Implementing HbA1c monitoring in sub-Saharan Africa: Lessons learnt from a pilot project in Mozambique

IF 2.2 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health in Practice Pub Date : 2024-05-16 DOI:10.1016/j.puhip.2024.100504

Fausto Ciccacci , Flavio Ismael , Fernanda Parruque , Dércio Júlio Maquete , Sandra Loureiro , Moises Balamala , Leilo Morviducci , Andrea Manto , Fabiana Lanti , Stefano Orlando , Giovanni Guidotti

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Abstract

Aims

We aimed to evaluate lesson learnt from a pilot project in Mozambique focused on point-of-care (POC) HbA1c testing for diabetes management in primary health care facilities.

Methods

Over a three-year period, several health centers were equipped with POC HbA1c testing machines. The evaluation involved 12 months of data collection, interviews with patients and staff, and regular supervision visits.

Results

The project screened over 22,000 individuals and provided HbA1c testing to 2362 diabetes patients. Among the analyzed results, 65.7 % had HbA1c levels below 7 %, 10.9 % between 7 % and 8.5 %, and 23.4 % above 8.5 %. POC testing showed advantages such as reduced costs and improved workload management.

Conclusions

Limited access to HbA1c testing remains a challenge in African countries. The pilot project demonstrated the feasibility of POC HbA1c testing and highlighted the need for increased efforts to make it more widely available, leading to improved diabetes management and patient outcomes.

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在撒哈拉以南非洲实施 HbA1c 监测：从莫桑比克试点项目中汲取的经验教训

目的我们旨在评估莫桑比克一个试点项目的经验教训，该项目侧重于在初级卫生保健设施中进行护理点 HbA1c 检测以管理糖尿病。结果该项目筛查了 22000 多人，为 2362 名糖尿病患者提供了 HbA1c 检测。在分析的结果中，65.7% 的患者 HbA1c 水平低于 7%，10.9% 的患者介于 7% 和 8.5% 之间，23.4% 的患者高于 8.5%。POC 检测具有降低成本和改善工作量管理等优势。该试点项目证明了 POC HbA1c 检测的可行性，并强调有必要加大力度使其更加普及，从而改善糖尿病管理和患者预后。

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