Global Dialysis Perspective: Senegal

Many countries in sub-Saharan Africa face enormous economic and human resource challenges in the management of patients with ESKD (1). Dialysis, the most common form of RRT in these countries, requires costly equipment (2) and is inaccessible to patients that are poor. This situation is exacerbated by a limited number and the busy schedules of dialysis centers. The hemodialysis population rate remains low at between 0 and 200 per million inhabitants in sub-Saharan Africa, so many patients die without accessing dialysis because of a lack of means. In many countries in sub-Saharan Africa, dialysis facilities are unavailable (3,4).Senegal is a country in West Africa bordered by the Atlantic Ocean to the west, Mauritania to the north, Mali to the east, Guinea and Guinea-Bissau to the south, and the Gambia located within (Figure 1). It covers 196,712 km2 and has 16,209,125 inhabitants (5), with an average density of 82 inhabitants per km2. There is a disparity in the distribution of the population between the 14 administrative regions: Dakar, the capital, constitutes the smallest area and includes 23% of the total population and 75% of the urban population, whereas the southeastern regions house only 6% of the total population. Young people aged <20 years represent 55% of the population, with an annual growth rate of 4%. According to the World Bank, the country has a lower-middle-income classification on the basis of gross national income, which is US$1410 per capita. Since 1987, patients with ESKD have been treated with hemodialysis. Only 25 patients were on dialysis in 2004 in the country. There are currently no national data on the incidence or causes of ESKD. However, in the Dakar University Hospital, the causes are dominated by hypertensive nephropathy …