Screening Chronic Kidney Disease in Madagascar: Findings from Five Provinces
Eliane Mikkelsen Ranivoharisoa1*, Sedera Aurelien Mioramalala2, Rodolphe Andriamifidison3, Antso Hasina Raherinandrasana3, Njarason Charles Ruffin Randria malala4, Norotiana Stephanie Raotoson5, Mamy Rabarijaona1, Sitraka Barthelemy Rakotonandrasana1, Lilie Ramaroson6, Ben Didier Parfait Ravelonandrasana7, Claude Cormerais8, Benja Ramilitiana1, Lova Narindra Randriamanantsoa9, Julio Rakotonirina10, Michel Quillard8, Willy Harilalaina Franck Randriamarotia1 and Ziad A.Massy9
1University Hospital of Befelatanana, Antananarivo, Madagascar
2National Center for the Application of Pharmaceutical Research, Antananarivo, Madagascar
3University Hospital Center for Care and Public Health, Analakely, Antananarivo, Madagascar
4,6University Hospital of Antanambao, Tulear, Madagascar
5University Hospital of MahavokyAtsimo, Tulear, Madagascar
7University Hospital of Tambohobe, Fianarantsoa, Madagascar
8CARE Association, La Baule, France
9Intensive Care Unit of Nephrology, University Hospital of Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
10Ambroise-Pare University Hospital Center, Boulogne-Billancourt, Paris, France
Citation: Ranivoharisoa EM, Mioramalala SM, Andriamifidison R, Raherinandrasana AH, Malala NCRR et al (2021). Screening Chronic Kidney Disease in Madagascar: Findings from Five Provinces. SciTech Central Nephrology 2021.
Received: September 06, 2021 Accepted: September 08, 2021 Published: September 08, 2021
Abstract
Chronic Kidney Disease (CKD) becomes a major public health problem. Almost of the time, patients in developing countries are seen lately with End-Stage of Renal Disease (ESRD). The main objective of this study is to evaluate CKD in Madagascar through a national survey by using strip test of creatinine. The second objective is to determine its associated factors. We have conducted a randomized cross sectional study during 3 years. Screening was done in 5 out of 6 provinces including Tananarive, Fianarantsoa, Tamatave, Tuléar and Majunga provinces. Sampling was done with randomization by cluster methods. All residents Malagasy people aged over 18 years old were included. All incompleted survey and data were excluded. Sociodemographics, clinical and biological characteristics were retained. CKD was defined as a decrease of an estimated-glomerular filtration rate (e-GFR) of creatinine calculated with CKD EPI formula less than 60ml/mn/1.73m2. Kidney Disease Improving Global Outcomes Classification was used to stadify the severity of CKD. STATA software was used for statistical analysis. In total, 1018 persons were included. Mean age was 42 years old (+/-15.8) with sex-ratio1.2. CKD rate was 15.91%. Studied population was categorized in middle social class (64.54%). In 65.03% of cases, population were in activity. CKD proportion in stages G3a, G3b, G4 and G5 were seen respectively in 9.82%, 2.75%, 1.08% and 2.26%. After statistical analysis, CKDwere associated with age : 50-74 years old (ORa=5.93 ; 95% CI 3.93–8.95 ; p=0.0000), over 75 years old (ORa=11.96; 95% CI 5.16–27.72 ; p=0.0000), personal history of hypertension (ORa=1.81 ; 95% CI 1.17–2.79; p=0.007), diabetes (ORa = 1.58; 95% CI 1.09-2.43; p=0.03) and upper social class (ORa= 2.56 ; 95% CI 1.21–5.41; p=0.013). The prevalence of CKDincreases in Madagascar. The first line therapeutic must focus on preventing by an early screening and treating Hypertension with diabetes.
Keywords: Chronic kidney disease, Diabetes, Hypertension, Madagascar, Prevalence
