Risk of death and the economic accessibility at the dialysis therapy for the renal insufficient patients in Lubumbashi city, Democratic Republic of Congo
Mundongo Thamba, Henri; Van Caillie, Didier; Mutach Kapend, Franciset al.
2014 • In Pan African Medical Journal, 19:61, p. 1-8
accessibilité aux soins; dialyse; risque de décès; economic access; dialysis; death risk
Abstract :
[en] The last five years, Lubumbashi records the emergence centers of dialysis. We achieved this study to evaluate the risk factors of death for the
renal insufficient patients and the economic accessibility to this peak therapy. A cross sectional study based on a random sample of 53 patients has
been completed in 2012. The data is analyzed using the SPSS 19.0 software. A significance level of p < 0.05 and Confidence interval fixed to 95%.
The Fischer exact test and the odds ratio have been used. The participation rate was 65.4%. The mean age was 49.49 ± 13.30 years old and 60.4
% were aged > 50 years old. The sex ratio 0.3 women by men was noted. 83% of patients was private versus other category (p<0.05). 66 % are
renal insufficient chronic patients versus 34 % of recent renal insufficient patients. 90% of patients were diabetic hypertensive. The patients'
monthly income declared was US$ 205 for 52.8% of patients, US $ 525 for 34% patients and US $ 750 for 13.2% of patients versus US $ 1, 270
monthly mean care cost. The deaths are associated statistically with an interruption of the treatment (χ²=9.30, p=0.0022, OR= 8.5) and with the
irregularity of treatment (χ²=8.65, p=0.0032, OR=6). Africa in comparison with countries of other continents, to invest in advanced medical
equipment is a salutary measure, but the majority of patients are not able to pay the costs of health care. Our results shown that, the dialysis
became an ultimate recourse for the renal insufficient patients at Lubumbashi city but the economic accessibility remains a major obstacle.
Consequently, it's important to subsidize the health care of these patients.
Research Center/Unit :
CEPE - Centre d'Études de la Performance des Entreprises - ULiège
Disciplines :
Public health, health care sciences & services
Author, co-author :
Mundongo Thamba, Henri; Université de Lubumbashi > Faculté de Médecine
Van Caillie, Didier ; Université de Liège > HEC-Ecole de gestion : UER > Diagnostic et contrôle de l'entreprise
Mutach Kapend, Francis; Centre Médical du Centre Ville - Lubumbashi
Kaj Malonga, Françoise; Université de Lubumbashi > Faculté de Médecine
Ditend Yav, Grévisse; Faculté d'Economie et de Gestion > Université de Lubumbashi
Tshimwang Nawej, Pascal; Centre Médical du Centre-Ville - Lubumbashi
Language :
English
Title :
Risk of death and the economic accessibility at the dialysis therapy for the renal insufficient patients in Lubumbashi city, Democratic Republic of Congo
Alternative titles :
[fr] Risque de décès et accessibilité économique à la thérapie par dyalise pour les patients de la ville de Lubumbashi souffrant d'insuffisance rénale
(2010) Chronic kidney disease, national institute of diabetes and kidney diseases., , http://www2.niddk.nihgov/aboutniddk/organization, Health people 2010 objectives. accessed 2nd November 2013
(2010) Chronic kidney disease, national institute of diabetes and kidney diseases, , http://wwwniddk.nihgov/aboutniddk/organization, United States Renal Data System (USRDS) cited in Health people 2010 objectives. accessed 2th November 2013
Ulasi, I.I., Ijoma, C.K., (2010) The Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in South-East Nigeria., , Google Scholar
Ruggenenti, P., Remuzzi, G., Angiotensin-converting enzyme inhibitor therapy for non-diabetic progressive renal disease (1997) Curr Opin Nephrol Hypertens., 6 (5), pp. 489-495. , PubMed | Google Scholar
Klahr, S., Levey, A.S., Beck, G.J., Caggiula, A.W., Hunsicker, L.J., Kusek, J.W., Striker, G., MDRD Study Group, the effects of dietary protein restriction and blood pressure control on progression of chronic renal failure (1994) N Engl J Med., 330, pp. 878-884. , PubMed | Google Scholar
Hebert, L.A., Kusek, J.W., Greene, T., Agodoa, L.Y., Jones, C.A., Levey, A.S., Breyer, J.A., Wang, S., Modification of Diet in Renal Disease Study Group-Effects of blood pressure control on progressive renal disease in blacks and whites (1997) Hypertension., 30, pp. 428-435. , PubMed | Google Scholar
Tight blood pressure control reduces the risk of macrovascular and microvascular complications in Type 2 diabetes (1998) British Medical Journal, , (in press). Google Scholar
Ohkubo, Y., Kishikawa, H., Araki, E., Miyati, T., Isami, S., Motoyoshi, S., Kojima, Y., Shichiri, M., Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin dependent diabetes mellitus: A randomized prospective 6-year study (1995) Diabetes Research and Clinical Practice., 28, pp. 103-117. , Google Scholar
(2006) Global burden of disease, , http://www3.who.int/whosis/menu.cfm?path=evidence, March. accessed 6th November 2013
Akinsola, W., Odesanmi, W.O., Ogunniyi, J.O., Ladipo, G.O., Diseases causing chronic renal failure in Nigerians-a prospective study of 100 cases (1989) African Journal of Medicine and Medical Sciences., 18 (2), pp. 131-137. , PubMed | Google Scholar
Adetuyibi, A., Akisanya, J.B., Onadeko, B.O., Analysis of the causes of death on the medical wards of the University College Hospital, Ibadan over a 14 year period (1960-1973) (1976) Transactions of the Royal Society of Tropical Medicine and Hygiene., 70 (5-6), pp. 466-473. , PubMed | Google Scholar
Pruijm, M.T., Madeleine, G., Riesen, W.F., Burniern, M., Bovet, P., Prevalence of microalbuminuria in the general population of Seychelles and strong association with diabetes and hypertension independent of renal markers (2008) Journal of Hypertension., 26, pp. 871-877. , Google Scholar
Statistiques mondiales 2012., , www.who.int/gho/publications, OMS. accessed 6th November 2013
Ijoma, C.K., Ulasi, I., Kalu, A.O., Cost implications of treatment of end-stage renal disease in Nigeria (1998) Journal of College of Medicine, 3 (2), pp. 95-96. , PubMed | Google Scholar
Metnitz, P.G., Krenn, C.G., Steltzer, H., Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients (2002) Crit Care Med., 30 (9), pp. 2051-2058. , PubMed | Google Scholar
Bozet, G., Insuffisance rénale chronique terminale- De quoi meurent les patients? Entretien avec Pr Bernard Canaud, service de néphrologie, dialyse et soins intensifs, hôpital Lapeyronie, Montpellier (2007) Le quotidien du Médecin., p. 8244. , www.quotimed.com, accessed 6th November 2013. Google Scholar
Nichols, G., Brown, J., The impact of cardiovascular disease on medical care costs in subjects with and without type 2 diabetes (2002) Diabetes Care, 25 (3), pp. 482-486. , PubMed | Google Scholar
Clarke, P., Kelman, C., Colagiuri, S., Factors influencing the cost of hospital care for people with diabetes in Australia (2006) Journal of diabetes and its complications, 20 (6), pp. 349-355. , PubMed | Google Scholar
Donnan, P., Leese, G., Morris, A., Hospitalizations for people with type 1 and type 2 diabetes compared with the non diabetic population of Tayside, Scotland: A retrospective cohort study of resource use (2000) Diabetes Care., 23, pp. 1774-1779. , Google Scholar
Selby, J., Ray, G., Zhang, D., Colby, C., Excess costs of medical care for patients with diabetes in a managed care population (1997) Diabetes, 20 (9), pp. 1396-1402. , PubMed | Google Scholar
Journois, D., (2007) Conséquences de la défaillance rénale sur le devenir des patients., pp. 173-190. , www.sfar.org/acta/dossier/archives/ca07_14/ca_07.htm, Congrès national d'anesthesie et de réanimation, conférences d'actualisation. accessed 6th November 2013