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  1. 1. Ulm- Kumasi cooperation <ul><ul><li>Benjamin Ackon Eghan jnr. B.Sc,MBChB, M.Sc, DIC, PhD) </li></ul></ul><ul><ul><li>Research Fellow, </li></ul></ul><ul><ul><li>Department of Medicine, </li></ul></ul><ul><ul><li>Kwame Nkrumah University of Science and Technology, School of Medical Sciences (KNUST/SMS), Kumasi,Ghana. </li></ul></ul>
  2. 2. Outline <ul><li>Problem </li></ul><ul><li>Initial efforts at solving problem </li></ul><ul><li>Strategy </li></ul><ul><li>Activities </li></ul><ul><li>Future </li></ul>
  3. 3. Average annual incidence of CRF/ESRF per 1,000 admission to KATH.
  5. 5. Levels of serum creatinine at first presentation and percentage of patients. <ul><li>Highlights </li></ul><ul><li>Range </li></ul><ul><ul><li>177-2857 </li></ul></ul><ul><li>6%: -177-300 </li></ul><ul><li>22%: <500 </li></ul><ul><li>48%:501-1000 </li></ul><ul><li>72%:>500 </li></ul>
  6. 6. Efforts
  7. 7. Current situation
  8. 8. Projection for the future
  9. 9. The major question for Kidney medicine in developing countries is how to define strategies that can identify early enough those subjects who are at risk of developing kidney disease later in life.
  10. 10. Strategy <ul><li>Handle kidney diseases at three basic levels namely: </li></ul><ul><ul><ul><li>Primary </li></ul></ul></ul><ul><ul><ul><li>Secondary </li></ul></ul></ul><ul><ul><ul><li>Tertiary </li></ul></ul></ul>
  11. 11. Primary kidney care <ul><li>Main objective </li></ul><ul><ul><li>To limit the incidence of renal disease. </li></ul></ul><ul><ul><li>Controlling the causes and risk factors of renal diseases. </li></ul></ul>
  12. 12. Secondary kidney care. <ul><li>Objective </li></ul><ul><ul><li>Early detection </li></ul></ul><ul><li>Altering the susceptibility of people who are prone to getting a renal disease (high risk strategy). </li></ul><ul><li>Or </li></ul><ul><li>reducing their exposure to things that make them susceptible by general health promotion and specific protective measures. </li></ul>
  13. 13. Secondary kidney care. <ul><li>Mass screening (Bolivian example) </li></ul><ul><li>Mandatory pre-employment </li></ul><ul><li>Pre-enlisting into the army or police </li></ul><ul><li>Pre-school </li></ul><ul><ul><ul><ul><li>urine testing </li></ul></ul></ul></ul>
  14. 14. Tertiary
  15. 15. Activities <ul><li>Lecture in Uni Ulm on tropical nephrology </li></ul><ul><li>International conference on Nephrology-August 2003 at Rexmar hotel in Kumasi. </li></ul><ul><li>Future: cooperation in research on making diagnosis, making dialysis work in Kumasi </li></ul><ul><li>Research: causes of renal diseases in Kumasi </li></ul>