Kidney failure ravages Yobe, Jigawa communities Experts battle to unravel causes
Kidney failure has continued to ravage communities in Yobe and Jigawa States, even as doctors battle to unravel causes. Daily Trust gathered that despite its prevalence, the potential causes of the disease are still unknown.
Our correspondents who went round some hospitals noted that the ailment has continued to claim lives owing to lack of adequate facilities, health personnel with knowledge in the area and high cost of treatment.
At the Yobe State University Teaching Hospital, Khaltum lies on a bed as plastic tubes protrude through
her arms, connected to a dialysis machine next to her.
She looked pale and unconscious, when she was brought into the dialysis unit, but as she began to receive treatment, gradually, her condition stabilized.
Outside the room was her worried aged mother, father and other family members who struggled to raise funds to offset Khaltum’s medical bill and keep her alive.
Her brother, Abubakar, said her condition was between life and death when they brought her to the hospital, sometime in October 2018.
“For 12 months now, Khaltum has been bed-ridden in the hospital, receiving two dialysis sessions weekly,” he sobbed.
Head of the hospital’s Dialysis Unit, Idriss Usman, said the case of Khaltum is not different from the over 200 patients that are on regular dialysis in the centre.
He decried that if not for the recent support by government, 90 percent of patients with renal failure attending the hospital could not afford their sessions, despite that, many of them died.
“High prevalence of the disease compelled the state government to declare free dialysis for Yobe indigenes because many people died and are still dying from the ailment,” he said.
He observed that what the government did relieved many patients of the burden of dialysis, but that there is still a problem as the root cause of the disease is yet to be uncovered to halt the prevalence.
According to experts, the disease escalated to communities not only in Yobe, but Jigawa State, due to lack of understanding of the potential causes of the disease.
The experts believe that unless state and federal governments take measures to uncover the cause of the disease, the helpless patients will continue to die because not many people can afford the cost of dialysis and, in worst case, kidney transplant.
Records at the Yobe State Teaching Hospital, Damaturu, made available to Daily Trust, revealed that there is high prevalence of the renal disease in Bade (Gashua), Jakusko, Nguru, Yusufari, Bursari, Gaidam, as well as in neighbouring Hadeija and Kafin Hausa in Jigawa State.
Dr Suleiman Mohammed Maina, a Consultant Nephrologist, with the University of Maiduguri Teaching Hospital, said a baseline survey conducted on the disease by his team, two years ago, revealed that majority of kidney patients visiting the hospitals are from Gashua town.
He said the survey, which was conducted at the Federal Medical Centre, Nguru, indicated that Gashua had 50 per cent of the total number of patients; Gaidam 10 to 15 per cent, Bursari 10 to15 per cent while the other parts of the state shared the remaining.
“Dialysis record in Maiduguri, also showed that minority of the patients are from the farming/fishing communities along the shores of Hadeija-Kamadugu/Yobe river, where Gashua emirate sits,” he said.
According to the doctor, alarmed by high prevalence of the disease in recent time, a group of young men from Bade (Gashua) emirate, contacted him for collaboration and advice on ways to uncover the cause and overcome the trend.
“We had several meetings with them on ways to identify the causes of the disease. We formed different committees and I happened to be part of the scientific committee. Veterinary Doctors and NAFDAC officials were also involved and they have taken samples of meat and water for analysis,” he explained.
On early scientific approach taken to unravel the causality of the disease, Maina said they were making efforts to generate prevalence data from various sources, but that it is capital intensive.
“In generating the data, we will identify the patient’s location, occupation and lifestyle. This will help us to know the hazard and predisposition factors that may likely cause the disease in their respective communities. If they are farmers in regular contact with chemicals or consume traditional medicine, we will have a clue on how and where to start.
“Also blood of goats, in the area, and water samples have been collected to evaluate whether cadmium will be traced in the goats blood or heavy metals from water sources. But, the whole research depends on funding, which is our major challenge for now.” he said.
He regretted that despite the prevalence of the disease the two states and the entire northeast region have very few doctors who specialise in Nephrology.
“We only have one specialist in Yobe, one in Borno, two in Bauchi, one in Adamawa while Gombe and Taraba have none. Also, we have few nurses in the field. Government must sit up to address the impending epidemic,” he said.
When contacted, Dr Mamman Mohammed, of the Department of Veterinary, Public Health and Preventive Medicine, University of Maiduguri, said a research carried out on different food substances and environmental media had revealed “violative concentrations of Cadmium (Cd), Lead (Pb)’’.
Daily Trust gathered that the researchers prioritized Cadmium (Cd) as focus due to the role it plays in the development of chronic kidney diseases even at low level environmental exposure.
Mohammed said he and three other colleagues from the University of Maiduguri and Ahmadu Bello University, Zaria, have started a study into the prevalence of the disease in the areas. They used hospital records which indicated that most cases were among people between the ages of 20 to 40 years, particularly in the last 15 to 20 years.
He regretted that the actual cause of the disease is not known yet and its epidemiology remains poorly understood, most probably, due to poor health facilities and lack of qualitative health records.
“Cadmium is a heavy metal with high toxic potentials, even at very low exposure levels, resulting in acute and chronic effects on health and environment. It is relatively a rare element and its most common natural sources in the environment are volcanoes and weathering. Man-made activities play vital roles in the emissions and spread of Cadmium,” he explained. He said a study was carried out to evaluate levels of Cadmium and blood samples of 356 semi-intensively managed goats were collected from five randomly selected wards in the study area, and the concentration of blood cadmium was analysed.
“A total of 55 goats were sampled from Dagona; 72 from Katuzu; 78 from each of Lawan Musa and Sabon Gari; and 73 from Usur/Dawayo wards,” he said.
Mohammed further observed that all the affected areas are significantly agrarian population that depends heavily on River Hadejia-Kamadugu/Yobe as source of livelihood.
“Fishery, livestock, irrigation and rain-fed farming practices are their major occupations throughout the year. They live along the river bank,” he said.
He also said that previously there were reports expressing concern over deteriorating quality of the basin’s environment, especially due to dumping of industrial and municipal wastes at the upstream Kano river and from the large scale irrigation project at the Hadejia valley.
“So, the wastes from human activities from the upstream are the major sources of toxic heavy metals in the environment. Nephrotoxic metals such as Cadmium (Cd), Lead (Pb), Arsenic (As) and Mercury (Hg) are some of the metals associated with anthropogenic (poisonous to kidney) activities”.
“The National Agency for Food, Drugs Administration and Control.(NAFDAC) has reported concentrations of Cadmium (Cd) and lead (Pb) in samples of drinking water from the area ranging from 0.01 to 0.10 ppm and Not Detected to 0.30 ppm for Cd and Pb respectively,” he added.
According to him, a recent study carried out reported high concentrations of As, Cd, Pb, Nickel (Ni) and Chromium (Cr) from the water sources used for irrigation in Jawa, a village located in the study area, while Waziri and Lawan villages, have also reported high concentrations of Cd and Pb in vegetables raised in the area. Another research reported elevated levels of Cd and Pb in freshwater catfish from River Yobe.
“These findings could be good indicators of heavy metals pollution status of the environment and, possibly, its associated risks. But, the focus of the current research is on single metal due to financial constraints,” he said.
A visit to some of the affected areas by Daily Trust, revealed that the statistics received from the hospital underestimated the public health crisis of the disease.
Umar Abubakar Ahmad, is the Chief Imam of Gashua Central Mosque. He said the kidney disease is aggravating by the day.
“Many people have died and are still dying from this disease. I pity the patients each time they come to mosques, seeking assistance and in most cases they die from the disease.
“The dialysis is just temporary and, in most cases, the patient dies because it is