Peritoneal dialysis in Africa.

Area of Science:

• Nephrology
• Public Health
• Global Health

Background:

• Africa faces significant challenges in providing essential health interventions, with renal replacement therapy often not considered a priority.
• The continent grapples with poverty and underdevelopment, impacting healthcare access for its large population.

Purpose of the Study:

• To review the current state of dialysis, particularly peritoneal dialysis (PD), in Africa.
• To identify barriers and facilitators for the provision of PD in African countries.

Main Methods:

• Analysis of global and African dialysis population statistics, including prevalence rates for general dialysis and PD.
• Examination of factors influencing PD provision, such as cost, infrastructure, and healthcare professional availability.

Main Results:

• In 2007, Africa's dialysis population was 4.5% of the global total, with a prevalence of 74 per million population (pmp), far below the global average of 250 pmp.
• Peritoneal dialysis (PD) prevalence in Africa was 2.2 pmp (global: 27 pmp), with 85% of patients in South Africa. North Africa accounts for 93% of African dialysis patients, but PD contribution is minimal (0-3%).
• Key barriers to PD include high cost, rural settings, transportation difficulties, low electrification, poor sanitation, and a limited number of nephrologists.

Conclusions:

• Successful regular PD programs are feasible in tropical regions.
• Cost remains a major barrier, but domestic manufacturing, as seen in South Africa, can facilitate wider PD use.
• International societies can significantly aid PD implementation through education and training initiatives.