AWARENESS AND PERCEPTION OF ILISHAN REMO COMMUNITY MEMBERS ON CHRONIC KIDNEY DISEASE, OGUN STATE, NIGERIA

CHAPTER ONE

INTRODUCTION

1. Background to the Study

In most developed countries, chronic diseases like diabetes and hypertension are presenting high rate of prevalence, posing significant burdens on those who are diagnosed, and making increase in the costs of healthcare systems. Chronic kidney disease is said to be exhibiting similar trends as diabetes and hypertension, though it is not well known like diabetes and hypertension (Arogundade & Barsoum, 2008). Chronic kidney disease (CKD) is a permanent and progressive damage of kidney function, which results in the weakening and worsening of renal function or end-stage renal disease (ESRD). ESRD represents the end of the continuum of CKD. It is an overwhelming medical, social and economic problem for the patients, their families, and the country as a whole (Olugbenga, Ayodele, & Olutayo, 2010). No fewer than 24 million Nigerians are suffering from Chronic Kidney Disease which represents 14.2 per cent of the populace; also one in every seven individual in Nigeria has a degree of Chronic Kidney Disease or the other (Effa, 2016). About 20 per cent of deaths in Nigerian Hospitals are linked to kidney disease. Approximately about 50 per cent of patients do not recognize the origin of their kidney disease for the reason that it was reported late in the hospital for treatment (Oluseyi, Ayodeji, Enajite, Oladimeji & Ifedayo, 2016). The increase in the prevalence of CKD in developed and developing countries has occasioned a transformed interest in global CKD prevention because it is now considered a threat (Arogundade & Barsoum, 2008).  It is vital to identify and detect the disease early, though, for developing countries, if detected early is very important to deter mortality, because the bulk of the victims cannot afford the charges of management and treatment at the last stage of the disease.

Kidney disease can occur at any age and can affect any races and studies have revealed that African, Americans, Hispanics, American Indians and those from South Asian origin (those from India, Bangladesh, Sri Lanka or Pakistan) are at a greater risk of coming down with CKD. This threat is owed to high rates of diabetes and high blood pressure in these populations (Couser, Remuzzi, Mendis, & Tonelli, 2011). blood test and urine test are adequate to detect CKD and if still at early stage, low cost management and treatments can slow the development of the disease, decrease the possibility of heart attacks and strokes and thereafter improving the quality of life (World Kidney Day: Chronic Kidney Disease; 2015)

Significantly CKD has a strong influence on morbidity and fatal outcomes. Chronic kidney disease was ranked 27^th in the list of causes of total number of deaths worldwide in 1990, but later rose to 18^th in 2010 according to the global burden of disease study. (Jha, Garcia-Garcia, & Iseki, 2013). But among over 300 sources accounted for in the global burden of disease, contemporary study reveals that CKD is the 15th and 20th prominent cause of years lived with disability (Global Burden of Disease Study; 2013), and disability-adjusted life years (Murray, Barber, & Foreman, 2013).

1. Statement of the Problem

CKD is a predominant and possibly rising disease across sub-Saharan Africa with threats that comprises both communicable and non-communicable diseases.  African countries extremely depend on external resources for health care financing (12% compared to global average of 0.4%) (John, Bocheng, Scott, & Nicole, 2014). Most of this is still dedicated to specific diseases such as malaria, HIV and TB. CKD and other Non-Communicable disease not on the radar.  Communicable diseases continues to be the principal cause of death in Africa but behavioral diseases like chronic kidney and heart diseases are becoming more prominent (Guest & Peter, 2015). Health complications or circumstances turn out to be public health concerns when four criteria are met (Levey, Atkins, & Coresh, 2007). First, if the burden of the disease is high (i.e., many people are affected, and then it has been on the increase lately, and possibly will escalate in the future). This burden is proven in terms of mortality, morbidity, quality of life, and cost and also poses as a risk by the public. Secondly, the problem is spread unfairly (i.e. it affects mainly minorities and disadvantaged persons to a larger degree). Third, there is indication that protective approaches, that target economic, political, and environmental features that affect a populace’s health could considerably diminish the burden of the condition; and fourth, evidence shows that such protective approach do not yet exist (Couser, Remuzzi, Mendis, & Tonelli, 2011). Not less than 24 million Nigerians are suffering from Chronic Kidney Disease which symbolizes 14.2 per cent of the populace; also one in every seven individuals in Nigeria has one degree of Chronic Kidney Disease or the other (Effa, 2016).  About 20 per cent of deaths in Nigerian Hospitals are initiated by kidney disease. Almost about 50 per cent of patients do not know the cause of their kidney disease because it was informed late in the hospital for treatment (Ulasi,& Ijoma 2010). Also CKD is the 15th and 20th prominent cause of years lived with disability (Global Burden of Disease Study, 2013), and disability-adjusted life years (Murray, Barber, & Foreman, 2013). Moving through the years of the era of the 21^st century, the burden of CKD, in association with the suffering and financial implications, is becoming alarming thereby making it a major public health concern. It is preventable and the inception can be deferred as well as slow down its progression. Regrettably, the application of this knowledge, which can drastically reduce the weight and menace of CKD, is inadequate and unsatisfactory. Efficiently addressing this major health issue will require a broad public health approach (Couser, Remuzzi, Mendis, & Tonelli, 2011). Hence the research work sought to propose practical solutions to the gap in awareness and perception of Ilishan Remo community members on chronic kidney disease.