Summary of the Endocrinology Program at Black Lion Hospital, Addis Ababa, Ethiopia

Faculty:
Dr. Ahmed Reja, Division Head

Medical School: Belarus

Medicine Residency: Addis Ababa University

Endocrinology Fellowship: Sheffield, UK

Dr. Tedla Kebede Geletew

Medical School: Addis Ababa University

Medicine Residency: Addis Ababa University

Endocrinology Fellowship: Birmingham, UK

Fellows (2012-2014)

Dr. Helen Yifter Bitew

Medical School: Gonder College of Medical Sciences, Gonder, Ethiopia

Medicine Residency: Addis Ababa University

Endocrinology Fellowship: Addis Ababa University (2012-2014)

Dr. Abdurazek Ahmed Abdela

Medical School: Kartoum University, Kartoum, Sudan

Medicine Residency: Addis Ababa University

Endocrinology Fellowship: Addis Ababa University (2012-2014)

The Diabetes Clinic was built in 1994 by generous contributions from Lions International. It has now served this community for 20 years. There are 4 diabetes clinics per week (2 general diabetes, 1 diabetes in pregnancy, and 1 diabetes foot clinic; a total of about 250 patient visits per week) and 2 general endocrinology clinics per week (a total of 40-50 patient visits per week).

Diabetes testing and monitoring

A1C testing is not available.

Self-monitoring of blood glucose (SMBG) is not done by most patients but a few do.

Glucose control is assessed by a single fasting blood glucose before or during each visit and by asking patients about the frequency of hypoglycemic symptoms.

A serum creatinine, urine protein, and serum lipid panel are done annually in most diabetes patients.

Retinal photography is done in clinic by 3 trained nurses annually in most diabetes patients.

Endocrine testing and monitoring

Tests available: TSH, T4, Free T4, T3, Free T3, Cortisol, ACTH, Testosterone, Estradiol, Progesterone, LH, FSH, Prolactin

Tests not usually available: PTH, Growth Hormone, IGF-1, Cosyntropin (ACTH) stimulation testing

Imaging

Thyroid ultrasound and US guided FNA are done in radiology, not Endocrinology

Nuclear Medicine exists but thyroid uptake and scanning and I-131 treatment is usually not available due to lack of isotope availability

CT and MRI of the brain, chest and abdomen are available

Medications available to these patients:

Diabetes medications: Metformin, Glibenclamide, NPH Insulin, Regular Insulin, 70/30 NPH Regular Mix.

Blood pressure medications: Enalapril, Captopril, Losartan, Nifedipine, Propranolol, Methyldopa, Hydrochlorothiazide, Furosemide, Spironolactone

Lipid medications: Lovastatin, simvastatin

Thyroid medications: Thyroxine, Propylthiouracil, Propranolol

Adrenal medications: Prednisolone

Greatest current needs:

Clinical Care: A1c testing, SMBG meters and strips, Cosyntropin (ACTH) stimulation testing,

Neck ultrasound for clinic and training in ultrasound guided FNA, Patient education materials

Education: journal subscriptions, visiting professor programs