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McCulloch MI, Argent AC, Morrow B, Nourse P, Coetzee A, Du Buisson C, Reddy D, Buckley J, Sinclair PJ, Gajjar P, Semanska L, Eddy A, Feehally J, Cano F, Warady BA. Lessons learned from regional training of paediatric nephrology fellows in Africa. Pediatr Nephrol 2023; 38:3757-3768. [PMID: 37278919 PMCID: PMC10243235 DOI: 10.1007/s00467-023-06022-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Access to care for children with kidney disease is limited in less well-resourced regions of the world and paediatric nephrology (PN) workforce development with good practical skills is critical. METHODS Retrospective review of a PN training program and trainee feedback from 1999 to 2021, based at Red Cross War Memorial Children's Hospital (RCWMCH), University of Cape Town. RESULTS A regionally appropriate 1-2-year training program enrolled 38 fellows with an initial 100% return rate to their country of origin. Program funding included fellowships from the International Pediatric Nephrology Association (IPNA), International Society of Nephrology (ISN), International Society of Peritoneal Dialysis (ISPD), and the African Paediatric Fellowship Program (APFP). Fellows were trained on both in- and out-patient management of infants and children with kidney disorders. "Hands-on skills" training included examination, diagnosis and management skills, practical insertion of peritoneal dialysis catheters for management of acute kidney injury and kidney biopsies. Of 16 trainees who completed > 1 year of training, 14 (88%) successfully completed subspecialty exams and 9 (56%) completed a master's degree with a research component. PN fellows reported that their training was appropriate and enabled them to make a difference in their respective communities. CONCLUSIONS This training program has successfully equipped African physicians with the requisite knowledge and skills to provide PN services in resource-constrained areas for children with kidney disease. The provision of funding from multiple organizations committed to paediatric kidney disease has contributed to the success of the program, along with the fellows' commitment to build PN healthcare capacity in Africa. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Mignon I McCulloch
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa.
| | - Andrew C Argent
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Brenda Morrow
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Peter Nourse
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Ashton Coetzee
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Christel Du Buisson
- Department of Paediatric Nephrology, Tygerberg Hospital Children's Hospital, University of Stellenbosch, Stellenbosch, South Africa
| | - Deveshni Reddy
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Jonathan Buckley
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Paul J Sinclair
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Priya Gajjar
- Department of Paediatric Nephrology, Red Cross Children's Hospital, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Lucie Semanska
- International Pediatric Nephrology Association (IPNA) Office Administration, IPNA Programs Coordinator, Kansa City, MO, USA
| | - Allison Eddy
- Professor Emeritus (Pediatrics), The University of British Columbia|Musqueam Traditional Territory, Investigator, BC Children's Hospital Research Institute, Scientific & Research Staff, BC Children's Hospital, Vancouver, Canada
| | - John Feehally
- Emeritus Consultant Nephrologist, University Hospitals of Leicester, Honorary Visiting Fellow, Leicester, UK
| | - Francisco Cano
- Pediatric Nephrologist, Luis Calvo Mackenna Children's Hospital, University of Chile, Santiago, Chile
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