Introduction:
Providing hemodialysis to patients in some remote areas of sub-Saharan Africa may be challenging. In Cameroon, where hemodialysis is the main modality of renal replacement therapy, public in-patients hemodialysis centers are availbale in all the 10 regions of the country with the last public center opened in Januray 2023 in Ngaoundere where dialysis are provided to patients with some difficulties and problems.
Methods:
We reviewed our one year and half experience with hemodialysis service in this tertiary hospital located in a of Norhten Cameroon from the patients records and hemodialysis registers of the Ngaoundere regional hospital (Adamawa region of Cameroon) from January 2023 to August 2024. . This was a scoping view to present the profile of hemodialysis patients and the challenges our center face in hemodialysis services. It was conducted as a qualitative study with a report of the present the situation of the center.
Results:
Patients caracteristics. In one year and half, 170 patients had at least one dialysis session in the center. Of them, 101 (69.41%) were males. The mean age of the patients was 47 years. Most were unemployed or in small jobs (73%) and without any education background (60%). Socio-cultural considerations : the center is located in a muslim region where dialysis is not well perceived (Only 10% of initiated patients accepted dialysis the first time). Causes of CKD: Hypertensive nephropathy, accounted as the leading cause of end-stage renal disease. Access to hemodialysis care: 25 US dollars per year for two weekly dialysis sessions. Only one center with 10 dialysis generators for the region, 35 % of patients are at 10 km or more from the center. Anemia management: erythropoietin is not available in the region. Blood transfusion is the only option for renal anemia. Vascular access : AVFs are performed by vascular surgeons, 800 km from the dialysis center in the capital city. Access to medications and laboratory testing : parathormone, serum iron, ferritin, transferin are not performed in the city. Hemodialysis unit staff: 8 nurses for 50 dialysis patients as of August 31, 2024. Viral screening and immunization: not always done for substancial and financial reasons. Water, dialysis material and electricity suppliers: the center is not autonomous.
Conclusions:
Patients with end stage renal disease need a life-saving supportive renal replacement therapy. Hemodialysis is available in the Adamawa region of Cameroon for less than 2 years but it cames with difficuties. Efforts should be intensified to improve other modalities of renal replacement therapy, in particular peritoneal dialysis. Also, preventive measures such as education for affected patients and proper screening program for the general population would be necessary to ameliorate the quality of dialysis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.