Monday, 15 November 2010 11:00 By Bernard Lugongo As countries worldwide join hands to mark Diabetes Day on November 14, the trend of the disease in Tanzania is still worrisome. Currently, the rate of prevalence of the disease has doubled as compared to the situation in the last ten years. People living in urban areas have been most at risk of the deadly disease as opposed to those living in rural areas. According to Mr Ramadhan Mongi, executive director of Tanzania Diabetic Association (TDA), the rate of prevalence of the ailment has shot to more than 6 per cent on adult population living in towns. He said in the last 10 years the rate of prevalence was at 3 per cent, calling for additional efforts in combat the problem. We need to increase efforts in fighting the diabetes as it is among four most leading killer diseases, he stressed. But, he acknowledged that awareness over the ailment among the people was still a major challenge. Education about diabetes has reached those already affected after being diagnosed. There was a need to spread the education to all members of the society was still very low. In the last ten years, many people believed that the ailment was only for well-off individuals, but now people have started to understand, he insisted. In the 1980s, the prevalence of type 2 diabetes was among the lowest in the world: 0.8 per cent in cities and abiut 0.9 per cent in rural areas, deabetes in Tanzania is placed in an increased economic burden on the population and on the national budget for health care. A study in the Kilimanjaro Region showed that the total direct costs relating to the treatment of diabetes accounted for a quarter of the minimum wage, resulting in about 46 per cent of the patients having permanent financial difficulties. Research in Dar es Salaam reported that only 1 in 5 of residents with diabetes was receiving government-funded treatment. On Tanzania Mainland, diabetes clinics have been established in each of the 19 regional hospitals, four referral hospitals, and three district hospitals. Additionally, in Dar es Salaam City, diabetes clinics have been established in each of the three district hospitals. Diabetes clinics have also been established in Zanzibar and in Pemba. Until the regional network was established early in 2005, diabetes services were provided at regional hospitals only as part of routine outpatient care by staff with no specialist diabetes training. In his article, Dr Ramaiya explained that specialised diabetes care was available at just five referral hospitals in Tanzania. The hospitals were run by a handful of consultants, diabetes physicians and diabetes educators. Access to diagnosis and treatment, particularly for people in Tanzania's rural areas, was extremely limited. A survey in early 2004 showed that before training only about a third of health care staff at the regional hospitals were sufficiently aware of key aspects of diagnosis, treatment, education, and complications in diabetes. Evaluation in January 2005, a year after the training showed that the necessary awareness of diabetes had risen to 65 per cent among the trained healthcare workers. Similarly, more than two thirds of patients with diabetes surveyed at hospitals in 2004, were unaware that their problems were related to high or low concentrations of glucose in their blood and did not know that they could or should monitor those concentrations. In the past years, Muhimbili National Hospital in Dar es Salaam, has become the national centre of excellence for diabetes care, incorporating a medical laboratory, foot clinic and a diabetes information centre to train doctors, nurses, and people with diabetes from around the country. The hospital also sees patients referred from the regional hospitals. There is still much to do: referrals may be hampered by cost and the limited transport network in the country. The regional clinics needed the ongoing guidance from diabetes educators to ensure that the guidelines were followed. Communicable diseases, such as HIV/Aids, tuberculosis and malaria, make up the big burden of diseass facing sub-Saharan Africa. Within the next two decades, however, non-communicable diseases such as hypertension and diabetes are expected to contribute to more deaths than communicable diseases. Dr Ramaiya called for an urgent need to develop awareness, education, and accessibility of care in line with the World Health Organisation's aims of sustainable intervention by helping countries develop their own infrastructure and professional expertise in health care. Tanzania's approach to managing diabetes in a sustainable way could be a model for other developing countries, he said. World Diabetes Day is a global event. It brings together millions of people in over 160 countries to raise awareness of diabetes, including children and adults affected. The disease, healthcare decision-makers and the media. Numerous local and national events are organised by the member associations of the International Diabetes Federation and by other associations and organisations, healthcare professionals, healthcare authorities, and individuals with an interest in diabetes. World Diabetes Day unites the global diabetes community to produce a powerful voice for diabetes awareness. This years message is Lets take control of diabetes Now. Led by the International Diabetes Federation (IDF) and its member associations, the slogan is in line with the campaigns five-year focus (2009-2013) on Diabetes Education and Prevention. For this year, the campaign would build on the achievements of last year by strengthening global awareness of diabetes and empowering people to get active and take control of their health to prevent the disease and its complications. World Diabetes Day is about mobilising the global diabetes community to produce a powerful voice for diabetes suffers, said IDF president Jean Claude in his message to mark the day. He added: We want all concerned to take the necessary action to control an epidemic that affects the lives of over 300 million people in the World today. For the general public and people at high risk of the disease, the campaign aims at raising awareness and disseminate tools for prevention. For people with diabetes, the focus will be on disseminating tools to improve knowledge of the disease in order to better understand it and to prevent complications. For governments and policy-makers, efforts will placed on communicating the cost-effective implications of diabetes, prevention strategies and promoting diabetes education as a core component of management of the disease and treatment.