A roadmap for kidney care in AfricaAn analysis of International Society of Nephrology–Global Kidney Health Atlas Africa data describing current gaps and opportunities

African Journal of Nephrology

article

Ikechi Okpechi¹  Abdou Niang³  Mohammed Hafez⁴  Gloria Ashuntantang⁵  Deenaz Zaidi¹  Feng Ye¹  Aliyu Abdu⁶  Adanze Asinobi⁷  Rasheed Balogun⁸  Innocent Chukwuonye⁹  Hassane Diongole^1,10  Emmanuel Effa^1,11  Udeme Ekrikpo^1,12  Zaghloul Gouda^1,13  Jibrin Hussaini^1,14  Francois Kaze⁵  Kajiru Kilonzo^1,15  Robert Kalyesubula^1,16  Amna Kununa^1,17  Muhammad Makusidi^1,18  Ikechukwu Mbah^1,19  Mignon McCullough^2,20  Yewondwossen Mengistu^2,21  Mothusi Moloi^2,22  George Moturi^2,23  Kwazi Ndlovu²  John Ngigi^2,24  Yannick Nklandu^2,25  Joseph Ntarindwa^2,26  Julius Okel^2,27  Timothy Olanrewaju^2,28  Charlotte Osafo^2,29  Ugochi Samuel-Okpechi^3,30  Mazin Shigidi^3,31  Ernest Sumaili^2,25  Ifeoma Ulasi^3,32  Theophilus Umeizudike^3,33  Nicola Wearne²  Vivekanand Jha^3,34  Adeera Levin^3,37  David Johnson^3,38  Aminu Bello¹ 

[1] Department of Medicine, University of Alberta;Division of Nephrology and Hypertension, University of Cape Town;Department of Nephrology, Cheikh Anta Diop, University Teaching Hospital;Department of Internal Medicine, Faculty of Medicine, Cairo University;Faculty of Medicine and Biomedical Sciences, University of Yaounde I;Department of Medicine, Aminu Kano Teaching Hospital, Bayero University;Department of Paediatrics, University of Ibadan College of Medicine;Division of Nephrology, University of Virginia;Division of Renal Medicine, Department of Internal Medicine;Division of Nephrology, Department of Medicine, National Hospital Zinder;Department of Internal Medicine, Edward Francis Small Teaching Hospital;Department of Medicine, University of Uyo;Department of Nephrology, Damanhour Medical National Institute, Ministry of Health;Zenith Medical Centre;Kilimanjaro Christian Medical University College, Tumaini University;Departments of Physiology and Medicine, Makerere University;Khartoum Teaching Hospital;Division of Nephrology, Usmanu Danfodiyo University Sokoto;Department of Medicine College of Medicine and Health Sciences, Bingham University;Red Cross War Memorial Children’s Hospital, University of Cape Town;School of Medicine, Addis Ababa University;Department of Medicine, University of Botswana;ortis Kidney Centre;Renal Department, Kenyatta National Hospital;Nephrology Unit, University of Kinshasa;Service d’hémodialyse, King Faisal Hospital;Division of Nephrology, The Aga Khan University Hospital;Department of Medicine, College of Health Sciences, University of Ilorin;Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana;Department of Internal Medicine, Federal Medical Centre;Faculty of Medicine, University of Khartoum;Department of Medicine, University of Nigeria;Department of Medicine, Lagos State University Teaching Hospital;George Institute for Global Health, University of New South Wales;School of Public Health, Imperial College;Manipal Academy of Higher Education;Nephrology Division, University of British Columbia;Translational Research Institute;Department of Nephrology, Princess Alexandra Hospital;Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital

关键词: CKD;    kidney failure;    dialysis;    transplantation;    cost;    policy;   

DOI  :  10.21804/25-1-5100

学科分类：数学（综合）

来源: African Association of Nephrology

【 摘 要 】

Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres (8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive approach to policy formulations that support and protect patients with kidney disease in the continent, especially from the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for noncommunicable diseases, this paper proposes an African roadmap for optimal kidney care.

【 授权许可】

CC BY