas Negras” (Sable Antelopes), the Portuguese coach guided the squad in 14 games, with five wins seven defeats and two draws.

However, the national team conceded 15 goals and scored 15 goals as well, two of which in the recent 2-2 draw with Egypt, in a group F game, played at 11 de Novembro Stadium, in Luanda, qualifier for the 2022 World Cup, in Qatar.

Head Coach Pedro Manuel will manage the Angolan team for the last time this afternoon (2 pm) in the game with Libya, in Bengazhi, to close the group stage of the World Cup race, in a match whose result, even a win, no longer helps Angola to qualify for the next stage.

Source: Angola Press News Agency