Conference abstract
Income level, sources of financing and prognosis in maintenance hemodialysis in Yaoundé
Pan African Medical Journal - Conference Proceedings. 2023:17(5).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.5.1823
Archived on: 04 Jun 2023
Contact the corresponding author
Keywords: Income, financing, prognosis and chronic kidney disease (CKD)
Oral presentation
Income level, sources of financing and prognosis in maintenance hemodialysis in Yaoundé
Maimouna Mahamat1,2,&, Kammo Eteme Suzane1, Teuwafeu Denis Georges3, Mambap Tatang Alex4, Nono Tomta Aristide2, Nzana Bandolo Victorine1, Fouda Hermine1, Kaze Folefack François1
1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon, 2Haemodialysis unit, Yaoundé General Hospital, Yaoundé, Cameroon, 3Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon, 4Department of Clinical Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
&Corresponding author
Introduction: studies showed that low income is associated with high mortality in hemodialysis, particularly in lack of health insurance settings like Cameroon. We aimed to assess the relationship between income level, financing sources, and prognosis in maintenance hemodialysis (MHD) at Yaoundé.
Methods: we conducted a cross-sectional study from January 1st to May 31st, 2022 at the hemodialysis department of two tertiary hospitals in Yaoundé. We included all consenting patients > 18 years, on MHD for at least 3 months. We collected socio-demographic, economic, and clinical data. Income level was defined as the average money earned or received every month. Participants were asked to select their income from a list of four categories: < 58.3 USD (very low), 58.3-160.9 USD (low), 160.9-241.3 USD (adequate), 241.3-321.8 USD (good), >321.8 USD (excellent). The prognosis was determined during the study period; it was considered good with the absence of complications or poor if complications occurred such as infection, severe anemia, vascular access infection, or failure and death. Data were analyzed with EPI Info version 7.2. The confidence interval (CI) was set at 95% and a significant value of p<0.05.
Results: we included 205 patients (59.51% male) with a median age [IQR] of 52 [38-63] years. Nephrosclerosis (86.34%) and chronic glomerulonephritis (33.17%) were the main baseline nephropathy. The median dialysis [IQR] vintage or duration was 20 [9-55] months. Income level was very low (50.73%), low (9.76%), adequate (10.73%), good (6.34%), and excellent (22.44%). The sources of funding were family (41.46%), self and family (19.50%), Self (16.10%), and health insurance (10.24%). The prognosis was good at 22.44%. Very low monthly income was associated with poor prognosis [OR (95% CI): 2.66 (1.27-5.55) p=0.009]. Excellent income level on the other hand was associated with self-funding sources [OR (95% CI): 20.33 (5.56-74.25) p<0.0001]. We did not find a statistically significant association between patient funding sources and prognosis.
Conclusion: the majority of MHD patients have a very low monthly income with family financing of care. All this contributes to their poor prognosis.
Income level, sources of financing and prognosis in maintenance hemodialysis in Yaoundé
Maimouna Mahamat1,2,&, Kammo Eteme Suzane1, Teuwafeu Denis Georges3, Mambap Tatang Alex4, Nono Tomta Aristide2, Nzana Bandolo Victorine1, Fouda Hermine1, Kaze Folefack François1
1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon, 2Haemodialysis unit, Yaoundé General Hospital, Yaoundé, Cameroon, 3Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon, 4Department of Clinical Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
&Corresponding author
Introduction: studies showed that low income is associated with high mortality in hemodialysis, particularly in lack of health insurance settings like Cameroon. We aimed to assess the relationship between income level, financing sources, and prognosis in maintenance hemodialysis (MHD) at Yaoundé.
Methods: we conducted a cross-sectional study from January 1st to May 31st, 2022 at the hemodialysis department of two tertiary hospitals in Yaoundé. We included all consenting patients > 18 years, on MHD for at least 3 months. We collected socio-demographic, economic, and clinical data. Income level was defined as the average money earned or received every month. Participants were asked to select their income from a list of four categories: < 58.3 USD (very low), 58.3-160.9 USD (low), 160.9-241.3 USD (adequate), 241.3-321.8 USD (good), >321.8 USD (excellent). The prognosis was determined during the study period; it was considered good with the absence of complications or poor if complications occurred such as infection, severe anemia, vascular access infection, or failure and death. Data were analyzed with EPI Info version 7.2. The confidence interval (CI) was set at 95% and a significant value of p<0.05.
Results: we included 205 patients (59.51% male) with a median age [IQR] of 52 [38-63] years. Nephrosclerosis (86.34%) and chronic glomerulonephritis (33.17%) were the main baseline nephropathy. The median dialysis [IQR] vintage or duration was 20 [9-55] months. Income level was very low (50.73%), low (9.76%), adequate (10.73%), good (6.34%), and excellent (22.44%). The sources of funding were family (41.46%), self and family (19.50%), Self (16.10%), and health insurance (10.24%). The prognosis was good at 22.44%. Very low monthly income was associated with poor prognosis [OR (95% CI): 2.66 (1.27-5.55) p=0.009]. Excellent income level on the other hand was associated with self-funding sources [OR (95% CI): 20.33 (5.56-74.25) p<0.0001]. We did not find a statistically significant association between patient funding sources and prognosis.
Conclusion: the majority of MHD patients have a very low monthly income with family financing of care. All this contributes to their poor prognosis.
