Cost estimate of chronic hemodialysis in Kinshasa, the Democratic Republic of the Congo: A prospective study in two centers

Izeidi, Patrick P M; Nlandu, Yannick Mayamba; Lepira, François Bompeka; Makulo, J.R.; Engole, Yannick Mompango; Mokoli, Vieux Momeme; Bukabau, Justine Busanga; Kwilu, Fulbert N; Nseka, Nazaire Mangani; Sumaili, Ernest Kiswaya

doi:10.1111/hdi.12802

Cited by 15 publications

(14 citation statements)

References 24 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study carried out in the city of Kinshasa (Democratic Republic of Congo) in a non-subsidized context reported an annual average cost of hemodialysis of US$28,280, i.e. 22 times higher than the direct cost in Burkina Faso [ 17 ]. This low direct cost of hemodialysis found in our context compared to that of the Democratic Republic of Congo could be explained by several factors such as the existence of a subsidy for dialysis in Burkina Faso, the fact that patients do not perform all check-ups and also-they select the drugs to be purchased because of their limited resources.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the presence of a companion during care, residence in a rural area, ambulatory follow-up, use of personal cars, and care in the dialysis center of the Yalgado Teaching Hospital had a significant association with higher direct cost. Other studies in the Democratic Republic of Congo and China found comorbidity and residence environment as factors significantly associated with the cost of dialysis [ 6 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso)

et al. 2022

View full text Add to dashboard Cite

Background Chronic renal failure can lead to dialysis and/or a kidney transplant in the final stage. The number of patients under dialysis has increased considerably in the world and particularly in sub-Saharan Africa. Dialysis is a very expensive care. This is the reason why this study on the costs of dialysis management was initiated in Burkina Faso. The objective of the study is to determine the direct medical and non-medical costs of managing chronic renal failure among dialysis patients in Ouagadougou in 2020. Methods An analytical cross-sectional study was conducted. Data were collected in the hemodialysis department of three public university hospitals in Ouagadougou, Burkina Faso. All dialysis patients with chronic renal failure were included in the study. Linear regression was used to investigate the determinants of the direct medical and non-medical cost of hemodialysis. Results A total of 290 patients participated in this study, including children, adults, and the elderly with extremes of 12 and 82 years. Almost half of the patients (47.5%) had no income. The average monthly total direct cost across all patients was 75842 CFA or US$134.41.The average direct medical cost was 51315 CFA or US$90.94 and the average direct non-medical cost was 24 527 CFA or US$43.47. Most of the patients (45.2%) funded their hemodialysis by their own source. The multivariate analysis showed that the presence of an accompanying person during treatment, residing in a rural area, ambulatory care, use of personal cars, and treatment at the dialysis center of Yalgado Teaching Hospital were associated with higher direct costs. Conclusion The average cost of dialysis services borne by the patient and his family is very high in Burkina Faso, since it is 2.1 times higher than the country's minimum interprofessional wage (34664 CFA or US$61.4). It appears that the precariousness of the means of subsistence increases strongly with the onset of chronic renal failure requiring dialysis. Thus, to alleviate the expenses borne by dialysis patients, it would be important to extend the government subsidy scheme to the cost of drugs and to promote health insurance to ensure equitable care for these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso)

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Despite the fact that the number of participants was low (only 17 patients out of 51) in the center practicing lower prices per HD session and the serological status at the initiation of HD was not well established, the high frequency of HCV infection in this center could be explained by the high treatment rates with an inadequate nursing medical staff-patient's ratio probably responsible for nosocomial transmission. Because in a country like the DRC where dialysis is not subsidized and where social security and mutual funds are poorly developed, the consumables used in dialysis inevitably participate in the calculation of the prices of hemodialysis sessions (13). The motivation of nursing/medical staff and their number in relation to patients treated also have an impact on the quality of care.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa

Ngilibuma¹,

Mokoli²,

Nlandu³

et al. 2022

Ann. Afr. Med

View full text Add to dashboard Cite

Contexte et Objectifs. Le nombre des patients hémodialisés en Afrique subsaharienne en constante augmentation ; justifiant de ce fait une meilleure prise en charge de ces patients. La présente étude détermine la prévalence de l’infection par le virus de l’hépatite C en en determinant les génotypes ainsi que les facteurs y associés dans ce groupe de patients. Méthodes. 127 patients hémodialisés chroniques ont subis des tests sérologiques à la recherche des anticorps anti-VHC dans plusieurs centres de Kinshasa de février à juin 2018. Le génotype viral a été déterminé par la RT-PCR. Résultats. La fréquence des anticorps anti-VHC a varié de 0 à 52,9 % dans ce groupe. Les génotypes le plus fréquents ont été le 4 (18/22) et le 2 (2/22) ; étant sumultanément rétrouvé chez un patient, et indéterminé chez un autre sujet. Avoir reçu au moins 4 transfusions [7,21 (1,09-10,61; p=0.040)], ne pas être sous EPO [5,81(1,47-12,96); p=0.012)], être en hémodialyse depuis au moins 14 mois [3,63(1,60-5,05); p=0.035)] et être dialysé dans un centre surchargé [2,06 (0,83-5,86); p=0.073)] étaient associés à un risque plus élevé d’infection par le VHC. Conclusion. Ses principaux déterminants sont : le nombre des transfusions sanguines et la durée d'HD ; d’où la nécessité de réduire les transfusions sanguines chez les sujets dialysés par l'administration d'EPO, étant donné le coût prohibitif du traitement contre le VHC dans notre contexte. Context and objective. The steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes, and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). Methods. A cross-sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real-time polymerase chain reaction (RT- PCR). Results. Twenty-two (17.3 %) patients were positive for anti-HCV antibodies, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09-10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection. Conclusion. This high HCV prevalence (17.3 %) represents a substantial health burden in HD patients from Kinshasa, DR Congo. It is largely driven by the number of blood transfusions, the duration time in hemodialysis. Observations from the present study underscore the need of reducing the number of blood transfusions in people on dialysis through the administration of erythropoietin, given the unaffordable cost of HCV therapy for most individuals in DR Congo.

show abstract

“…Despite the fact that the number of participants was low (only 17 patients out of 51) in the center practicing lower prices per HD session and the serological status at the initiation of HD was not well established, the high frequency of HCV infection in this center could be explained by the high treatment rates with an inadequate nursing medical staff-patients ratio probably responsible for nosocomial transmission. Because in a country like the DRC where dialysis is not subsidized and where social security and mutual funds are poorly developed, the consumables used in dialysis inevitably participate in the calculation of the prices of hemodialysis sessions (13). The motivation of nursing/medical staff and their number in relation to patients treated also have an impact on the quality of care.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa: Prevalence and Risk Factors

Ngilibuma

Mokoli

Nlandu

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

IntroductionThe steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). MethodsA cross sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real time polymerase chain reaction (RT- PCR). ResultsTwenty-two (17.3 %) patients were anti-HCV positive, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09-10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection.ConclusionThis study highlights the importance of strategies to prevent HCV infection in hemodialysis patients in Kinshasa. This issue is important for SSA countries which are facing several economic and logistical challenges.

show abstract

Cost estimate of chronic hemodialysis in Kinshasa, the Democratic Republic of the Congo: A prospective study in two centers

Cited by 15 publications

References 24 publications

The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso)

The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso)

Prevalence and determinants of Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa

Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa: Prevalence and Risk Factors

Contact Info

Product

Resources

About