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. 1992 May 9;304(6836):1215–1218. doi: 10.1136/bmj.304.6836.1215

Must diabetes be a fatal disease in Africa? Study of costs of treatment.

S S Chale 1, A B Swai 1, P G Mujinja 1, D G McLarty 1
PMCID: PMC1881760  PMID: 1515790

Abstract

OBJECTIVE--To estimate the costs of diagnosis and treatment of diabetes in Tanzania. DESIGN--Costs estimated from the reported and recorded experience of patients with newly presenting diabetes in 1989-90 and of diabetic patients first seen in 1981-2. SETTING--Muhimbili Medical Centre, Dar es Salaam. SUBJECTS--464 patients (315 men and 149 women). 262 patients diagnosed during 1 September 1989-31 August 1990 (group 1) and 202 during 1 June 1981-31 August 1982 (group 2). RESULTS--The average annual direct cost of diabetes care in 1989-90 was $287 for a patient requiring insulin and $103 for a patient not requiring insulin. Purchase of insulin accounted for 68.2% ($156) of the average annual outpatient costs for patients requiring insulin. For patients not requiring insulin the cost of oral hypoglycaemic drugs and treatment of chronic complications and infections accounted for 42.5% ($29.3) and 48.8% ($33.7) of costs respectively. Cost of outpatient care of diabetic patients for the whole of Tanzania was estimated at $2.7m, *75,128 (32.2%) of which was for insulin. Doctors' and nurses' costs accounted for 0.2% of total costs of outpatient care. The annual direct inpatient care costs were estimated at $1.25m. Around 0.2% of the Tanzanian population aged 15 years and over used the equivalent of 8% of the total government health expenditure, which was $47,4088,382. CONCLUSION--Diabetes places a severe strain on the limited resources of developing countries. If African patients with diabetes have to pay for their treatment most will be unable to do so and will die.

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Selected References

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  1. Aaron H., Schwartz W. B. Rationing health care: the choice before us. Science. 1990 Jan 26;247(4941):418–422. doi: 10.1126/science.2300804. [DOI] [PubMed] [Google Scholar]
  2. Corrigan C. B., Ahrén B. Ten years experience of a diabetes clinic in northern Tanzania. East Afr Med J. 1987 Nov;64(11):772–781. [PubMed] [Google Scholar]
  3. McLarty D. G., Kinabo L., Swai A. B. Diabetes in tropical Africa: a prospective study, 1981-7. II. Course and prognosis. BMJ. 1990 Apr 28;300(6732):1107–1110. doi: 10.1136/bmj.300.6732.1107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. McLarty D. G., Swai A. B., Kitange H. M., Masuki G., Mtinangi B. L., Kilima P. M., Makene W. J., Chuwa L. M., Alberti K. G. Prevalence of diabetes and impaired glucose tolerance in rural Tanzania. Lancet. 1989 Apr 22;1(8643):871–875. doi: 10.1016/s0140-6736(89)92866-3. [DOI] [PubMed] [Google Scholar]
  5. Rolfe M., Armstrong J. R. Diabetes mellitus on the Zambian Copperbelt. J R Coll Physicians Lond. 1989 Oct;23(4):255–259. [PMC free article] [PubMed] [Google Scholar]
  6. Scott R. S., Brown L. J., Clifford P. Use of health services by diabetic persons. II. Hospital admissions. Diabetes Care. 1985 Jan-Feb;8(1):43–47. doi: 10.2337/diacare.8.1.43. [DOI] [PubMed] [Google Scholar]
  7. Swai A. B., Lutale J., McLarty D. G. Diabetes in tropical Africa: a prospective study, 1981-7. I. Characteristics of newly presenting patients in Dar es Salaam, Tanzania, 1981-7. BMJ. 1990 Apr 28;300(6732):1103–1106. doi: 10.1136/bmj.300.6732.1103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Triomphe A., Flori Y. A., Costagliola D., Eschwege E. The cost of diabetes in France. Health Policy. 1988;9(1):39–48. doi: 10.1016/0168-8510(88)90116-9. [DOI] [PubMed] [Google Scholar]

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