Browsing by Author "Rampamba, Enos M."

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    Fixed dose drug combinations – are they pharmacoeconomically sound?:
    (Informa UK Limited, 2020) Godmana, Brian; McCabee, Holly; Leong, Trudy D.; Mueller, Debjani; Martini, Antony P.; Hoxhak, Iris; Mwital, Julius C.; Mutashambara Rwegereram, Godfrey; Masselen, Amos; Costao, Juliana de Oliveira; Rezende Macedo do Nascimentoa, Renata Cristina; Pires de Lemoso, Livia Lovato; Tachkovs, Konstantin; Milushewas, Petya; Patrickt, Okwen; Lum Nibat, Loveline; Laiusw, Ott; Sefah, Israel; Abdulsalimy, Suhaj; Soleymaniz, Fatemeh; Guantai, Anastasia N; Achieng, Loice; Oluka, Margaret; Jakupi, Arianit; Logviss, Konstantīns; Hassali, Mohamed Azmi; Kibuule, Dan; Kalemeera, Francis; Mubita, Mwangana; Fadaregg, Joseph; Ogunleye, Olayinka O.; Saleem, Zikria; Hussain, Shazhad; Bochenek, Tomasz; Mardare, Ileana; Alrasheedy, Alian A.; Furst, Jurij; Tomek, Dominik; Markovic-Pekovic, Vanda; Rampamba, Enos M.; Alfadl, Abubakr; Amu, Adefolarin A.; Matsebula, Zinhle; Thi Phuong, Thuy Nguyen; Thanh, Binh Nguyen; Kalungia, Aubrey Chichonyi; Zaranyika, Trust; Masuka, Nyasha; Olarua, Ioana D.; Wale, Janney; Hill, Ruaraidh; Kurdia, Amanj; Timoneya, Angela; Campbell, Stephen; Meyer, Johanna C.
    Introduction: There are positive aspects regarding the prescribing of fixed dose combinations (FDCs) versus prescribing the medicines separately. However, these have to be balanced against concerns including increased costs and their irrationality in some cases. Consequently, there is a need to review their value among lower- and middle-income countries (LMICs) which have the greatest prevalence of both infectious and noninfectious diseases and issues of affordability. Areas covered: Review of potential advantages, disadvantages, cost-effectiveness, and availability of FDCs in high priority disease areas in LMICs and possible initiatives to enhance the prescribing of valued FDCs and limit their use where there are concerns with their value. Expert commentary: FDCs are valued across LMICs. Advantages include potentially improved response rates, reduced adverse reactions, increased adherence rates, and reduced costs. Concerns include increased chances of drug:drug interactions, reduced effectiveness, potential for imprecise diagnoses and higher unjustified prices. Overall certain FDCs including those for malaria, tuberculosis, and hypertension are valued and listed in the country’s essential medicine lists, with initiatives needed to enhance their prescribing where currently low prescribing rates. Proposed initiatives include robust clinical and economic data to address the current paucity of pharmacoeconomic data. Irrational FDCs persists in some countries which are being addressed. KEYWORDS: Fixed dose combinations; pharmacoeconomics; adherence; medicines; noncommunicable diseases; infectious diseases; lower and middle income countries
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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