World Kidney ForumCKD Prevention in Sub-Saharan Africa: A Call for Governmental, Nongovernmental, and Community Support
Section snippets
Burden of CKD in SSA
The SSA region comprises nearly 50 sovereign African states that lie south of the Sahara Desert. Geographically, the demarcation line is the southern edge of the Sahara Desert, which cuts through Sudan, Chad, Niger, Mali, and Mauritania. SSA countries are grouped into 5 subregions: Eastern Africa, Southern Africa, West Africa, Central Africa, and the islands of the eastern coast of the continent, Madagascar, Mauritius, the Comoros, and the Seychelles (Fig 1).
SSA contains approximately 70% of
Cause of CKD in SSA
Although diabetic nephropathy has now emerged as the most common cause of ESRD, accounting for the greatest proportion of patients in RRT programs in developed countries and some developing ones, it is still a distant third common cause of ESRD in SSA. Several studies in Nigeria established that hypertensive nephrosclerosis and chronic glomerulonephritis are leading causes of CRF in Nigeria, but the prevalence of diabetic nephropathy is increasing, and obstructive uropathy also contributes
ESRD Management in SSA
A major bedrock of management of advanced CKD (ESRD) is RRT, which typically is unavailable, and where rarely available, is cost intensive and therefore inaccessible by the majority of affected individuals in SSA. Grassman et al28 reported that about 1.8 million people worldwide were undergoing treatment for ESRD at the end of 2004, 77% of whom were on dialysis treatment, whereas the remaining 23% were living with a functioning renal transplant. In North America, Europe, and the Middle East,
CKD Prevention Programs in SSA
Unfortunately, despite the dismal outcome of ESRD in SSA, there is as yet no government-funded/aided national prevention program in the entire subregion. Efforts in different parts of the subcontinent are disjointed, uncoordinated, and selective. The most well-established program in SSA is the Chronic Disease Outreach Primary Prevention Program (CHOPPP) established in Soweto by Dr Katz, patterned along the Australian Chronic Disease Outreach Programme described by Dr Wendy Hoy et al.38 The
Acknowledgements
We acknowledge the support of the following for providing information about their programs: Professor A. Akinsola (Nigeria), Dr A.A. Sanusi (Nigeria), Dr I. Katz (South Africa), Professor S. Naicker (South Africa), Dr C.O. Amira (Nigeria), Dr A. Asinobi (Nigeria), Professor Boucar Diouf (Senegal), Dr Dwomoa Adu (Ghana), Dr Gloria Ashuntantan (Cameroon), and Dr Linda Ezekiel (Tanzania).
Support: None.
Financial Disclosure: None.
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