Eye Department KCMC Newsletter
Issue 4 Volume 4 Serial 14 30th December 2014
The Final Outcome of
Kilimanjaro Diabetic Programme
Kilimanjaro Diabetic Programme
(KDP) was established by Anthony Hall in November 2010 in response to lack of
screening for Diabetic Eye Disease in Kilimanjaro Region. This project had
received funding from CBM Australia for a comprehensive diabetic care in which
screening for diabetic retinopathy formed the main component. Some 14 centres
were selected in the seven districts of Kilimanjaro where Diabetic Clinics were
set up. The purpose of setting up diabetic clinics was to segregate the
diabetic patients to make healthcare service delivery easier.
KCMC diabetologist Dr I. Lyaruu
is the consulting physician for the programme and had been offering training to
the participating clinicians on the best practices, there is a nutritionist and
a physiotherapist who advised on lifestyle changes needed for diabetics.
In the diabetic clinics, the
patients formed Diabetic Clubs, these clubs were formed in view of raising
funds for glucose testing strips and medication. This need arose because of the
inherent problems with regards to the availability of glucose testing strips
and anti-diabetic medication in the district hospitals.
In the diabetic clinics a
consistent method of records keeping was established with registers, cards and
booklets for diabetic patients. The programme also issued an identification
number to enable easy tracing of information. Eventually it was decided that
these record methods shall be taken over by the National Diabetic Programme.
KDP held regular stakeholders
meetings whereby the views of the participants could be aired, facilitated the
linking of the now defunct Kilimanjaro Diabetic Association, Tanzania Diabetic
Association and the National Diabetic Programme. There had been training
sessions on medical management of diabetes, nutrition and lifestyle changes
needed for diabetic patients.
Achievements
1. Formation of Diabetic Clinics
in 14 hospitals in Kilimanjaro Region.
2. Diabetic education to
secondary healthcare workers.
3. Augmentation of formation of
Diabetic Clubs for purposes of sustainability.
4. Screening of 4344 patients for
Diabetic Eye Disease.
5. Public awareness campaigns on
diabetes management.
6. Formation of Kilimanjaro
Branch of Tanzania Diabetic Association.
Challenges
1. Sporadic availability of
insulin in some district hospitals.
2. Inconsistent disbursement of
funds from Council Health Management Team basket funds to district hospitals
for diabetic healthcare provision.
Conclusion
Kilimanjaro Diabetic Programme
has paved way to establishment of diabetic clinics in Tanzania as it is being
implemented by the Non Communicable Diseases division of the Ministry of
Health. Awareness has been created on the importance of screening for diabetic
retinopathy in the region and there are moves to extend the activities to
Arusha Region.
Table 1: Outcomes of
KDP as of October 2014.
|
|
Parameter
|
Numbers
|
|
1
|
Total Number of
Registered Patients
|
4494
|
|
2
|
Fundus Photographs
|
4344
|
|
3
|
Patients Referred
to KCMC
|
1267
|
|
4
|
Patients Arrived at
KCMC
|
421
|
|
5
|
Treated for
Diabetic Retinopathy
|
156
|
|
6
|
Cataract Surgery
|
53
|
|
|
|
|
|
7
|
Body Mass Index
Measured
|
2349
|
|
8
|
Underweight (BMI ≤
18)
|
97 (4%)
|
|
9
|
Normal Weight (18
> BMI ≤ 25)
|
929 (40%)
|
|
10
|
Overweight (25 >
BMI ≤ 30)
|
829 (35%)
|
|
11
|
Obese (BMI > 30)
|
494 (21%)
|
|
|
|
|
|
12
|
Random Glycemia
Tested
|
4285
|
|
13
|
Random Glycemia ≤ 7
mM/L
|
972 (23%)
|
|
14
|
Random Glycemia
> 7 mM/L
|
3313 (77%)
|
|
|
|
|
|
15
|
Blood Pressure
Measured
|
4293
|
|
16
|
BP ≤ 140/90 mmHg
|
2944 (69%)
|
|
17
|
PB > 140/90 mmHg
|
1350 (31%)
|
|
|
|
|
|
18
|
Patients with No
Diabetic Retinopathy
|
2975 (73%)
|
|
19
|
Background Diabetic
Retinopathy
|
750 (18%)
|
|
20
|
Pre-Proliferative
DR
|
242 (6%)
|
|
21
|
Proliferative
Diabetic Retinopathy
|
120 (3%) [These
Need Laser Treatment]
|
|
22
|
Total
|
4087
|
|
|
|
|
|
23
|
No Maculopathy Seen
|
3400 (83%)
|
|
24
|
Some Maculopathy
|
211 (5%)
|
|
25
|
Clinically Significant Diabetic Macula Edema
|
476 (12%) [These
Need Laser Treatment]
|
|
26
|
Total
|
4087
|
|
|
|
|
Editor: W. Makupa, Eye Department KCMC, P.O.Box 3010 Moshi – Tanzania
Tel: +255 784 332 667 Fax: +255 27 275 4381 Email: makupauw@yahoo.com
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