Interview with Dr. Elias Siraj on Ethiopia’s Alarming New Data on Diabetes

Dr. Elias S. Siraj, Professor of Medicine & Chief of Endocrinology as well as Director of Strelitz Diabetes Center at Eastern Virginia Medical School in Norfolk, Virginia. In the following interview he discusses research findings showing an alarmingly growing prevalence of diabetes in Ethiopia. (Courtesy photo)

Tadias Magazine
By Tadias Staff

Published: November 26th, 2018

New York (TADIAS) – As Ethiopia’s population grew exponentially to over 100 million in the past few decades so did the number of public health problems associated with population growth, the migration of rural residents to big cities, and dramatic changes in ways of living.

According to two recent studies conducted by the International Diabetes Federation (IDF) and Ethiopia’s Ministry of Health respectively chronic diseases such as obesity, high blood pressure and diabetes are on the rise throughout Ethiopia and are becoming a significant public health hazard. Such chronic diseases are essentially lifestyle-related health issues primarily caused by poor diet and lack of physical exercise.

The IDF currently ranks Ethiopia as being home to the largest diabetic population in Africa with a combined estimate of 20% of Ethiopian adults as likely to either have diabetes (5.2%) or be prediabetic (15%).

“That’s a huge number affecting millions of people,” says Dr. Elias S. Siraj, Professor of Medicine & Chief of Endocrinology as well as Director of Strelitz Diabetes Center at Eastern Virginia Medical School in Norfolk, Virginia. “It’s also important to note that about three fourth of them (76%) do not even know they have diabetes because they were never tested, or if they were tested they don’t have the proper knowledge to understand what it means and what the findings are.”

“Diabetes is basically diagnosed by measuring blood sugar levels,” Dr. Elias explains. “If the blood sugar level while fasting — meaning not eating for 8 hours in the morning — is above 126 it’s called diabetes. If the number is between 100 and 125 that’s prediabetes.” Dr. Elias added: “So prediabetes is basically knocking on the door. It is saying I am coming if you don’t do something. It does not mean that everyone will develop diabetes, but most of them will. A lot of people who are prediabetic over the years will transition into diabetes.”

Dr. Elias, who is also an alumni of the University of Gondar, the first medical college in Ethiopia, and a member of the Diaspora volunteer organization People To People (P2P), shared the findings with Tadias last week to mark World Diabetes Day, which took place on November 14th. He pointed out that 425 million people around the globe have diabetes and an additional 352 million are prediabetic. “If you add it up that’s 15% of adults in the world,” Dr. Elias told Tadias in an interview. “This is massive.”

“So to put it in context, for a country like Ethiopia to have twenty percent of its population as having either diabetes or prediabetes, that’s alarming and a wake-up call to policymakers,” Dr. Elias adds.

The second source of data on diabetes in Ethiopia, called the STEPS survey, comes from the nation’s Ministry of Health. “For the first time in Ethiopia a representative sample from the whole country was collected to study diabetes and other chronic conditions,” noted Dr. Elias. “For the first time, The Ministry of Health selected 10,000 individuals from both rural and urban areas. The STEPS survey shows that Diabetes is prevalent among 3.2% of the sample and prediabetes was present in 9.1%. That means close to 12% are diabetic or prediabetic. In addition, high blood pressure was seen in 16% while 15% were considered overweight or obese. What these numbers tell us is that there is no question that chronic diseases are on the rise in Ethiopia.”

“Irrespective of the slight difference both studies tell the same story and share the same message,” Dr. Elias argued. “The prevalence of diabetes is really big and actually increasing.”

What’s the Solution?

In their introduction to the results of the STEPS survey the Ethiopian researchers highlight that according to the World Health Organization (WHO), 2017 report, “Non-Communicable Diseases (NCDs) kill 40 million people” and “Chronic NCDs are rising fastest among lower–income countries.”

The reports adds: “The federal Ministry Health of Ethiopia established a National Strategic Action Plan for Non–Communicable Disease in Ethiopia (2014–2016), and developed national treatment guidelines and training materials on major NCDs like hypertension and diabetes. The national WHO STEPS survey was undertaken by the Federal Ministry of Health (FMOH) as part of a situational analysis of NCD risk factors to provide baseline data for subsequent interventions.”

Dr Elias notes that there are adjustments being made to address the issue of chronic diseases but admits that most funding currently given to developing countries usually ends up financing programs that focus on infectious diseases. He emphasizes that the key is to “create public awareness” and “educate the public.”

Although the IDF results were released a year ago, Dr. Elias notes that “Ethiopia is being labeled as number one in the volume of diabetes in Africa and there was no press release on the topic from the Ministry of Health, the Ethiopian Medical Association, the Ethiopian Diabetes Association.” Dr. Elias added: “It seems trivial, but it’s very important from a public health standpoint. Everybody has to be aware, the media, the public, medical professionals and the authorities. Policymakers allocate budget if the society is aware, because awareness creates pressure.”


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