39 research outputs found
Integrated management: chronic kidney disease, diabetes mellitus, hypertension
No full textThe increasing burden of chronic kidney disease and end stage kidney failure presents a challenge for both developedand emerging countries. While dialysis and transplantation consumes an ever-increasing proportion of the health budgetin countries such as the United States, Japan and Taiwan, there is limited availability of these expensive therapies in themajority of emerging countries and more so in African nations.Aims: To review the prevalence, causes and integrated strategies for treatment and prevention of end stage renaldisease (ESRD) in Sub-Saharan Africa (SSA).Materials and Methods: Review of literature and information received from colleagues in Africa.Results: Approximately 70% of the least developed countries of the world are in SSA. Rapid urbanisation is occurringin many parts of the continent, contributing to overcrowding and poverty. While infections and parasitic diseases arestill the leading cause of death in Africa, non-communicable diseases are coming to the forefront. There is a continuingbrain drain of healthcare workers (physicians and nurses) from Africa to more affluent regions, resulting in largerural areas of Africa having no health professionals to serve these populations. There are no nephrologists in manyparts of SSA; the numbers vary from 0.5 per million population (pmp) in Kenya to 0.6 pmp in Nigeria, 0.7 pmp inSudan and 1.1 pmp in South Africa.Chronic kidney disease (CKD) affects mainly young adults aged 20-50 years in SSA and is primarily due to hypertensionand glomerular diseases. HIV-related chronic kidney disease is assuming increasing prominence and often presentslate, with patients requiring dialysis. Diabetes mellitus affects 9.4-million people in Africa. The prevalence of diabeticnephropathy is estimated to be 6-16% in SSA. The current dialysis treatment rate is <20pmp (and nil in many countriesof SSA), with in-centre haemodialysis the modality of renal replacement therapy (RRT) for the majority. Transplantationis carried out in a few SSA countries: South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana and Rwanda, with mostof the transplants being living donor transplants, except in South Africa where the majority are from deceased donors.Prevention programmes are in their infancy in most of SSA, due to lack of personnel and resources.Conclusion: Chronic kidney disease care is especially challenging in SSA, with large numbers of ESRD patients,inadequate facilities and funding, and lack of national or regional registries. Integrated management of CKD and itsrisk factors is necessary to impact on the burden of ESRD
Africa and Nephrology: The Forgotten Continent
No full textChronic kidney disease (CKD) is not a priority on the health agenda in Africa and it remains a ‘forgotten condition’. Most people in Africa do not have access to dialysis or transplantation, if they develop end-stage renal disease. Cardiovascular disease (CVD) and HIV/AIDS enjoy a more prominent profile as a serious cause of morbidity and mortality, but despite the clear links of CVD and HIV with CKD, there has been a failure to highlight the link between chronic illnesses like diabetes, hypertension and HIV/AIDS and both CKD and CVD. Management of chronic illnesses requires a functioning public health system and good links between primary and specialist care. Despite calls to establish CKD prevention programs, there are very few in Africa and they have not been integrated into existing primary healthcare systems. This is aggravated by shortages of both financial and human resources and failure to strengthen health systems managing chronic diseases. The result is that very few people in Africa with CKD are managed early or receive dialysis or transplantation. This article investigates some of the issues impacting on the recognition of CKD as a public health issue, and will also consider some factors which could make CKD a more prominent chronic disease in Africa.</jats:p
An effective approach to chronic kidney disease in South Africa
No full textCITATION: Moosa, M. R., et al. 2016. An effective approach to chronic kidney disease in South Africa. South African Medical Journal, 106(2):156-159, doi:10.7196/SAMJ.2016.v106i2.9928.The original publication is available at http://www.samj.org.zaENGLISH ABSTRACT: Very few patients with end-stage kidney disease in South Africa receive renal replacement treatment (RRT), despite the rapidly growing demand, because of resource constraints. Nephrologists who agonise daily about who to treat and who not to, and have been doing so since the inception of dialysis in this country, welcomed the opportunity to interact with the National Department of Health at a recent summit of stakeholders. The major challenges were identified and recommendations for short- to long-term solutions were made. While the renal community can still improve efficiencies, it is clear that much of the responsibility for improving access to RRT and reducing inequities must be borne by the national government. The summit marks the first step in a process that we hope will ultimately culminate in universal access to RRT for all South Africans.AFRIKAANSE OPSOMMING: Geen opsomming beskikbaarhttp://www.samj.org.za/index.php/samj/article/view/9928Publisher's versio
Noise-induced hearing loss and hearing protection : Attitudes at a South African coal mine
No full textDATA AVAILABILITY : The data that support the findings of this study are available
on request from the corresponding author, K.N.BACKGROUND : Negative attitudes and beliefs are major contributing factors to the rising numbers of noise-induced hearing loss (NIHL) cases in coal mines both locally and internationally. International literature confirms limited knowledge surrounding employees’ attitudes and beliefs regarding NIHL and hearing protection devices (HPDs), hence the need for the study.
OBJECTIVES : To ascertain the attitudes and beliefs about NIHL and HPD use among employees at a large scale underground coal mine in Mpumalanga.
METHOD : A descriptive and exploratory cross-sectional study was conducted using a self-administered questionnaire, developed by the National Institute for Occupational Safety and Health (NIOSH) on Beliefs about Hearing Protection and Hearing Loss (BHPHL). Participants (n = 241) included employees from a coal mine in Mpumalanga, South Africa.
RESULTS : Out of 241 completed surveys, this study found that 84% were aware of when to replace earmuffs; 95% believed wearing HPDs could prevent hearing loss in noisy environments; 83% felt their hearing was impacted by loud noise. Additionally, 86% mentioned discomfort from earmuff pressure; 95% emphasised HPD importance; and 95% used HPDs around loud sounds. Moreover, 98% knew how to properly wear earplugs, while lower education levels were linked to higher susceptibility to NIHL.
CONCLUSION : The study identified positive attitudes towards NIHL and HPD use, but existing NIHL cases must be acknowledged. Organisations can use the findings to develop tailored hearing conservation programmes (HCP), including education, involving employees in protection decisions and promoting diligent HPD usage.
CONTRIBUTION : This study contributes to the limited literature on noise perceptions, NIHL, and HPD use in mining, emphasising the impact attitude has on HPD use and assessing the effect of miners NIHL knowledge on compliance. The findings, unique to coal mining, hold significance for enhancing hearing conservation and reducing NIHL.http://www.sajcd.org.zahj2024School of Health Systems and Public Health (SHSPH)Non
