Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality globally, being especially rife in low- and middle-income countries (LMICs) and continues to rise within Sub-Saharan Africa. CKD disproportionately affects people of African ancestry, who develop the illness at a younger age and have a more rapid progression towards kidney failure. This increased risk and susceptibility has partly been attributed to the rapid epidemiological transition, culminating in a high and sustained increase in the prevalence of hypertension and type 2 diabetes mellitus, in combination with a high burden of infectious diseases as well as a genetic predisposition to CKD.
Moreover, there are different methods used to detect kidney damage, all of which can influence the diagnosis and staging of CKD, with this consequently affecting the reported population prevalence. Due to the lack of data in many African countries, and limitations associated with current available data, the true burden of CKD in Africa is underestimated and thus remains largely unknown. Despite the growing evidence pointing to an increasing prevalence of CKD across Africa, there has not been an Africa-wide concerted effort to provide reliable estimates.
To stem the tide, the Non-Communicable Diseases Research Unit (NCDRU) of the South African Medical Research Council (SAMRC) has championed the formation of the CKD in Africa (CKD- Africa) Collaboration. This initiative led by Dr Cindy George, is an African network comprising of CKD studies that pools individual participant data from all relevant existing African studies. The formation of this network is described in the paper entitled “The Chronic Kidney Disease in Africa (CKD-Africa) collaboration: lessons from a new pan-African network” recently being published in the BMJ Global Public Health journal. This work was supported by the National Research Foundation (NRF) through the Thuthuka Funding instrument. The collaboration brings together almost 50 researchers from Africa, Europe and USA, all of which are actively engaged in research projects across Africa. The 12 African countries currently involved in the consortium includes: Egypt, Uganda, Kenya, Seychelles, Tanzania, Burundi, South Africa, Republic of Congo, Cameroon, Nigeria, Ghana and Burkina Faso.
The primary aims of the CKD-Africa Collaboration
Through collective efforts, the consortium will lead the way in being able to determine the burden of CKD in Africa, with accuracy and confidence. This can lead to the creation of resources for easily tracking disease burden as well as allow for modelling future projections of CKD to be performed in Africa. Overall, this work will lead to a greater understanding of the mechanisms driving CKD across the continent.
Furthermore, having reliable disease burden estimates can be used to construct policy guidelines related to screening and prevention; to address the consequences of CKD in Africa and inform on health services planning.
To date, the network has successfully curated data from 39 studies conducted in 12 African countries, totaling 35 747 participants thus far, with many studies still in the process of enrolling.
“We are excited to announce the consortium and look forward to expanding the network even further. This network has far-reaching potential for Africa, as it is in an ideal position to validate findings across geographical and national boundaries, to test hypotheses and to generate a new understanding of CKD progression and its complications,” said Dr Cindy George, Senior Scientist at the NCDRU.
We would encourage all researchers across the continent to contact us as we continue to seek collaborations with other groups who have suitable data. Also, although the CKD-Africa Collaboration is focused primarily on CKD research, many of the lessons learnt can be applied more widely in public health research especially in LMICs. Through collaboration we can make a difference, added George.
Although many successful research consortia exist, very few papers have been published on this topic, with this being the first from Africa, detailing the challenges faced and lessons learnt in setting up and managing a research consortium.
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