Africans with Diabetes Face Higher Rate of COVID-19

By Adedapo Adesanya

The World Health Organisation (WHO) has said that Africa’s death rates from COVID-19 infections are significantly higher in patients with diabetes, according to a preliminary analysis.

At a presentation on Thursday, the global health watchdog said that Africa’s sharp increase in diabetes was clashing with the COVID-19 pandemic and poor access to vaccines.

According to Dr Matshidiso Moeti, WHO Regional Director for Africa, “COVID-19 is delivering a clear message: fighting the diabetes epidemic in Africa is in many ways as critical as the battle against the current pandemic.

“The COVID-19 pandemic will eventually subside, but Africa is projected in the coming years to experience the highest increase in diabetes globally. We must act now to prevent new cases, vaccinate people who have this condition and, equally importantly, identify and support the millions of Africans unaware they are suffering from this silent killer.”

Diabetes impairs the body’s ability to produce or process insulin, a substance essential to counteracting a dangerous rise in blood sugar. The disease causes inflammation and poor blood circulation, both of which increase the risk of complications, including death, from COVID-19.

A recent WHO analysis evaluated data from 13 countries on underlying conditions or comorbidities in Africans who tested positive for COVID-19. It revealed a 10.2 per cent case fatality rate in patients with diabetes, compared with 2.5 per cent for COVID-19 patients overall.

The case fatality rate for people with diabetes was also twice as high as the fatality rate among patients suffering from any comorbidity. In addition to people with diabetes, the three most frequent underlying conditions included patients with HIV and hypertension.

The countries contributing data to the analysis were Burkina Faso, Chad, Cote d’Ivoire, the Democratic Republic of the Congo, Eswatini, Guinea, Namibia, Niger, Rwanda, Senegal, Seychelles, Sao Tome and Principe and Uganda.

In a statement, WHO revealed that an estimated 24 million people are living with diabetes in Africa in 2021 citing data from the International Diabetes Federation and the continent is expected to experience the highest increase in diabetes globally, with the number of Africans suffering from the disease predicted to rise to 55 million by 2045, an increase of 134 per cent compared with 2021.

It noted that Africa is the region with the highest number of people who do not know their diagnosis – an estimated 70 per cent of people with diabetes do not know they have the disease.

On his part, Dr Benido Impouma, Director, Communicable and Noncommunicable Diseases Cluster at WHO Regional Office for Africa added that since the early days of the pandemic, people with diabetes in countries around the world have been prioritized to receive COVID-19 vaccinations but Africa has faced challenges in this strategy.

“Health officials in Africa should take advantage of the growing availability of low-cost rapid diagnostic tests to routinely test patients in diabetes centres to ensure early detection and proper care. These centres also can be key venues for vaccination.”

Speaking further, Dr Moeti noted that, “Nine months since COVID-19 vaccination campaigns began in Africa, we are still nowhere near where we need to be with protecting our most vulnerable.

“There is an urgent need to step up vaccination and other key services to people at high risk, including those with diabetes.

“All Africans at risk of diabetes must have access to testing. We can also stop diabetes from claiming more lives by promoting healthy, affordable diets and regular exercise.”

In addition to COVID-19 risks, diabetes can also increase the risk of heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness and nerve damage, including erectile dysfunction.

During the COVID-19 pandemic, access to diabetes care has been severely disrupted in the African Region. Lockdowns to limit the spread of COVID-19, for example, have impeded access to health care and the basic elements of proper disease management, such as routine glucose monitoring and eating a healthy diet.

To improve equitable access to quality diabetes care, WHO launched the Global Diabetes Compact in April 2021. This builds on work in recent years to roll out the WHO Package of Essential Noncommunicable Disease (WHO PEN) interventions for primary health care in low-resource settings.

So far, 21 African countries have started using this package. Benin, Eritrea, Eswatini, Lesotho and Togo have achieved national expansion covering all primary health care facilities.