AACE MENA 2025-Regional Barriers to Diagnosis and Management of Adrenal Insufficiency

Regional Barriers to Diagnosis and Management of Adrenal Insufficiency

Video Transcription

Video Summary

The presentation addressed regional challenges in diagnosing and managing adrenal insufficiency in low-resource settings, focusing on Africa and the Middle East. Key etiologies vary: infections like TB and HIV dominate in sub-Saharan Africa, while autoimmune causes are more recognized in well-resourced Middle Eastern centers. Genetic syndromes are notable in North Africa. Diagnostic difficulties arise from symptom overlap with prevalent infections, limited access to cortisol and ACTH testing, and inadequate imaging and antibody assays. Management is hampered by delayed treatment, frequent crisis presentations, poor steroid availability, inconsistent patient and physician education, and fragmented healthcare systems. COVID-19 further disrupted care and access. Proposed solutions include establishing national registries, improving telemedicine, enhancing healthcare provider training, developing region-specific guidelines, and increasing community awareness. Policy actions needed involve ensuring steroid availability as essential medicines and insurance coverage for diagnosis and emergency care. Ultimately, despite its rarity, adrenal insufficiency is frequently misdiagnosed and life-threatening, requiring urgent attention to improve outcomes in developing regions.

Keywords

adrenal insufficiency

low-resource settings

diagnostic challenges

Africa and Middle East

steroid availability

healthcare disparities