Type 2 diabetes control and complications in specialised diabetes care centres of six sub-Saharan African countries: the Diabcare Africa study.

AIM: The Diabcare Africa project was carried out across six sub-Saharan African countries to collect standardised and comparable information for the evaluation of diabetes control, management and late complications in diabetic populations at specialist clinics. METHODS: A cross-sectional, descriptive study of 2352 type-2 diabetes patients who were treated at specialist clinics for at least 12 months prior to the study. RESULTS: The mean age of patients was 53.0±16.0 years and had 8.0±6.0 years known duration of diabetes. 47% had their HbA1c assessed in the past year (mean 8.2±2.4%) with 29% achieving a level <6.5%. 21% had BP within 130/80 mmHg and 65% were treated for hypertension. Fasting lipids were assessed in 45% of the patients with mean cholesterol level of 4.9±1.2 mmol/L, HDL-cholesterol of 1.3±0.7 mmol/L and triglycerides of 1.2±0.7 mmol/L. 13% of the patients were treated for hyperlipidaemia, mostly with statins. Background retinopathy (18%) and cataract (14%) were the most common eye complications. Macrovascular disease was rare, and 48% had neuropathy. CONCLUSIONS: Half of the patients benefitted from standard care, and a third had appropriate glycaemic control - attributed to access to, rather than quality of care. This study provided evidence to support appropriate interventions to diabetic populations of sub-Saharan origin.

Sustainable improvements in injury surveillance in Ghana.

The mortuary is an important foundation for injury surveillance. However, mortuary data are incomplete in many developing countries. The Komfo Anokye Teaching Hospital (KATH) mortuary handles most injury deaths for Kumasi, Ghana. During 1994-1995, many cases in KATH's mortuary logbooks had missing information deaths. A low-cost pilot programme was adopted to improve recording of injury deaths. During 1996-1999, 633 deaths per year were recorded. Project sustainability assessment in 2006 showed that reporting was high, with 773 cases per year. Data quality was standard with similar per cents of missing values for key variables compared with the pilot period. Supplemental data constituting 20% was obtained from the intensive care unit, for which data recording in the mortuary was incomplete. Low-cost improvements can lead to improved mortuary reporting of injury deaths. Collation of data from multiple sources remains a problem at KATH. Improved organisation and training could remedy the situation.