Chronic disease, inclusive but not limited to HIV, is a fast-growing problem in Kenya. Within AMPATH's geographic area of western Kenya, there are already an estimated 60,000 persons living with diabetes, and that number is expected to double over the next couple of decades. Unfortunately, as the threat of early death and disability from chronic disease like diabetes grows in sub-Saharan Africa, it is clear that countries like Kenya have almost nothing in place to meet this challenge. However, the emerging success story of HIV care programs such as AMPATH demands a re-thinking of what might be possible if this same leadership and creativity were applied to the unmet needs of those suffering from other chronic diseases.
Through the collaboration of many partners from both the pharmaceutical industry and academic medical centers, AMPATH is making considerable progress in improving the level of care for resource-constrained patients with diabetes. AMPATH currently provides care, education and medications to patients enrolled in the diabetes clinic at Moi Teaching and Referral Hospital. They have also recently expanded the program to the rural clinic of Webuye. However, there remains a considerable amount of work to be done to improve accessibility and availability of services, overall glycemic control and long-term outcomes for diabetic patients.
To meet this growing concern, AMPATH has begun the process of transitioning its HIV clinics into more comprehensive chronic disease clinics. AMPATH is beginning this transition in three sites: Mosoriot, Turbo and Burnt Forest. In the initial stages of this process, these clinics will begin treating and caring for patients with hypertension and diabetes, in addition to HIV. Through these clinics and the current treatment being provided in Eldoret and Webuye, AMPATH will be able to provide diabetes care to a growing population of those who previously could not afford it. With funding, including a generous grant and product support from the Abbott Fund, AMPTH will support training/education for both providers and patients, monitoring and evaluation, laboratory support, continued support of phone-based care, transportation, and infrastructure enhancements to facilitate diabetes care.
AMPATH currently has over 2,100 patients with diabetes mellitus enrolled in the AMPATH program. Of these, 151 patients receive intensive home glucose monitoring (HGM) at Moi Teaching and Referral Hospital (MTRH) and Webuye and 600 patients are provided with occasional random blood sugar tests. AMPATH cares for 190 in-patients with diabetes mellitus at MTRH and Webuye over the year.