Browsing by Author "Kurdi, Amanj"

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    Activities in Namibia to limit the impact of COVID-19 versus Europe and Iran and the implications for the future
    (2020) Kibuule, Dan; Nambahu, Lahya; Sefah, Israel Abebrese; Kurdi, Amanj; Thi Phuong, Thuy Nguyen; Kwon, Hye-Young; Godman, Brian
    Introduction and aims: Considerable differences in prevalence and mortality rates from COVID-19, with higher rates among European countries and Iran versus African and Asian countries in part due to early and extensive prevention measures. There has been considerable controversy surrounding hydroxychloroquine, with resultant misinformation increasing prices and suicides. Growing concerns also with unintended consequences of lockdown and other measures. Consequently, a need to investigate changes in utilisation and prices of relevant medicines during the pandemic in Namibia with its proactive approach to guide future decision making. Community pharmacists play a key role in this respect. Methods: Questionnaire survey among 55 pharmacists from March to end June 2020. Results: Proactivity among some pharmacists to plan for the pandemic with increased stocks. Limited increases in utilisation of antimalarials and antibiotics in Namibia versus other countries enhanced by restrictions on self-purchasing in Namibia, reflected in limited price rises and shortages. Higher use of Vitamin C/ immune boosters in Ghana and Nigeria versus Namibia reflected in higher price rises, with increased utilisation and prices of PPE across all countries. Encouragingly lower increases in herbal medicines in Namibia versus Ghana. Concerns though with unintended consequences. Conclusion: Encouraging to see continued low prevalence and mortality rates from COVID-19 in Namibia and limited increase in utilisation of antimalarials and antibiotics with prescribing restrictions. Concerns with rising rates of malaria and other infectious diseases following lockdown need addressing. Pharmacists can help plan for the future, educate the public during pandemics, help with vaccinations and general medicines management.
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    Covid-19, healthcare and self-medication issues in resource limited-settings :
    (Busitema University, 2021) Sefah, Israel Abebrese; Essah, Darius Obeng; Haque, Mainul; Opanga, Sylvia A; Kumar, Santosh; Chikowe, Ibrahim; Kibuule, Dan; Rampamba, Enos M; Kalungia, Aubrey C; Thi Phuong, Thuy Nguyen; Saleem, Zikria; Markovic‑Pekovic, Vanda; Kurdi, Amanj; Godman, Brian
    Introduction and objectives: There have been concerns with the level of misinformation regarding COVID-19 and its treatment, drug shortages, as well as increased use and prices of antimalarials, antibiotics and hygiene products during the recent pandemic. Community pharmacists can play a significant role in disease prevention and treatment in the fight against COVID-19 including providing hygiene information and medicine availability across Africa and generally. Consequently, there is a need to review the role of community pharmacists in preventing unintended consequences during any pandemic as well as the impact of COVID-19 on the demand, availability and prices of suggested medicines for its management. Method: Multiple approach involving a qualitative review of the management of COVID-19 across countries coupled with a pilot study in Ghana among six purposely selected community pharmacists during the early stages of the pandemic assessing patterns of demand, availability and prices of medicines suggested for the management of COVID-19. Alongside this, pharmacists’ future role enhancing appropriate medicine use in Ghana and wider combined with the help of senior level co-authors. Results: The majority (five out of six) of pharmacists in Ghana reported increased demand for hydroxychloroquine, antibiotics and vitamins as immune boosters resulting in shortages with price increases particularly for antimalarials. Conclusion: The global lockdown had impacted on the supply and prices of medicines in Ghana similar to other countries. Community pharmacists can play a key role with encouraging safe medicine use, reducing self-purchasing of medicines and planning workflows during future pandemics including vaccinations. They can also help address potential misinformation and its consequences as well as the unintended consequences of pandemics including better management of non-communicable diseases. Keywords: Community pharmacists, COVID-19, Ghana, misinformation, self-medication, supply chain
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    Evidence-based public policy making formedicines across countries: findings andimplications for the future
    (Future Medicine Ltd, 2021) Godman, Brian; Fadare, Joseph; Kwon, Hye-Young; Zampirolli Dias, Carolina; Kurdi, Amanj; Dias God ́oi, Isabella Piassi; Kibuule, Dan; Hoxha, Iris; Opanga, Sylvia; Saleem, Zikria; Bochenek, Tomasz; Markovi ́c-Pekovi ́c, Vanda; Mardare, Ileana; Kalungia, Aubrey C; Campbel, Stephen; Allocati, Eleonora; Pisana, Alice; Martin, Antony P; Meyer, Johanna C
    im:Global expenditure on medicines is rising up to 6% per year driven by increasing prevalence ofnon-communicable diseases (NCDs) and new premium priced medicines for cancer, orphan diseases andother complex areas. This is difficult to sustain without reforms.Methods:Extensive narrative review ofpublished papers and contextualizing the findings to provide future guidance.Results:New models arebeing introduced to improve the managed entry of new medicines including managed entry agreements,fair pricing approaches and monitoring prescribing against agreed guidance. Multiple measures have alsosuccessfully been introduced to improve the prescribing of established medicines. This includes encour-aging greater prescribing of generics and biosimilars versus originators and patented medicines in a classto conserve resources without compromising care. In addition, reducing inappropriate antibiotic utiliza-tion. Typically, multiple measures are the most effective.Conclusion:Multiple measures will be needed toattain and retain universal healthcare. Keywords:antimicrobials•biosimilars•COVID-19•demand-side measures•generics•guidelines•managedentry•oncology•orphan medicines•quality indicators•statins
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    Ongoing and planned activities to improve the management of patients with Type 1 diabetes across Africa; implications for the future
    (Taylor & Francis, 2020) Godman, Brian; Basu, Debashis; Pillay, Yogan; Almeida, Paulo H. R. F.; Mwita, Julius C.; Rwegerera, Godfrey Mutashambara; Paramadhas, Bene D Anand; Tiroyakgosi, Celda; Okwen, Patrick; Niba, Loveline Lum; Sefah, Israel; Oluka, Margaret; Guantai, Anastasia N; Kibuule, Dan; Kalemeera, Francis; Mubita, Mwangana; Fadare, Joseph; Ogunleye, Olayinka O.; Rampamba, Enos M; Wing, Jeffrey; Mueller, Debjani; Alfadl, Abubakr; Amu, Adefolarin A; Matsebula, Zinhle; Kalungia, Aubrey; Zaranyika, Trust; Masuka, Nyasha; Wale, Janney; Hill, Ruaraidh; Kurdi, Amanj; Timoney, Angela; Campbell, Stephen; Meyer, Johanna C
    Background Currently about 19 million people in Africa are known to be living with diabetes, mainly Type 2 diabetes (T2DM) (95%), estimated to grow to 47 million people by 2045. However, there are concerns with early diagnosis of patients with Type 1 diabetes (T1DM) as often patients present late with complications. There are also challenges with access and affordability of insulin, monitoring equipment and test strips with typically high patient co-payments, which can be catastrophic for families. These challenges negatively impact on the quality of care of patients with T1DM increasing morbidity and mortality. There are also issues of patient education and psychosocial support adversely affecting patients’ quality of life. These challenges need to be debated and potential future activities discussed to improve the future care of patients with T1DM across Africa. Methodology Documentation of the current situation across Africa for patients with T1DM including the epidemiology, economics, and available treatments within public healthcare systems as well as ongoing activities to improve their future care. Subsequently, provide guidance to all key stakeholder groups going forward utilizing input from senior-level government, academic and other professionals from across Africa. Results Whilst prevalence rates for T1DM are considerably lower than T2DM, there are concerns with late diagnosis as well as the routine provision of insulin and monitoring equipment across Africa. High patient co-payments exacerbate the situation. However, there are ongoing developments to address the multiple challenges including the instigation of universal health care and partnerships with non-governmental organizations, patient organizations, and pharmaceutical companies. Their impact though remains to be seen. In the meantime, a range of activities has been documented for all key stakeholder groups to improve future care. Conclusion There are concerns with the management of patients with T1DM across Africa. A number of activities has been suggested to address this and will be monitored. KEYWORDS: Type 1 diabetes healthcare, policies-insulin primary, healthcare glucose, monitoring patient, co-paymentsAfrica
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    Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries:
    (Taylor & Francis, 2019) Godman, Brian; Haque, Mainul; McKimm, Judy; Bakar, Muhamad Abu; Sneddon, Jacqueline; Wale, Janney; Campbell, Stephen; Martin, Antony P; Hoxha, Iris; Abilova, Vafa; Paramadhas, Bene D Anand; Mpinda-Joseph, Pinkie; Matome, Matshediso; Pires de Lemos, Livia Lovato; Sefah, Israel; Kurdi, Amanj; Opanga, Sylvia; Jakupi, Arianit; Saleem, Zikria; Hassali, Mohamed Azmi; Kibuule, Dan; Fadare, Joseph; Bochenek, Tomasz; Rothe, Celia; Furst, Jurij; Markovic-Pekovic, Vanda; Bojanić, Ljubica; Schellack, Natalie; Meyer, Johanna C; Matsebula, Zinhle; Thi Phuong, Thuy Nguyen; Jan, Saira; Kalungia, Aubrey; Mtapuri-Zinyowera, Sekesai; Sartelli, Massimo; Hill, Ruaraidh
    Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use.Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known.Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals.Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.
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    Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications
    (Frontiers in Pharmacology, 2021) Sefah, Israel A.; Ogunleye, Olayinka O.; Essah, Darius O.; Opanga, Sylvia A.; Butt, Nadia; Wamaitha, Annie; Guantai, Anastasia N.; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Nambahu, Lahya; Abubakar, Abdullahi R.; Sani, Ibrahim H.; Saleem, Zikria; Kalungia, Aubrey C.; Phuong, Thuy N. T.; Haque, Mainul; Islam, Salequl; Kumar, Santosh; Sneddon, Jacqueline; Wamboga, Joshua; Wale, Janney; Miljković, Nenad; Kurdi, Amanj; Martin, Antony P; Godman, Brian
    Background: Countries across Africa and Asia have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE). However, there has been considerable controversy surrounding some treatments including hydroxychloroquine where the initial hype and misinformation led to shortages, price rises and suicides. Price rises and shortages were also seen for PPE. Such activities can have catastrophic consequences especially in countries with high copayment levels. Consequently, there is a need to investigate this further. Objective: Assess changes in utilisation, prices, and shortages of pertinent medicines and PPE among African and Asian countries since the start of pandemic. Our approach: Data gathering among community pharmacists to assess changes in patterns from the beginning of March until principally the end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: One hundred and thirty one pharmacists took part building on the earlier studies across Asia. There were increases in the utilisation of principally antimalarials (hydroxychloroquine) and antibiotics (azithromycin) especially in Nigeria and Ghana. There were limited changes in Namibia and Vietnam reflecting current initiatives to reduce inappropriate prescribing and dispensing of antimicrobials. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries where documented. In addition, generally limited change in the utilisation of herbal medicines. However, shortages have resulted in appreciable price increases in some countries although moderated in others through government initiatives. Suggestions in Namibia going forward included better planning and educating patients. Conclusion: Encouraging to see increases in the utilisation of vitamins/immune boosters and PPE. However, concerns with increased utilisation of antimicrobials needs addressing alongside misinformation, unintended consequences from the pandemic and any appreciable price rises. Community pharmacists and patient organisations can play key roles in providing evidence-based advice, helping moderate prices through improved stock management, and helping address unintended consequences of the pandemic. Keywords: Africa, Asia, community pharmacists, COVID-19, medicines, protective equipment, price rises, shortages
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    Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa:
    (2020) Ogunleye, Olayinka O.; Basu, Debashis; Debjani Mueller; Sneddon, Jacqueline; Seaton, R. Andrew; Yinka-Ogunleye, Adesola F.; JWamboga, oshua; Miljković, Nenad; Mwita, Julius C.; Rwegerera, Godfrey Mutashambara; Rwegerera, Godfrey Mutashambara; Okwen, Patrick; Niba, Loveline Lum; Nsaikila, Melaine; Rashed, Wafaa M.; Hussein, Mohamed Ali; Hegazy, Rehab; Amu, Adefolarin A.; Boahen-Boaten, Baffour Boaten; Matsebula, Zinhle; Gwebu, Prudence; Chirigo, Bongani; Mkhabela, Nongabisa; Dlamini, Tenelisiwe; Sithole, Siphiwe; Malaza, Sandile; Dlamini, Sikhumbuzo; Afriyie, Daniel; Asare, George Awuku; Amponsah, Seth Kwabena; Sefah, Israel; Oluka, Margaret; Guantai, Anastasia N.; Opanga, Sylvia A.; Sarele, Tebello Violet; Mafisa, Refeletse Keabetsoe; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Kalemeera, Francis; Mubita, Mwangana; Fadare, Joseph; Sibomana, Laurien; Ramokgopa, Gwendoline Malegwale; Whyte, Carmen; Maimela, Tshegofatso; Hugo, Johannes; Meyer, Johanna C.; Schellack, Natalie; Rampamba, Enos M.; Visser, Adel; Alfadl, Abubakr; Malik, Elfatih M.; Malande, Oliver Ombeva; Kalungia, Aubrey C.; Mwila, Chiluba; Zaranyika, Trust; Chaibva, Blessmore Vimbai; Olaru, Ioana D.; Masuka, Nyasha; Wale, Janney; Hwenda, Lenias; Kamoga, Regina; Hill, Ruaraidh; Barbui, Corrado; Bochenek, Tomasz; Kurdi, Amanj; Campbell, Stephen; Martin, Antony P.; Thi Phuong, Thuy Nguyen; Thanh, Binh Nguyen; Godman, Brian
    Background: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of otherinfectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. Objective: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. Our Approach: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. Ongoing Activities: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. Conclusion: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.
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    Review of ongoing Aoactivities and challenges to improve the care of patients with type 2 diabetes across Africa and the implications for the future
    (Frontiers in pharmacology, 2020) Godman, Brian; Basu, Debashis; Pillay, Yogan; Mwita, Julius C.; Tiroyakgosi, Celda; Rwegerera, Godfrey Mutashambara; Okwen, Patrick Mbah; Niba, Loveline Lum; Nonvignon, Justice; Sefah, Israel; Oluka, Margaret; Guantai, Anastasia N.; Kibuule, Dan; Kalemeera, Francis; Mubita, Mwangana; Fadare, Joseph; Ogunleye, Olayinka O.; Distiller, Larry A.; Rampamba, Enos M.; Wing, Jeffrey; Mueller, Debjani; Alfadl, Abubakr; Amu, Adefolarin A.; Matsebula, Zinhle; Kalungia, Aubrey; Zaranyika, Trust; Masuka, Nyasha; Wale, Janney; Hill, Ruaraidh; Kurdi, Amanj; Timoney, Angela; Campbell, Stephen; Meyer, Johanna C.
    Background: There has been an appreciable increase in the number of people in Africa with metabolic syndrome and Type 2 diabetes (T2DM) in recent years as a result of a number of factors. Factors include lifestyle changes, urbanisation, and the growing consumption of processed foods coupled with increasing levels of obesity. Currently there are 19 million adults in Africa with diabetes, mainly T2DM (95%), estimated to grow to 47 million people by 2045 unless controlled. This has a considerable impact on morbidity, mortality and costs in the region. There are a number of issues to address to reduce the impact of T2DM including improving detection rates and current access to services alongside addressing issues of adherence to prescribed medicines. There are also high rates of co-morbidities with infectious diseases such as HIV and tuberculosis in patients in Africa with T2DM that require attention. Objective: Document ongoing activities across Africa to improve the care of patients with T2DM especially around issues of identification, access, and adherence to changing lifestyles and prescribed medicines. In addition, discussing potential ways forward to improve the care of patients with T2DM based on ongoing activities and experiences including addressing key issues associated with co-morbidities with infectious diseases. Our Approach: Contextualise the findings from a wide range of publications including internet based publications of national approaches coupled with input from senior level government, academic and other professionals from across Africa to provide future guidance. Ongoing Activities: A number of African countries are actively instigating programmes to improve the care of patients with T2DM starting with improved diagnosis. This recognises the growing burden of non-communicable diseases across Africa, which has been neglected in the past. Planned activities include programmes to improve detection rates and address key issues with diet and lifestyle changes, alongside improving monitoring of care and activities to enhance adherence to prescribed medicines. In addition, addressing potential complexities involving diabetes patients with infectious disease co-morbidities. It is too early to fully assess the impact of such activities, Conclusion: There are a number of ongoing activities across Africa to improve the management of patients with diabetes including co-morbidities. However, more needs to be done considering the high and growing burden of T2DM in Africa. Ongoing research will help further benefit resource allocation and subsequent care. Keywords: Type 2 diabetes, Africa, national initiatives, diagnosis, medicines, adherence, patient groups
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    Strategies to Improve Antimicrobial Utilization with a Special Focus on Developing Countries
    (MDPI, 2021) Godman, Brian; Egwuenu, Abiodun; Haque, Mainul; Ombeva Malande, Oliver; Schellack, Natalie; Kumar, Santosh; Saleem, Zikria; Sneddon, Jacqueline; Hoxha, Iris; Islam, Salequl; Mwita, Julius; Rezende Macedo do Nascimento, Renata Cristina; Piassi Dias Godói, Isabella; Lum Niba, Loveline; Amu, Adefolarin A.; Acolatse, Joseph; Incoom, Robert; Abebrese Sefah, Israel; Opanga, Sylvia; Kurdi, Amanj; Chikowe, Ibrahim; Khuluza, Felix; Kibuule, Dan; Ogunleye, Olayinka O.; Olalekan, Adesola; Markovic-Pekovic, Vanda; Meyer, Johanna C.; Alfadl, Abubakr; Thi Phuong, Thuy Nguyen; Kalungia, Aubrey C.; Campbell, Stephen; Pisana, Alice; Wale, Janney; Seaton, R. Andrew
    Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up. Keywords: antimicrobials; antimicrobial stewardship programs; antimicrobial resistance; healthcareassociated infections; COVID-19; lower- and middle-income countries; misinformation; patient initiatives; surgical site infections; vaccines