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Tannor EK, Davidson B, Nlandu Y, Bagasha P, Bilchut WH, Davids MR, Diongole HM, Ekrikpo UE, Hafiz EO, Ibrahim KS, Kalyesubula R, Nalado AM, Olanrewaju TO, Onu UC, Pereira-Kamath N, Sakajiki AM, Salah M, Vincent L, Arruebo S, Bello AK, Caskey FJ, Damster S, Donner JA, Jha V, Johnson DW, Levin A, Malik C, Nangaku M, Okpechi IG, Tonelli M, Ye F, Ashuntantang GE, Arogundade FA. Capacity for the management of kidney failure in the International Society of Nephrology Africa region: report from the 2023 ISN Global Kidney Atlas (ISN-GKHA). Kidney Int Suppl (2011) 2024; 13:12-28. [PMID: 38618494 PMCID: PMC11010621 DOI: 10.1016/j.kisu.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 04/16/2024] Open
Abstract
The burden of chronic kidney disease and associated risk of kidney failure are increasing in Africa. The management of people with chronic kidney disease is fraught with numerous challenges because of limitations in health systems and infrastructures for care delivery. From the third iteration of the International Society of Nephrology Global Kidney Health Atlas, we describe the status of kidney care in the ISN Africa region using the World Health Organization building blocks for health systems. We identified limited government health spending, which in turn led to increased out-of-pocket costs for people with kidney disease at the point of service delivery. The health care workforce across Africa was suboptimal and further challenged by the exodus of trained health care workers out of the continent. Medical products, technologies, and services for the management of people with nondialysis chronic kidney disease and for kidney replacement therapy were scarce due to limitations in health infrastructure, which was inequitably distributed. There were few kidney registries and advocacy groups championing kidney disease management in Africa compared with the rest of the world. Strategies for ensuring improved kidney care in Africa include focusing on chronic kidney disease prevention and early detection, improving the effectiveness of the available health care workforce (e.g., multidisciplinary teams, task substitution, and telemedicine), augmenting kidney care financing, providing quality, up-to-date health information data, and improving the accessibility, affordability, and delivery of quality treatment (kidney replacement therapy or conservative kidney management) for all people living with kidney failure.
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Affiliation(s)
- Elliot Koranteng Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Bianca Davidson
- Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Yannick Nlandu
- Nephrology Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Peace Bagasha
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Directorate of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | | | - M. Razeen Davids
- Division of Nephrology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Hassane M. Diongole
- Division of Nephrology, Department of Medicine, National Hospital Zinder, Zinder, Niger
- Faculty of Health Sciences, University of Zinder, Zinder, Niger
| | - Udeme E. Ekrikpo
- Department of Medicine, University of Uyo/University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Ehab O.A. Hafiz
- Electron Microscopy Department, Clinical Laboratory Division, Theodor Bilharz Research Institute, Giza, Egypt
| | - Kwaifa Salihu Ibrahim
- Nephrology Unit, Department of Medicine, Wuse District Hospital, Abuja, Nigeria
- Department of Internal Medicine, College of Health Sciences, Nile University, Federal Capital Territory, Abuja, Nigeria
| | - Robert Kalyesubula
- Department of Physiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aisha M. Nalado
- Department of Medicine, Bayero University Kano, Kano, Nigeria
| | - Timothy O. Olanrewaju
- Division of Nephrology, Department of Medicine, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ugochi Chika Onu
- Renal Unit, Department of Medicine, University of Nigeria Teaching Hospital, ItukuOzalla, Enugu State, Nigeria
| | | | - Aminu Muhammad Sakajiki
- Department of Medicine, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Mohamed Salah
- National Institute of Urology & Nephrology, Cairo, Egypt
| | | | - Silvia Arruebo
- The International Society of Nephrology, Brussels, Belgium
| | - Aminu K. Bello
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fergus J. Caskey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jo-Ann Donner
- The International Society of Nephrology, Brussels, Belgium
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
| | - David W. Johnson
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Australasian Kidney Trials Network at the University of Queensland, Brisbane, Queensland, Australia
| | - Adeera Levin
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charu Malik
- The International Society of Nephrology, Brussels, Belgium
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ikechi G. Okpechi
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
- Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Canada and Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
| | - Feng Ye
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gloria Enow Ashuntantang
- Faculty of Medicine and Biomedical Sciences, Yaounde General Hospital, University of Yaounde I, Yaounde, Cameroon
| | - Fatiu Abiola Arogundade
- Renal Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Karam S, Abdul Hafidz MI, Calice-Silva V, Chen T, Dupuis S, Ekrikpo UE, Francis A, Jha V, Kalyesubula R, Kumar V, Nakhoul G, Pereira-Kamath N, Tannor EK, Tran A, Wijewickrama E, Wong MM, Chanchlani R. Nurturing Global Leadership, Advocacy, Research, and Collegiality: The Unique Experience of The International Society of Nephrology Emerging Leaders Program. Kidney Int Rep 2023; 8:1703-1707. [PMID: 37705897 PMCID: PMC10496062 DOI: 10.1016/j.ekir.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Affiliation(s)
- Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, USA
| | | | - Viviane Calice-Silva
- Pro-Rim Foundation, Joinville, Santa Catarina, Brazil and Department of Clinical Medicine, Faculty of Medicine, University of the Region of Joinville (UNIVILLE), Joinville, Santa Catarina, Brazil
| | - Titi Chen
- Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Sophie Dupuis
- International Society of Nephrology, Brussels, Belgium
| | | | - Anna Francis
- Department of Clinical Medicine, School of Medicine, University of Queensland, Brisbane, Australia
| | - Vivekanand Jha
- International Society of Nephrology, Brussels, Belgium
- George Institute for Global Health, UNSW, New Delhi, India
- School of Public Health, Imperial College, London, UK
| | - Robert Kalyesubula
- Department of Physiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Georges Nakhoul
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Elliot K. Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anh Tran
- International Society of Nephrology, Brussels, Belgium
| | - Eranga Wijewickrama
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Michelle M.Y. Wong
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children’s Hospital, Hamilton, Ontario, Canada
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Francis A, Abdul Hafidz MI, Ekrikpo UE, Chen T, Wijewickrama E, Tannor EK, Nakhoul G, Wong MMY, Pereira-Kamath N, Chanchlani R, Kalyesubula R, Karam S, Kumar V, Calice-Silva V, Jha V. Barriers to accessing essential medicines for kidney disease in low- and lower middle-income countries|. Kidney Int 2022; 102:969-973. [PMID: 36044940 DOI: 10.1016/j.kint.2022.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/21/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Anna Francis
- Department of Clinical Medicine, School of Medicine, University of Queensland, Brisbane, Australia.
| | | | | | - Titi Chen
- Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Eranga Wijewickrama
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Elliot K Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Georges Nakhoul
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio, USA
| | - Michelle M Y Wong
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Robert Kalyesubula
- Department of Physiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Viviane Calice-Silva
- Pro-Rim Foundation, Joinville, Santa Catarina, Brazil; Department of Clinical Medicine, Faculty of Medicine, University of the Region of Joinville (UNIVILLE), Joinville, Santa Catarina, Brazil
| | - Vivekanand Jha
- International Society of Nephrology, Brussels, Belgium; George Institute for Global Health, UNSW, New Delhi, India; Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India; School of Public Health, Imperial College, London, UK
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