3.42% deaths caused by CKD – WHO

MBABANE – The World Health Organisation (WHO) data published in 2020 revealed that kidney disease in Eswatini contributed 3.42 per cent of the total deaths in the country.

The report further indicated that chronic kidney disease (CKD) prevalence was 3.2 per cent, 0.3 per cent, and 0.1 per cent in Eswatini, Botswana, and Uganda, respectively, implying that Eswatini has one of the highest CKD prevalence rates in the region.

The CKD is understood to have started many years ago in Eswatini, but specific treatment modalities started to become stronger by the year 2000, with the invention of Haemodialysis (HG). The knowledge base increased in Eswatini such that clinical assessment, CKD prevention, early diagnosis, and treatment started to be rolled out to various patients, particularly those who made it to Mbabane Government Hospital.

Currently, only three public health facilities offer dialysis maintenance in the country, this being Mbabane Government Hospital, Raleigh Fitkin Memorial Hospital and Hlatikhulu Government hospital.

Queues

“Long queues are often observed as there are less resources than demand. Patients spend nights sleeping in hospital corridors awaiting appointments. There is a lack of (financial, psychological, clinical) support for chronic kidney disease patients,” commented Eswatini Kidney Foundation (ENKF) CEO Nkosinathi Dlamini.

He said there was lack of financial, psychological and clinical support for chronic kidney disease patients, pointing out that the cost of dialysis maintenance was very high (roughly E310 000 per annum per patient), excluding medication.

“Eswatini relies on neighbouring South Africa to conduct kidney transplants and the process is very costly (more than E2 million per procedure). This is such that the country has only conducted three transplants through this arrangement,” Dlamini said.

Adding, the CEO stated that data collected from RFM showed that since 2011 to 2023 June, there were 223 deaths from CKD reported from which 63 percent were males. He said from the Mbabane renal unit in 2023, there were 241 CKD patients undergoing dialysis.

As a way forward, the CEO is recommending the involvement of primary and secondary care facilities, along with directed screening of high risk populations, which includes children, patients with chronic medical conditions.

treatment

“There must be guideline based treatments of conditions commonly known to cause kidney failure to ensure optional treatment of the population. For example, a standardised pathway of treatment of hypertension (South African Hypertension Guidelines) as well as referral of high risk populations such as young hypertensive and those with resistant hypertension for further investigations and management,” the CEO said.

Further, Dlamini said there must be treatment of diabetes according to the International Federation of Diabetes Guidelines to retard the development and progression of target organ damage, as well as to avoid treatment related side effects.

He said there must also be easy referral and communication pathways including speed dial facilities and telemedicine along with frequent continued medical education sessions for nurses, doctors and allied health professionals.