Information Systems for Monitoring the Burden of Chronic Diseases in Public Reference Health Facilities in Central Africa
DOI :
https://doi.org/10.12856/JHIA-2013-v1-i1-67Résumé
Background and purpose: Chronic diseases are an increasingly important cause of death in sub-Saharan Africa. Diseases such as cancer, diabetes and arterial hypertension remained for years in the background, in the shadow of pandemics such as malaria, HIV / AIDS and tuberculosis. Chronic disease incidence in the Central African region however, is poorly documented. This study explores to what extent secondary use of clinical information stored in hospital information systems can help to provide evidence related to the burden of diabetes, cancer and hypertension in DR Congo, Rwanda and Burundi.
Methods: In the past 6 years, 4 reference hospitals of Kisangani, Bukavu, Kigali and Bujumbura implemented open source hospital information management tools integrating international classification systems such as ICD-10 and ICPC-2. Clinical and financial data from chronic disease treatments in the period 2006-2012 were merged into Diagnosis Related Groups (DRGs) for further analysis. Metrics related to case load, mortality load and financial burden have been calculated for diabetes, cancer and hypertension DRGs.
Results: 89,765 out-patient visits and 59,434 admissions have been analyzed in this study. The results show a worrying growth of the 3 chronic diseases in the region. Costs related to the studied diseases are expected to increase by 10% (diabetes) to 70% (cancer & hypertension) between 2011 and 2015 in the studied reference hospitals.
Conclusion: the study demonstrates that the problem of chronic diseases also grows rapidly in the Great Lakes region and therefore urgent steps must be taken, both by governments (Rwanda, DRC and Burundi), by the international donor community and by local hospital boards.
Keywords :Information systems, Diagnosis-Related Groups, Chronic Disease, Sub-Saharan Africa, Neoplasms, Hypertension, Diabetes
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McLarty D, Yusafali A, Swai A. Seasonal incidence of diabetes mellitus in tropical Africa. Diabet Med. 1989 Dec;6(9):762–5.
Moszynski P. Governments in sub-Saharan Africa need to tackle chronic disease burden. BMJ. 2011 Jun 3;342(jun03 2):d3500–d3500.
Qiang P, Hai S, Zhihong Z, Qing Y, Xiaoshu C. The seasonal variation of blood pressure in hypertensive patents treated with combination therapy in chief trial. Heart. 2011 Oct 12;97(Suppl 3):A114–A115.
Preventing Rising Chronic Disease in Sub-Saharan Africa. Ugandan Permanent Mission to the UN, New York; 2011.
Bischoff A, Ekoe T, Perone N, Slama S, Loutan L. Chronic Disease Management in Sub-Saharan Africa: Whose Business Is It? International Journal of Environmental Research and Public Health. 2009 Aug 14;6(8):2258–70.
Abegunde D, Mathers C, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. The Lancet. 2007 Dec;370(9603):1929–38.
Huddart J, Picazo O. The health sector human resource crisis in Africa: an issues paper [Internet]. SARA Project, AED; USAID; 2003. Available from: http://pdf.usaid.gov/pdf_docs/PNACS527.pdf
Adeyi O, Smith O, Robles S, World Bank. Public policy and the challenge of chronic noncommunicable diseases. Washington, D.C.: World Bank; 2007.
OpenClinic GA [Internet]. Available from: http://sourceforge.net/projects/open-clinic/
Hategekimana T, Tran Ngoc C, Porignon D, De Jonge M, Verbeke F, Van Bastelaer S. Monitoring of clinical activities and performances by using international classifications ICD-10 and ICPC-2. Three years experience of the Kigali University Teaching Hospital, Rwanda. electronic Journal of Health Informatics. 2010;5(1):e8.
Verbeke F, Murekatete C, Tran Ngoc C, Karara G, Gasakure E, Nyssen M. Evaluation of a new method for in-patient co-morbidity analysis based on KHIRI Pathology Group Set codes at the Kigali University Teaching Hospital. Journal for Health Informatics in Developing Countries. 2009;3(2). Available from: http://www.jhidc.org/index.php/jhidc/article/viewFile/31/64
De Jonghe M, Jamoulle M, Porignon D. Utilisation et évaluation du thésaurus belge 3BT adapté au Rwanda. Revue Médicale de Bruxelles. 2006;2006(27):274–8.
Verbeke M. The creation of the Belgian Bilingual Bi-encoded Thesaurus (3BT). Semantic Health; 2006. Available from: http://www.semantichealth.org/PUBLIC/Belgium_The%20creation%20of%203BT.pdf
Mbanya JCN, Motala AA, Sobngwi E, Assah FK, Enoru ST. Diabetes in sub-Saharan Africa. The Lancet. 2010 Jun 26;375(9733):2254–66.
Idemyor V. Diabetes in sub-Saharan Africa: health care perspectives, challenges, and the economic burden of disease. Journal of the National Medical Association. 2010 Jul;102(7):650–3.
Moltchanova E, Schreier N, Lammi N, Karvonen M. Seasonal variation of diagnosis of Type 1 diabetes mellitus in children worldwide. Biabet. Med. 2009 Jul;26(7):673–8.
Jamison DT, World Bank. Disease and mortality in Sub-Saharan Africa. Washington, D.C.: World Bank; 2006. Available from: http://public.eblib.com/EBLPublic/PublicView.do?ptiID=459346
World Health Organization. Health systems financing : the path to universal coverage [Internet]. Geneva: World Health Organization; 2010. Available from: http://www.who.int/entity/whr/2010/whr10_en.pdf
Meesen B, Hercot D, Noirhomme M, Ridde V, Tibouti A, Bicaba A, et al. Removing User Fees in the Health Sector in Low-Income Countries: A Multi-Country Review. New York: UNICEF; 2009 Sep. Available from: http://www.helpcentrum.be/itg/Uploads/Volksgezondheid/unicef/UNICEF_Multi-Country_review.pdf
Eurostat. Handbook on price and volume measures in national accounts. Luxembourg: Office for Official Publications of the European Communities; 2001. Available from: http://epp.eurostat.ec.europa.eu/cache/ITY_OFFPUB/KS-41-01-543/EN/KS-41-01-543-EN.PDF
Verbeke F, ICT-based Health Information Management Methods in sub-Saharan Hospitals. Brussels: Vrije Universiteit Brussel, VUBPress; 2012.
