Brazzaville - The sharp increase in the number of diabetes cases in Africa comes amid the COVID-19 pandemic and poor access to vaccines. Death rate from COVID-19 infections in Africa is significantly higher among people with diabetes, according to preliminary analysis presented today by the World Health Organization (WHO) ahead of World Day of diabetes on November 14th.
"COVID-19 sends a clear message: Tackling the diabetes epidemic in Africa is in many ways just as crucial as tackling the current pandemic," said Dr Matshidiso Moeti, WHO Regional Director for Africa. “The COVID-19 pandemic will eventually subside, but Africa is expected to experience the largest increase in the incidence of diabetes in the world in the next few years. We must act now to prevent new cases, vaccinate people with diabetes against COVID-19 and, no less important, identify and support the millions of Africans who are unaware they are affected by this silent killer. "
Diabetes affects the body's ability to make or use insulin, a substance that is essential for preventing dangerous increases in blood sugar levels. The disease causes inflammation and poor blood circulation, both of which increase the risk of complications from COVID-19, including the risk of death.
A recent WHO analysis assessed data from 13 countries looking at underlying conditions or co-morbidities in Africans who tested positive for COVID-19. It emerges from this analysis that the case fatality rate of COVID-19 is 10.2% in diabetic patients, against 2.5% for all patients with COVID-19. The case fatality rate from COVID-19 in people with diabetes was also twice as high as in patients with any other comorbidity. Besides diabetes, the three underlying conditions associated with the highest case fatality rates from COVID-19 include HIV and hypertension.
The countries providing data for this analysis were Burkina Faso, Côte d'Ivoire, Eswatini, Guinea, Namibia, Niger, Uganda, Democratic Republic of Congo, Rwanda, Senegal, Seychelles, Sao Tome and Principe and Chad.
About 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 largest increase in the number of diabetes cases in the world. Indeed, the number of Africans suffering from this disease is expected to reach 55 million by 2045, an increase of 134% compared to the data available in 2021. Africa is the continent with the largest number of people who do not know their status for diabetes. It is estimated that 70% of people with diabetes do not know they are affected by this disease.
"Health officials in Africa should take advantage of the growing availability of low-cost rapid diagnostic tests to routinely test patients in diabetes care centers to ensure early detection of this disease and appropriate care Said Dr Benido Impouma, Director of the Universal Health Coverage / Communicable and Noncommunicable Diseases Cluster at the WHO Regional Office for Africa. “These centers can also be key sites for vaccination,” he added.
From the early days of the pandemic, people with diabetes were prioritized in all countries around the world to receive doses of the COVID-19 vaccine. Africa has found it difficult to apply this strategy.
Access to vaccines remains limited. So far, only 6.6% of Africa's population is fully vaccinated against COVID-19, compared to a global average of around 40%. Data from 37 countries indicate that, since March 2021, more than 6.5 million doses of COVID-19 vaccine have been given to Africans with co-morbidities, or 14% of all doses given to date. . Efforts to prioritize people with co-morbidities like diabetes are accelerating, with nearly half of those 6.5 million doses administered in the past two months. However, much remains to be done to ensure that people at high risk actually receive the vaccines they need.
“Nine months after the start of COVID-19 vaccination campaigns in Africa, we are still far from the goal we have set for the protection of our most vulnerable groups,” said Dr. Moeti. “There is an urgent need to scale up immunization and other essential services for people at high risk, including those with diabetes. "
There are two main types of diabetes: type 1 diabetes is caused early in life by a condition that damages the pancreas and affects the production of insulin; type 2 diabetes is linked to poor diet, obesity and lack of exercise, and results from the body's poor use of insulin. Almost 90% of people with diabetes globally, and the vast majority in Africa, have type 2 diabetes, and the rising incidence rates of diabetes in Africa are attributed to the same poor diet and the same sedentary lifestyles that are causing a rise in the number of cases of type 2 diabetes worldwide. Besides the risks associated with COVID-19, diabetes can increase the risk of heart attack, stroke, kidney failure,
“All Africans exposed to diabetes must have access to screening,” said Dr. Moeti. “We can also prevent more diabetes from taking its toll by promoting healthy, affordable diets and regular physical activity. "
Since the start of the COVID-19 pandemic, access to diabetes care has been seriously disrupted in the African Region. Lockdowns imposed to limit the spread of COVID-19, for example, have hampered access to health care and basic elements of good management of diabetic patients, such as routine blood sugar monitoring and a healthy diet.
In order to improve equitable access to quality care for diabetics, the WHO launched the Global Compact against Diabetes in April 2021. This initiative builds on the work undertaken in recent years to deploy all of WHO's interventions to combat non-communicable diseases (WHO PEN) within the framework of primary health care in low-resource settings. To date, 21 African countries have started using this set of tools. Benin, Eritrea, Eswatini, Lesotho and Togo have successfully transposed these services nationwide, ensuring coverage of all primary health care facilities.
WHO today held a press conference, hosted by APO Group. Dr Impouma was accompanied by Professor Maïmouna Ndour Mbaye, head of the internal medicine unit at Cheikh Anta Diop University in Dakar and director of the National Center for the fight against diabetes in Senegal, as well as by Mr. Greg Tracz, Managing Director of Diabetes Africa.
Also present to answer questions were Dr Phionah Atuhebwe, New Vaccine Introduction Officer at the WHO Regional Office for Africa, Dr Thierno Baldé, COVID-19 Response Operations Manager at the Office WHO Regional Office for Africa, and Dr Jean-Marie Dangou, Noncommunicable Disease Program Coordinator, WHO Regional Office for Africa.
Source: World Health Organization