Sudan Peritoneal Dialysis Program, Khartoum, Sudan.
Perit Dial Int. 2010 Jan-Feb;30(1):23-8. doi: 10.3747/pdi.2008.00226.
Africa is the world's second-largest and second most populous continent. It is also the poorest and most underdeveloped continent. Struggling to provide the essential health interventions for its occupants, the majority of African countries cannot regard renal replacement therapy a health priority.
In 2007, Africa's dialysis population constituted only 4.5% of the world's dialysis population, with a prevalence of 74 per million population (pmp), compared to a global average of 250 pmp. In almost half the African countries, no dialysis patients are reported. The prevalence of peritoneal dialysis (PD) was 2.2 pmp, compared to a global prevalence of 27 pmp, with the bulk of African PD patients (85%) residing in South Africa. In North African countries, which serve 93% of the African dialysis population, the contribution of PD to dialysis is only 0% - 3%. Cost is a major factor affecting the provision of dialysis treatment and many countries are forced to ration dialysis therapy. Rural setting, difficult transportation, low electrification rates, limited access to improved sanitation and improved water sources, unsuitable living circumstances, and the limited number of nephrologists are obstacles to the provision of PD in many countries.
The potential for successful regular PD programs in tropical countries has now been well established. Cost is a major prohibitive factor but the role of domestic manufacture in facilitating widespread use of PD is evidenced by the South African example. Education and training are direly needed and these are areas where international societies can be of great help.
非洲是世界上第二大、第二人口多的大陆。它也是最贫穷、最不发达的大陆。为其居民提供基本卫生干预措施困难重重，大多数非洲国家无法将肾脏替代疗法作为卫生重点。
2007 年，非洲的透析患者仅占全球透析患者的 4.5%，患病率为每百万人口 74 例（pmp），而全球平均患病率为 250 pmp。在近一半的非洲国家，没有报告透析患者。腹膜透析（PD）的患病率为 2.2 pmp，而全球患病率为 27 pmp，非洲 PD 患者的大部分（85%）居住在南非。在北非国家，这些国家服务于 93%的非洲透析患者，PD 对透析的贡献仅为 0%至 3%。成本是影响透析治疗提供的主要因素，许多国家被迫限制透析治疗。农村环境、交通困难、电气化率低、获得改善的卫生设施和改善水源的机会有限、不适宜的生活环境以及肾脏科医生数量有限，这些都是许多国家提供 PD 的障碍。
在热带国家成功实施常规 PD 项目的潜力已经得到充分证实。成本是一个主要的障碍因素，但南非的例子证明了国产制造在促进 PD 广泛使用方面的作用。教育和培训是迫切需要的，在这些领域，国际社会可以提供很大的帮助。
