Abstract
Dietary education, counseling and compliance in any non-communicable disease (NCD) including chronic kidney disease (CKD) remains a challenge in a resource limited setting. This is partly attributed to the lack of expertise and an inadequate understanding of appropriate eating habits. The Africa Healthcare Network (AHN) supported dialysis centers in Dar es Salaam, Tanzania, are unique in having a very strong “dietetic service” provided to its patients. Furthermore, the nurses working in the centers are well orientated with patient education through classroom sessions over their clinical training, which in itself has had its challenges. However, the process and learnings to-date have led to the development of a recent dietary database. The objective of this study was to develop and establish a database to collect all aspects of patients’ socioeconomic status, diet and nutrition status. Thereby providing a platform for strengthening existing dietary interventions and improving the patients’ clinical outcomes. The database, started in August 2019, will initially contain data from centers from Dar es Salaam, Tanzania only. Data from centers outside of Dar es Salaam, including Arusha and Mwanza, Tanzania, would be incorporated by December 2019. The data being collected and processed includes diet intake, protein, calorie, potassium and sodium intake; monthly serum albumin and monthly body mass index (BMI) in addition to the socio-economic factors: sex, age, previous residence/current residence (if shifted because of dialysis), previous and current occupation, marital status, and education status. In this study we evaluated the preliminary data from our patients from Dar es Salaam, Tanzania. The initial evaluation was done in 59 patients undergoing dialysis at Dar es Salaam. 60% of the patients were male. The mean age was 58.19±11.6 yrs and 58.19±11.6 yrs in the males and females respectively. 53% of males were underweight with BMI < 25. While only 10% of the females on dialysis were underweight. Albumin levels in the males were 24% < 37mg/dl better than the women (27% < 37mg/dl patients). 60% of males and 78% of the women achieved the recommended protein intake (1.3g/kg body weight). While female patients complained of less appetite, it was found they received a greater support from the spouse and daughters in most cases. The recently started dietary database is aimed to maintain diet intake, nutrition status management and the needed interventions. This would be a major effort to improve well-being and outcomes of our CKD patients in Tanzania. The data base also aims to facilitate curriculum development and capacity building of renal dietitian and nurses working in renal dialysis units of the future.
Published Version
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