Africa Rising Research Articles

Barriers and facilitators to cognitive impairment screening among older adults with diabetes mellitus and hypertension by primary healthcare providers in rural Uganda.

The burden of non-communicable diseases and cognitive impairment exhibit a linear rise in sub-Saharan Africa due to the increase in life expectancy. Non-communicable diseases like diabetes mellitus and hypertension increase the risk for cognitive impairment. To improve our understanding of the underpinnings of the cognitive impairment screening, this study explored the barriers and facilitators of routine cognitive impairment screening in a primary healthcare setting guided by the Capacity, Opportunity, Motivation Behavioral change (COM-B) model. This was a descriptive qualitative study with primary healthcare providers who provide care to older adults with diabetes mellitus and hypertension at three primary healthcare centers in Mbarara district southwestern Uganda. In-depth interviews were conducted using a semi structured interview guide. Interviews were audio-recorded, transcribed verbatim, and analyzed using the framework approach along the COM-B components. Each COM-B component factors were categorized as barriers and facilitators. We conducted 20 in-depth interviews with clinical officers, enrolled nurses, and a psychiatric nurse. The questions were guided by the Capacity, Opportunity and Motivation Behavioral change (COM-B) framework to identify barriers and facilitators to cognitive impairment screening. The factors that negatively affected the screening were considered as barriers, while the positive as facilitators. Capacity related barriers to cognitive impairment screening included chronic understaffing, primary healthcare provider non-involvement, lack of training/skills, lack of knowledge and awareness in screening, absence of caretakers, lack of patient awareness of cognitive problems; while facilitators were staff recruitment, primary healthcare provider involvement, and specialized training. Opportunity related barriers to screening included patient overload, infrastructure shortage, and time constraints. Motivation related barriers included lack of screening guidance and policy, while the facilitators were availability of mentorship programs for primary healthcare providers. Integrating cognitive impairment screening in primary health care requires engagement of relevant stakeholders with the focus on addressing implementation challenges through capacity development. Timely cognitive impairment screening at the first point of care initiates a cascade of interventions for timely enrollment into care, thus arresting the progress of cognitive impairment that leads to dementia.

Examining the relationship between armed conflict and coverage of maternal and child health services in 35 countries in sub-Saharan Africa: a geospatial analysis

Armed conflict is on the rise in sub-Saharan Africa and affects public infrastructures, including health systems, although evidence on population health is sparse. We aimed to establish how these disruptions ultimately affect health service coverage. We geospatially matched Demographic and Health Survey data with the Uppsala Conflict Data Program Georeferenced Events Dataset, covering 35 countries for the period from 1990 to 2020. We relied on linear probability models with fixed effects to capture the effect of nearby armed conflict (within 50 km of the survey cluster) on four service coverage indicators along the continuum of maternal and child health care. We also investigated effect heterogeneity by varying conflict intensity and duration, and sociodemographic status. The estimated coefficients represent the decrease in the probability (in percentage points) of the child or their mother being covered by the respective health service following deadly conflicts within 50 km. Any nearby armed conflict was associated with reduced coverage for all examined health services, with the exception of early antenatal care: early antenatal care (-0·5 percentage points, 95% CI -1·1 to 0·1), facility-based delivery (-2·0, -2·5 to -1·4), timely childhood vaccination (-2·5, -3·1 to -1·9), and treatment of common childhood illnesses (-2·5, -3·5 to -1·4). For all four health services, the negative effects increased for high-intensity conflicts and were significant throughout. When examining conflict duration, we did not find negative effects on the treatment of common childhood illnesses in prolonged conflicts. The analysis on effect heterogeneity revealed that, except for timely childhood vaccination, the negative effects of armed conflict on health service coverage were more pronounced in urban settings. Our findings suggest that health service coverage is significantly affected by contemporaneous conflict, but health systems can adapt to provide routine services, such as child curative services, in situations of prolonged conflict. Our analysis underlines the importance of studying health service coverage during conflict both at the finest possible scales and across different indicators, pointing at the need for differential policy interventions. None. For the French and Portuguese translations of the abstract see Supplementary Materials section.

Navigating the challenges of neuro-oncology in Africa: addressing diagnostic and treatment barriers in the region: a correspondence

Navigating the challenges of neuro-oncology in Africa: addressing diagnostic and treatment barriers in the region: a correspondence

Killer infection on the rise in Africa

Killer infection on the rise in Africa

Abstract P564: Prevalence of Metabolic Syndrome in a Young Sub-Saharan African Community

Background: Metabolic syndrome is known as a predictor of cardiovascular disease (CVD), a leading cause of death globally. The factors that comprise metabolic syndrome are on the rise in Sub-Saharan Africa, and data regarding the prevalence of metabolic syndrome in communities of aged less than 40 years old remain scarce. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency. Subjects aged between 18 and 80 years were recruited, however, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure (BP) and anthropometric measurements were performed in addition to a blood test measuring fasting triglycerides, high density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and plasma glucose. Metabolic syndrome was defined as fasting plasma glucose ≥110 mg/dl, serum triglycerides ≥150 mg/dl, serum HDL cholesterol <40 mg/dl, BP ≥130/85 mmHg or on BP medication, or waist girth >102 cm in males or >89 cm in females. Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P<0.05) in univariate analysis were included in the multivariate logistic model. Results: Of the 2,440 subjects recruited, 1080 participants were less than 40 years old and included in the current analysis. The mean age of these participants was 31 ± 7.53I. There were 296 (27%) male participants in our study. . Overall, there were 41 participants (3.8%) with metabolic. For individual components of metabolic syndrome, body mass index of 25 or higher was present in 32% of the population with a significant increase among women (38 vs 15% vs 3,7%, p<0,001). The prevalence of hypertension was28% and more than half of the population presented with dyslipidaemia (554 participants). Among those with dyslipidemia, 339 have a high total cholesterol index (61%, 95% CI: 57-65%). Conclusion: Our community-based cross-sectional study revealed a low prevalence of metabolic syndrome among younger participants in northern Senegal. However, the prevalence of dyslipidaemia was high.

Association between variants on the vitamin D Receptor gene and chronic kidney disease among a Yoruba population in Ibadan, Nigeria

Chronic kidney disease, characterized by progressive loss of kidney function is a disease of public health importance globally. The burden is on a steep rise in Nigeria and sub-Saharan Africa, thereby contributing to the double epidemic of communicable and non-communicable diseases in this region of the world. Genome-wide association studies have identified several variants on different genes including the Vitamin D receptor (VDR) gene, associated with CKD defining traits. This study evaluated the association between SNPs on the VDR gene rs4334089 (CviAll), rs1544410 (BsmI) and rs7975232 (ApaI) with CKD in a Yoruba population of Nigeria. This case-control study recruited a total of 203 participants. Variants were amplified and genotyped using PCR-RFLP. Genotypes were tested for conformity with the Hardy-Weinberg equilibrium and associations were tested under three inheritance patterns. Results showed the minor allelic frequency of rs1544410 (BsmI) differed significantly from the reference value for the Nigerian population as reported on 1000 Genomes database. We report for the first time the relationship between vitamin D receptor polymorphisms, (rs4334089 (CviAll), rs1544410 (BsmI) and rs7975232 (ApaI) and chronic kidney disease in a Yoruba population from Ibadan southwest Nigeria. We found a significant risk association of CviAII with CKD under the dominant inheritance model (OR = 5.29; p = 7.13e−8), while CviAII was associated with protection to CKD under the recessive inheritance model (OR = 0.04; p = 0.002). This study provides further evidence that vitamin D receptor gene polymorphisms contribute to the risk chronic kidney disease in the Ibadan southwest population.

Mathematical Model for Coinfection of HIV/AIDS and Kaposi’s Sarcoma with Treatment

HIV destroys T-cells in order to target the body's defence mechanism. Without treatment HIV infection advances in stages causing destruction and reduction in T-cells thus, rendering the body incapable of fighting other infections such as respiratory infections, sexually transmitted diseases and some cancers. Kaposi’s sarcoma is the cancer that allows a tumour to grow in an HIV patient and its presence in a patient is an indication that HIV has fully developed into AIDS in the patient. Research has indicated that AIDS-associated Kaposi Sarcoma was on the rise in sub-Saharan Africa until the introduction of Antiretroviral Therapy (ART). The Kenyan community has struggled in the past decade to combat the spread of HIV/AIDS and successes have been recorded in many areas. However, Kaposi Sarcoma, an opportunistic infection, has continued to rise steadily through the years. In this study, a simple model for the coinfection of HIV/AIDS and KS is developed and studied. The model solution is explored for positivity and boundedness while the DFE point is determined for stability where it was verified that the infection-free equilibrium <I>E</I>₀ is locally asymptotically stable when <img width="40" height="10" src="http://article.sciencepublishinggroup.com/journal/247/2471233/image001.png" />. The NGM is used to derive the basic reproduction number of the model. By providing treatment to the HIV and the co-infected population immune system is strengthened and thus progression rate to AIDS is reduced.

Growth and yield attributes of cowpea accessions grown under different soil amendments in a derived Savannah zone

&lt;abstract&gt; &lt;p&gt;Malnutrition and severe food insecurity are on the rise in sub-Saharan Africa. Cowpea (&lt;italic&gt;Vigna unguiculata&lt;/italic&gt; L.), an indigenous plant from Africa with a good nutritional composition, can be a strategic tool in the fight against hunger. Hence, the objective of this study was to assess the yield response of different cowpea accessions to soil amendments. The study adopted a 5 × 4 factorial in a randomized complete block design with three replications. The factors comprise five cowpea accessions (BBL, BBR, BCB, EBL and EBC) and four soil amendments (poultry manure [PoM], pig manure [PgM], NPK 15:15:15 fertilizer and control). There are significant differences among the cowpea accessions in all the studied attributes. The stability and mean performance analyses revealed that the top-ranked accessions were EBL and EBC, while BBL, BBR and BCB were below the population mean. The ranking order of the soil amendments was PoM &amp;gt; PgM &amp;gt; population mean &amp;gt; NPK &amp;gt; control. Accession EBL amended with PoM gave the highest plant weight (106.4 g), which was statistically similar to the same accessions amended with NPK (104.9 g) and PgM (100.4 g), but significantly higher than the other treatment combinations. Plant weight has a significant and positive correlation with pod length (r = 0.919**), number of leaves (0.623**), vine length (0.361**) and hundred seed weight (0.329*). The findings of this study showed that cowpea accessions responded differently to the soil amendments. This study recommends the use of additional nutrients as a supplement in the production of cowpea rather than relying solely on its self-fixed nitrogen.&lt;/p&gt; &lt;/abstract&gt;

A model-based estimation and mapping of school-age children living in poverty in the local areas of South Africa

Poverty, inequality, and unemployment are on the rise in South Africa. The focus of this study is on school-age children in poverty. Education is a critical policy imperative for the country. Model-based small area estimation was conducted to estimate the different poverty measures for lower and upper bound poverty levels. The primary data sources are the Income and Expenditure Survey 2010/2011 and the 2011 national population census. The model diagnostics and the validation of the estimates showed that the model-based estimates at the local municipality level are more reliable than the direct estimates. There are significant variations in poverty across the local municipalities of South Africa; therefore, spatially targeted poverty alleviation programmes are more beneficial.

Leaving No One Behind: Can Rising Africa Beat the Odds Against Poverty?

The number of poor people continues to rise in Africa, despite a slow decline in the poverty rate. Africa with a population of 422 million poor people, representing about 70 per cent of the world's poorest people shows that the global burden of poverty has shifted from the rest of the world to Africa. This paper discussed the causes of poverty on the continent and various responses by stakeholders toward accelerating its poverty reduction. It was found that with the available statistics and projections, Africa will still fall short of eradicating poverty by 2030, but it can bring it to a low level. The study, therefore, recommends that African policymakers should aim for growth that is inclusive and sustainable. International support from the world bank, ODA, G7, and others will play a vital role, especially through technology and resource transfers, also African continent need to improve its resource mobilization.

An investigation of the impact of green methods and technologies on the environmental sustainability of supportive educational buildings, case study of UCT

As water and energy costs rise in South Africa due to the limited water and energy supply, green methods and technologies implemented in buildings will help alleviate the burden of this crisis. Many literatures studied green building technology; however, there is limited research on the barriers and drivers of using green methods and technology in supportive educational buildings at universities. It is essential to note the distinction between the different types of university buildings. Although the focus will be primarily based on supportive educational buildings, the overall study deals with the university as a system in a holistic view. This study makes use of a mixed-method approach, using an over-arching case study of supportive educational buildings at the University of Cape Town. A field survey of a supportive education building at UCT and semi-structured interviews were conducted with executive management at UCT. Findings reveal that across UCT’s various buildings, numerous green methods and technologies have been installed to help monitor and manage water and energy usage. Furthermore, it was indicated that the university had employed various strategies since the early 2000s to increase environmental sustainability to achieve sustainability. Additionally, there has been a shift to positively influence student behaviour through the phasing in of water and energy-saving campaigns around campus. The findings also reveal that UCT has recently prioritised green methods and technologies implementation, which inherently improves the resource efficiency and environmental sustainability of the supportive education buildings and, consequently, the overall university.

The outlook of rheumatological care in Africa: Current state, challenges, and recommendation.

There is a gross lack of access to rheumatological access in Africa. For example, the most populous country in the continent, Nigeria, has just 30 rheumatologists serving a population of about 200 million. In Ghana, there are just 2 rheumatologists serving a population of about 28 million people. Unfortunately, the prevalence of rheumatologic and musculoskeletal diseases is on the rise in Africa. The main issues facing rheumatologic care in Africa are inadequate health professionals, inadequate research, and a weak health system. These factors have hindered the progress of rheumatologic care and treatment in the region. Prompt action must be taken in tackling these effects and to achieve better care for rheumatologic patients in Africa. This paper analyzes carefully the current state of rheumatologic care in Africa, identifying the needs for rheumatologic care, determinants of quality of rheumatologic care delivery, and the challenges currently facing rheumatology care in Africa. Also, this review gives some recommendations on ways by which the existing system of rheumatologic care in Africa can be improved.

A Mixed-Methods Participatory Intervention Design Process to Develop Intervention Options in Immediate Food and Built Environments to Support Healthy Eating and Active Living among Children and Adolescents in Cameroon and South Africa.

Rates of obesity and related non-communicable diseases are on the rise in sub-Saharan Africa, associated with sub-optimal diet and physical inactivity. Implementing evidence-based interventions targeting determinants of unhealthy eating and physical inactivity in children and adolescents’ immediate environments is critical to the fight against obesity and related non-communicable diseases. Setting priorities requires a wide range of stakeholders, methods, and context-specific data. This paper reports on a novel participatory study design to identify and address contextual drivers of unhealthy eating and physical inactivity of children and adolescents in school and in their home neighborhood food and built environments. We developed a three-phase mixed-method study in Cameroon (Yaoundé) and South Africa (Johannesburg and Cape Town) from 2020–2021. Phase one focused on identifying contextual drivers of unhealthy eating and physical inactivity in children and adolescents in each setting using secondary analysis of qualitative data. Phase two matched identified drivers to evidence-based interventions. In phase three, we worked with stakeholders using the Delphi technique to prioritize interventions based on perceived importance and feasibility. This study design provides a rigorous method to identify and prioritize interventions that are tailored to local contexts, incorporating expertise of diverse local stakeholders.

Estimating the burden of cancer in South Africa

Background: The incidence of cancer is on the rise in South Africa and globally. However, literature on the current and expected future burden of cancer in the country is lacking.Aim: To develop a model that forecasts the incidence of five of the most commonly diagnosed cancers in South Africa. The model aims to estimate the true underlying burden of cancer, as opposed to diagnosed cases only.Setting: South Africa.Methods: Age-specific incidence rates for each cancer are forecasted for the period 2019–2030, based on a combination of public and private sector cohort data. It is assumed that historical trends in changes in the incidence rate of cancer will continue over the forecasting period. Forecasted incidence rates are applied to population forecasts to find the total number of incident cancer cases for the relevant year.Results: The incidence of all cancers included in this research is increasing over time, with the total number of cases just less than doubling between 2019 and 2030 (from approximately 62 000 to 121 000 incident cases). This is a result of increases in the age-specific incidence rate of cancer, as well as the growth and ageing of the South African population.Conclusion: Results confirm that cancer is a major and growing public health problem in South Africa. This highlights the need for increases in resources available for cancer services, as well as rapid implementation of cancer prevention strategies, to reduce the number of future cancer cases, and thereby reduce the burden on the health system.

Introduction

Introduction Rachel Bernstein (bio) [End Page 1] Over the last decade, China's presence on the global stage has shifted dramatically: the country is now an economic powerhouse and increasingly influential in international organizations. As China rises, questions also arise pertaining to its strategic objectives toward many regions and in many domains. China appears to be seeking a "loose, partial, and malleable" hegemony over the global South—making the African continent a strategic priority for Beijing.1 This Asia Policy roundtable is a result of a current research initiative at the National Bureau of Asian Research, "Into Africa: China's Emerging Strategy," which aims to better understand China's strategic ambitions in Africa and assess how the continent fits into China's envisioned global order. The first three reports in this project to date have examined China's expansion into Africa from Beijing's perspective, often relying on Chinese-language sources to draw conclusions and analyze China's strategy.2 Yet, only looking at Beijing's viewpoint to get a fuller grasp on China-Africa relations would be a gross oversight that would provide an incomplete impression of China's engagement with the continent. Africa is a continent with 54 countries and a population of more than 1.3 billion people. China's engagement with the continent, of course, does not have the same level of impact or influence in all these countries, and not all states share the same opinion regarding China's presence. This roundtable seeks to share, highlight, and examine African perspectives regarding China's engagement with and influence on the continent. The essays here provide both regional and functional case studies examining different facets of the China-Africa relationship from the perspective of African [End Page 2] states, ranging from medical diplomacy and infrastructure development to smart cities in Kenya and the Digital Silk Road to local responses to China's growing influence and image campaigns in Zambia and Mauritius. Cobus van Staden evaluates China's medical diplomacy as the Covid-19 pandemic becomes endemic. While China's mask diplomacy in the early phases of the pandemic was effective and garnered positive responses, its later vaccine diplomacy suffered setbacks. Although Beijing appeared to overpromise and underdeliver, he concludes that vaccine and medical diplomacy can be considered a diplomatic victory for China, compared to the West's disappointing and underwhelming response. Looking at another area of diplomacy and outreach, Mandira Bagwandeen discusses China's infrastructure investments and application of the Belt and Road Initiative (BRI) in African countries as well as key outcomes from the Eighth Forum on China-Africa Cooperation (FOCAC) in November 2021. Amid accusations of debt-trap diplomacy and the financial pressures of the Covid-19 pandemic, she finds that China has demonstrated some willingness to negotiate debt-relief measures with African states. Discussions at FOCAC, however, indicated that China intends to begin re-directing its development assistance away from financing infrastructure development through large loans and toward trade facilitation. Also under the BRI umbrella is the Digital Silk Road, which is focused on improving states' infrastructure for information and communications technology and digital capabilities. As Ovigwe Eguegu explains, the Digital Silk Road is attractive to many African governments, including Ethiopia, Senegal, Gambia, and Zimbabwe, due to China's emphasis on digital sovereignty, which aligns with their development priorities. However, obstacles, such as a lack of digital infrastructure, still must be overcome before the Digital Silk Road becomes fully popularized in Africa. Bulelani Jili also addresses technology development in Africa, focusing particularly on smart cities in Kenya as a case study. He argues that China's "no strings attached" lending practices, especially for technology development, create opportunities for technology to be abused in societies where few data and privacy regulations exist. Jili asserts that it is not necessarily the sharing of the technologies that is worrisome, but the local governance conditions that can enable unjust surveillance practices in smart cities and using smart technologies. Obert Hodzi examines the effect of China's rise and presence in Africa on democracy and development, looking specifically at Zimbabwe, Rwanda, and Ethiopia. He argues that while China does not promote [End Page 3] its authoritarian model, by highlighting...

Sumich, J. (2018). The Middle Class in Mozambique: The State and the Politics of Transformation in Southern Africa (the International African Library). Cambridge: Cambridge University Press, 190 pages. ISBN: 9781108472883

Jason Sumich proposes to analyze the middle class in Mozambique, contextualized within the political changes of the state, within the broader context of Southern Africa. The book is organized chronologically in 7 chapters. The author starts by describing the Portuguese imperial project and late colonialism, followed by an analysis of Frelimo's social transformative project and its limits. He then discusses how the erosion of the social transformation project initiated in the post-independence transformed the basis of privilege. Followed by a discussion of the factors that led to the increasing cleavage between the middle class and the ruling elite. He rounds up his analysis by shedding light in an increased polarisation. His analyses, based on a long-term ethnography, are a departure from previous afro-pessimist views on African elites that also offers a critical reading of the Africa Rising narrative of the middle class. The book's analytical weakness comes from its narrow sample and post-independence dynamics, despite acknowledging colonial class legacy. This limits the analytical reach of the book and the elements he explores - class dynamics, power structures, the configuration of Maputo, gender and race relations, and the position of foreigners in the society - often lack nuance.

The Inherent Limitations of Gender-Based Violence to the Exclusion of LGBTIQ: A Guide for Social Workers

Drawing from the queer theory, this article strives to understand the scourge of gender-based violence against members of the homosexual community through a literature review. There is a gap in understanding this scourge against LGBTIQ. Additionally, there is a dearth of research on GBV within the social work fraternity despite the profession’s mandate to protect vulnerable groups. A comprehensive understanding of this hate crime is critically important in the current times where incidents of violence based on one’s gender are on the rise in South Africa. Social workers are in a privileged position to educate communities about these appalling crimes and to inform inclusive policies to curb this pandemic against members of the homosexual community.

Review of exponential rise in domestic violence amid COVID-19: theories and perspectives

The need for continuous research on domestic violence could be more espoused by the exponential increase in domestic violence, such that characterized the global reign of corona virus. Domestic violence cases have been on the rise in South Africa since 1994; and despite the existence of legal protections and statutory instruments that attempt to hinder domestic violence, there continues to be prevalence of violent behaviours across different families. Indisputably, the outbreak of coronavirus has created myriads of consequences for justice system in South Africa and the world at large. Due to the outbreak, the South African government announced a lockdown to mitigate the spread of the virus. Nonetheless, within a span of one week of the lockdown, the South African Police Services (SAPS) reported a shocking rise in the number of gender-based violence cases, which was approximately reported as 89000. The lockdown primarily suggests that victims be locked with the perpetrators for a period until it is deemed safe to end the lockdown. Using a systematic review of the empirical literature, the paper provides a quadripartite criminological perspective (comprising differential association theory, classical theory, frustration-aggression theory and social bond theory) on the rise of domestic violence during the outbreak of the virus. It further explores the aftermaths of COVID-19 on criminal justice system in terms of dealing with diverse cases of domestic violence in the Republic. Factors pertaining to issues of access to justice system during the lockdown, poor police response and victim reporting, sense of helplessness by victims, delayed justice, as well as victim support, system are significantly evaluated

Turning point: A new global COVID-19 wave or a signal of the beginning of the end of the global COVID-19 pandemic?

A new variant named Omicron (B.1.1.529), first identified in South Africa, has become of considerable interest to the World Health Organization. This variant differs from the other known major variants, as it carries a large number of unusual mutations, particularly in the spinous process protein and receptor binding domains. Some specific mutation sites make it vaccine resistant, highly infectious, and highly pathogenic. The world fears that the Omicron variant could be even more harmful than the previous major variant, given that it has emerged amid fierce competition to trigger a new global pandemic peak as infections in South Africa rise. However, some epidemiological evidence has emerged that the Omicron variant may produce milder patient symptoms. We speculate if the virulence of the Omicron variant will diminish as transmissibility increases, thereby signaling the beginning of the end for the global COVID‐19 pandemic. Based on this view, we make recommendations for COVID‐19 mitigation in the present and future. However, it will take a few weeks to determine the true threat posed by the Omicron variant and we need to be fully prepared for future outbreaks, regardless of their severity.

Impact of Continuing Medical Education in the Implementation of Health Projects: Case of the Project “Improving the Management of Diabetes and its Complications in The Department of Saint-Louis in Senegal”

Introduction: Diabetes is on the rise in sub-Saharan Africa, and particularly in Senegal where the latest prevalence estimates are around 3.4%. The region of Saint-Louis is a special case in terms of prevalence, since it far exceeds the national average, with more than 10% of the local population in 2011, or 30,000 to 40,000 cases. This epidemiological evolution of diabetes in the department of Saint-Louis is the direct consequence of many causes, including the lack of continuing medical education for paramedical staff. Material and methods: Our work proposes to return to the need for continuing medical education of paramedical staff in the department of Saint-Louis, through two surveys carried out with the diabetic people: a base line survey carried out before the training, and an end line survey after the diabetes training. The general objective is to assess the skills of health workers and their effectiveness in the management of diabetes and its complications, as well as the quality of diabetes management. Results: We found that the level of knowledge of nurses in charge of health posts and other paramedical staff is relatively heterogeneous. The average level obtained for right answers (66.76% during the base line survey and 82.4% during the end line survey) reflects the lack of continuing education concerning the diabetic disease in the department of Saint-Louis. Conclusion: The assessment of the knowledge of nursing staff in the department of Saint-Louis to which we proceeded is edifying. It is part of a logic of improving knowledge of diabetic disease and its complications. It shows that in the peripheral health structures, the need for continuing medical education is real.