Conference abstract

Impact of the current guidelines for blood cholesterol management, on eligibility for statin in a sub-saharan african population with type 2 diabetes mellitus

Pan African Medical Journal - Conference Proceedings. 2017:2(53).25 Dec 2017.
doi: 10.11604/pamj-cp.2017.2.53.98

Contact the corresponding author
Keywords: ACC/AHA guidelines, NICE guidelines, Statin, Type 2 diabetes, Sub-Saharan Africans
Oral presentation

Impact of the current guidelines for blood cholesterol management, on eligibility for statin in a sub-saharan african population with type 2 diabetes mellitus

Roger Tankombo1,&, Andre Pascal Kengne1, François Folefack Kaze1, Noel Désiré Mbango1, Vanessa Balla1, Henry Namme Luma1, Siméon Pierre Choukem1

1Faculty of Health Sciences, University of Buea, Buea, Cameroon

&Corresponding author
Roger Tankombo, Faculty of Health Sciences, University of Buea, Buea, Cameroon

Abstract

Introduction: the rising global burden of non-communicable diseases (NCDs) is gradually affecting Africa. We aimed to determine the eligibility for statin of people living with type 2 diabetes mellitus (T2DM), using the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and the 2014 United Kingdom, National Institute for Health and Care Excellence (NICE) guidelines.

Methods: we analyzed consecutive medical files of patients living with T2DM seen at the outpatient diabetic clinic of the Douala General Hospital-Cameroon between January 2009 and December 2015. Their socio-demographic characteristics, clinical, biochemical and therapeutic data were recorded.

Results: the mean age of the 824 participants (52.8% males) was 56.3±10.3 years. The ACC/AHA and the NICE guidelines assigned 644 (78.2%) and 564 (68.4%) participants respectively, to statin therapy (p < 0.0001). A total of 487 (75.6%) of those eligible by the ACC/AHA guidelines and 408 (72.3%) of those eligible by the NICE guidelines were not yet on statin, with a weak but significant agreement between the two guidelines (kappa = 0.206, p = 0.0021). An average monthly cost of statin treatment was $23.42 per person corresponding to about 40% of the minimum wage in the country.

Conclusion: following either the ACC/AHA or the NICE guidelines, more than 2/3 of our T2DM patients are eligible for statin therapy, with about 3/4 of them not yet on such therapy. The monthly incurred cost of this treatment approximate about half the minimum wage.