PMID- 28836972
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20181202
IS  - 1475-9276 (Electronic)
IS  - 1475-9276 (Linking)
VI  - 16
IP  - 1
DP  - 2017 Aug 24
TI  - Access to medicines and diagnostic tests integral in the management of diabetes 
      mellitus and cardiovascular diseases in Uganda: insights from the ACCODAD study.
PG  - 154
LID - 10.1186/s12939-017-0651-6 [doi]
LID - 154
AB  - BACKGROUND: Despite the burgeoning burden of diabetes mellitus (DM) and 
      cardiovascular diseases (CVD) in low and middle income countries (LMIC), access 
      to affordable essential medicines and diagnostic tests for DM and CVD still 
      remain a challenge in clinical practice. The Access to Cardiovascular diseases, 
      Chronic Obstructive pulmonary disease, Diabetes mellitus and Asthma Drugs and 
      diagnostics (ACCODAD) study aimed at providing contemporary information about the 
      availability, cost and affordability of medicines and diagnostic tests integral 
      in the management of DM and CVD in Uganda. METHODS: The study assessed the 
      availability, cost and affordability of 37 medicines and 19 diagnostic tests in 
      22 public hospitals, 23 private hospitals and 100 private pharmacies in Uganda. 
      Availability expressed as a percentage, median cost of the available lowest 
      priced generic medicine and the diagnostic tests and affordability in terms of 
      the number of days' wages it would cost the least paid public servant to pay for 
      one month of treatment and the diagnostic tests were calculated. RESULTS: The 
      availability of the medicines and diagnostic tests in all the study sites ranged 
      from 20.1% for unfractionated heparin (UFH) to 100% for oral hypoglycaemic agents 
      (OHA) and from 6.8% for microalbuminuria to 100% for urinalysis respectively. The 
      only affordable tests were blood glucose, urinalysis and serum ketone, urea, 
      creatinine and uric acid. Parenteral benzathine penicillin, oral furosemide, 
      glibenclamide, bendrofluazide, atenolol, cardiac aspirin, digoxin, metformin, 
      captopril and nifedipine were the only affordable drugs. CONCLUSION: This study 
      demonstrates that the majority of medicines and diagnostic tests essential in the 
      management of DM and CVD are generally unavailable and unaffordable in Uganda. 
      National strategies promoting improved access to affordable medicines and 
      diagnostic tests and primary prevention measures of DM and CVD should be 
      prioritised in Uganda.
FAU - Kibirige, Davis
AU  - Kibirige D
AD  - Department of Medicine, Uganda Martyrs Hospital Lubaga, P.O.BOX 7146, Kampala, 
      Uganda. kibirigedavis@gmail.com.
FAU - Atuhe, David
AU  - Atuhe D
AD  - Department of Medicine, Case Hospital Kampala, Kampala, Uganda.
FAU - Kampiire, Leaticia
AU  - Kampiire L
AD  - Infectious Disease Research Collaboration (IDRC), Kampala, Uganda.
FAU - Kiggundu, Daniel Ssekikubo
AU  - Kiggundu DS
AD  - Nephrology unit, Mulago National Referral and Teaching Hospital, Kampala, Uganda.
FAU - Donggo, Pamela
AU  - Donggo P
AD  - Department of Medicine, Lira Regional Referral Hospital, Lira, Uganda.
FAU - Nabbaale, Juliet
AU  - Nabbaale J
AD  - Division of Adult Cardiology, Uganda Heart Institute, Kampala, Uganda.
FAU - Mwebaze, Raymond Mbayo
AU  - Mwebaze RM
AD  - Department of Medicine, St. Francis hospital Nsambya, Kampala, Uganda.
FAU - Kalyesubula, Robert
AU  - Kalyesubula R
AD  - Departments of Physiology and Medicine, Makerere University College of Health 
      Sciences, Kampala, Uganda.
FAU - Lumu, William
AU  - Lumu W
AD  - Department of Medicine, Mengo Hospital, Kampala, Uganda.
LA  - eng
PT  - Journal Article
DEP - 20170824
PL  - England
TA  - Int J Equity Health
JT  - International journal for equity in health
JID - 101147692
RN  - 0 (Drugs, Essential)
SB  - IM
MH  - Cardiovascular Diseases/drug therapy/*prevention & control
MH  - Diabetes Mellitus/drug therapy/*prevention & control
MH  - *Diagnostic Tests, Routine/economics/statistics & numerical data
MH  - *Drugs, Essential/economics/supply & distribution
MH  - Health Services Accessibility/*statistics & numerical data
MH  - Humans
MH  - Uganda
PMC - PMC5571570
OTO - NOTNLM
OT  - Affordability
OT  - Availability
OT  - Cardiovascular diseases
OT  - Cost
OT  - Diabetes mellitus
OT  - Low and middle income countries
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethical approval to conduct this 
      study was granted by the ethics review board of St. Francis hospital, Nsambya 
      Uganda as mandated by the Uganda National Council of Science and Technology 
      (UNCST). CONSENT FOR PUBLICATION: No individual person's data in any form 
      (details, image and videos) was used in this manuscript. COMPETING INTERESTS: DK 
      works in the medical unit of GlaxoSmithKline (GSK) pharmaceutical Kenya Limited 
      in Uganda. GSK did not participate in the study funding, design or analysis of 
      the data. The views expressed in this manuscript are solely the author's (DK). 
      The rest of the authors declare no competing interests. PUBLISHER'S NOTE: 
      Springer Nature remains neutral with regard to jurisdictional claims in published 
      maps and institutional affiliations.
EDAT- 2017/08/25 06:00
MHDA- 2018/07/17 06:00
PMCR- 2017/08/24
CRDT- 2017/08/25 06:00
PHST- 2017/07/03 00:00 [received]
PHST- 2017/08/14 00:00 [accepted]
PHST- 2017/08/25 06:00 [entrez]
PHST- 2017/08/25 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
PHST- 2017/08/24 00:00 [pmc-release]
AID - 10.1186/s12939-017-0651-6 [pii]
AID - 651 [pii]
AID - 10.1186/s12939-017-0651-6 [doi]
PST - epublish
SO  - Int J Equity Health. 2017 Aug 24;16(1):154. doi: 10.1186/s12939-017-0651-6.