Last update:
09-Sep-2020

Sub-Saharan Africa (SSA) is a heterogeneous region with 47 countries, almost one billion people, and a gross domestic product of 1.7 trillion USD in 2017. The development of dialysis in Africa reflects the local socio-political circumstances. Up to seventies, Africa was recovering from long years of colonisation and political turmoil, so limited countries were able to establish dialysis centres. (a) Before the seventies: South Africa was the first country in SSA that started dialysis, when, in 1957, a general practitioner in Krugersdorp hospital dialysed 2 patients with acute kidney injury (AKI). In Kenya, acute haemodialysis (HD) was started in 1961 by Professor L.S. Otieno, followed by peritoneal dialysis (PD) two years later. In Nigeria, limited acute dialysis has been available in Lagos since 1965 and acute PD in Ibadan since 1967. Regular HD was firstly established at Lagos Teaching Hospital in 1981 by Professor T.A. Odutola. In Sudan, the first dialysis centre was a home dialysis unit, established in 1968, supervised by Mr. Osman Awadalla. (b) After the seventies: In Côte d'Ivoire, the first acute PD was performed in 1974 in Abidjan by Professor Alain Bondurand to treat a black fever patient with AKI. In Zimbabwe, Drs John Forbes and Janet Seggie placed a dialysis machine in Harare Central Hospital in the early 1970s; yet the machine was only occasionally used for the treatment of AKI until 1980. In Ethiopia, PD dialysis and less often HD was started in 1980 as reported by Dr Berhanu Habte to treat AKI at Addis-Ababa University Hospital. In Tanzania, Dr J. P. Miabaji reported that two dialysis machines were available at Dar-El-Salam University Hospital in the early 1980s, to treat AKI or important patients with plans for transplantation abroad. In Ghana, Dr T.C. Ankrah provided acute PD and sometimes HD for AKI in 1980. Other SSA countries started to establish dialysis units afterwards. However, dialysis services are still sparse in most countries due to the high costs and shortage of skilled personnel.

Key words: Haemodialysis AKI, Haemodialysis black fever, Haemodialysis sub-Saharan Africa after the seventies, Haemodialysis sub-Saharan Africa before the seventies, Home dialysis Sudan.