Management of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: a review.
BACKGROUND
Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes.


OBJECTIVE
To improve knowledge on the management of DKA in sub-Saharan Africa.


METHODS
Literature review from different published sources.


RESULTS
Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose.


CONCLUSIONS
A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers.
Department of Paediatrics and Child Health, Muhimbili National Hospital, P.O. Box 65000, Dares Salaam, Tanzania.
E S
ES
Majaliwa
A
A
Mohn
V
V
Chiavaroli
K
K
Ramaiya
A B M
AB
Swai
F
F
Chiarelli
D000293:Adolescent; D017954:Africa South of the Sahara; D002648:Child; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D019468:Disease Management; D006801:Humans