title: Applying lessons learnt from the 'DOTS' Tuberculosis Model to monitoring and evaluating persons with diabetes mellitus in Blantyre, Malawi.
abstract: The global burden of diabetes mellitus (DM) is immense and predicted to reach 438 million by 2030, with 80% of the cases being in the developing world. The management of chronic non-communicable diseases like DM is poor in most resource-limited settings, and the 'directly observed therapy, short course' (DOTS) framework for tuberculosis control has been proposed as a feasible way to improve this situation. In late 2009, aspects of the DOTS model were applied to the management of persons with DM in the diabetes clinic in Queen Elizabeth Central Hospital, Blantyre, Malawi, and a point-of-care electronic medical record system was set up to support and monitor patients in care. This is the first quarterly and cumulative report of persons with DM registered for care stratified by treatment outcomes, complications and medication history up to 31 December 2010. There were 170 new patients registered between October and December 2010, with 1864 ever registered by 31 December 2010. Most patients were alive and in care; 3 died, 53 defaulted and 3 transferred out. Of those on oral hypoglycaemic agents, metformin was most commonly used. Complications were common. The monitoring and evaluation will be further refined, and at the same time, the systems developed in Blantyre will be expanded to other parts of the country.
authors.affiliation: Department of Medicine, College of Medicine, Blantyre, Malawi.
authors.forename: Theresa J
authors.initials: TJ
authors.lastname: Allain
authors.forename: Joep J
authors.initials: JJ
authors.lastname: van Oosterhout
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Douglas
authors.forename: Sabine
authors.initials: S
authors.lastname: Joukes
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Gadabu
authors.forename: Christopher
authors.initials: C
authors.lastname: Darts
authors.forename: Anil
authors.initials: A
authors.lastname: Kapur
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
mesh_terms: D003906:Developing Countries; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000628:therapy*; D023801:Directly Observed Therapy / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D005378:Financial Support; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008295:Malawi / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents