A consolidated and geolocated facility list in Senegal from triangulating secondary data.

Having a geolocated list of all facilities in a country - a "master facility list" (MFL) - can provide critical inputs for health program planning and implementation. To the best of our knowledge, Senegal has never had a centralized MFL, though many data sources currently exist within the broader Senegalese data landscape that could be leveraged and consolidated into a single database - a critical first step toward building a full MFL. We collated 12,965 facility observations from 16 separate datasets and lists in Senegal, and applied matching algorithms, manual checking and revisions as needed, and verification processes to identify unique facilities and triangulate corresponding GPS coordinates. Our resulting consolidated facility list has a total of 4,685 facilities, with 2,423 having at least one set of GPS coordinates. Developing approaches to leverage existing data toward future MFL establishment can help bridge data demands and inform more targeted approaches for completing a full facility census based on areas and facility types with the lowest coverage. Going forward, it is crucial to ensure routine updates of current facility lists, and to strengthen government-led mechanisms around such data collection demands and the need for timely data for health decision-making.

A positive consequence of the COVID-19 pandemic: how the counterfactual experience of school closures is accelerating a multisectoral response to the treatment of neglected tropical diseases.

Global access to deworming treatment is one of the public health success stories of low-income countries in the twenty-first century. Parasitic worm infections are among the most ubiquitous chronic infections of humans, and early success with mass treatment programmes for these infections was the key catalyst for the neglected tropical disease (NTD) agenda. Since the launch of the 'London Declaration' in 2012, school-based deworming programmes have become the world's largest public health interventions. WHO estimates that by 2020, some 3.3 billion school-based drug treatments had been delivered. The success of this approach was brought to a dramatic halt in April 2020 when schools were closed worldwide in response to the COVID-19 pandemic. These closures immediately excluded 1.5 billion children not only from access to education but also from all school-based health services, including deworming. WHO Pulse surveys in 2021 identified NTD treatment as among the most negatively affected health interventions worldwide, second only to mental health interventions. In reaction, governments created a global Coalition with the twin aims of reopening schools and of rebuilding more resilient school-based health systems. Today, some 86 countries, comprising more than half the world's population, are delivering on this response, and school-based coverage of some key school-based programmes exceeds those from January 2020. This paper explores how science, and a combination of new policy and epidemiological perspectives that began in the 1980s, led to the exceptional growth in school-based NTD programmes after 2012, and are again driving new momentum in response to the COVID-19 pandemic. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.

Implementation of targeted cholera response activities, Cameroon.

Objective: To describe the implementation of case-area targeted interventions to reduce cholera transmission using a rapid, localized response in Kribi district, Cameroon. Methods: We used a cross-sectional design to study the implementation of case-area targeted interventions. We initiated interventions after rapid diagnostic test confirmation of a case of cholera. We targeted households within a 100-250 metre perimeter around the index case (spatial targeting). The interventions package included: health promotion, oral cholera vaccination, antibiotic chemoprophylaxis for nonimmunized direct contacts, point-of-use water treatment and active case-finding. Findings: We implemented eight targeted intervention packages in four health areas of Kribi between 17 September 2020 and 16 October 2020. We visited 1533 households (range: 7-544 per case-area) hosting 5877 individuals (range: 7-1687 per case-area). The average time from detection of the index case to implementation of interventions was 3.4 days (range: 1-7). Oral cholera vaccination increased overall immunization coverage in Kribi from 49.2% (2771/5621 people) to 79.3% (4456/5621 people). Interventions also led to the detection and prompt management of eight suspected cases of cholera, five of whom had severe dehydration. Stool culture was positive for Vibrio cholerae O1 in four cases. The average time from onset of symptoms to admission of a person with cholera to a health facility was 1.2 days. Conclusion: Despite challenges, we successfully implemented targeted interventions at the tail-end of a cholera epidemic, after which no further cases were reported in Kribi up until week 49 of 2021. The effectiveness of case-area targeted interventions in stopping or reducing cholera transmission needs further investigation.

Urethral Prolapse Case Report: Surgical and Social Considerations in Senegal.

We present three cases of urethral prolapse in prepubertal females in Senegal who presented with vulvar bleeding. Careful gynecologic and urologic physical exams were performed and revealed urethral origin and prolapse. Conservative versus surgical approaches were taken in different patients, but ultimately, each patient received a urethral meatoplasty. Surgical excision of these masses yielded a full recovery in the patients. A careful review of the literature was then undertaken and showed that surgical excision or ligation of the prolapse is preferable to more conservative treatment. The case series article discusses the rare occurrence of urethral prolapse, as well as the epidemiology and prognostic and therapeutic implications of urethral prolapse in prepubertal females. Introduction. Urethral prolapse is a rare condition occurring mostly in young black females. It can be worrying to the parents as it often causes vulvar bleeding. Case Presentation. We present three cases of urethral prolapse in prepubertal females who presented with vulvar bleeding. Physical exams were performed and revealed urethral origin and prolapse. Each patient underwent a urethral meatoplasty and subsequently experienced a full recovery after respective follow-up of 2 years, 1 year, and 1 year. Conclusion. Urethral prolapse is a rare condition which can be managed successfully by surgery. Plain Language Summary. This case report on pediatric urethral prolapse showcases the different presentations and modalities of treatment, as the literature does not show that a specific treatment is always undertaken. In some countries, there are strong social considerations and they demonstrate difficulty separating sexual abuse from genitourinary pathologies, which are important to address in the treatment of these conditions.

Quantification of Conceptual Model Uncertainty in the Modeling of Wet Deposited Atmospheric Pollutants.

Conceptual model uncertainty and parameter uncertainty are dominant contributors to the total uncertainty of a radioecological model output. In the present study the focus is on conceptual model uncertainty, which is often not acknowledged. Conceptual model uncertainty is assessed by subtracting from the total uncertainty of the model output the propagated parameter uncertainty, obtained by means of Bayesian inference analysis. The conceptual model uncertainty is quantified for two process-based models, which describe the interception of wet deposited pollutants under equilibrium and kinetic conditions, respectively. The natural variability due the chemical valence of the elements considered is accounted for in both models. Quantitative evidence has been obtained that the conceptual model uncertainty can contribute to the total uncertainty budget of the models for interception of wet deposited pollutants at least as much as, if not more than, parameter uncertainty.

Prevalence of SARS-CoV-2 antibodies in hemodialysis patients in Senegal: a multicenter cross-sectional study.

BACKGROUND: Hemodialysis patients are among high-risk groups for COVID-19. Africa is the continent with the lowest number of cases in the general population but we have little information about the disease burden in dialysis patients. OBJECTIVES: This study aimed to describe the seroprevalence of SARS-CoV-2 antibodies in the hemodialysis population of Senegal. PATIENTS AND METHODS: We conducted a multicenter cross-sectional survey, between June and September 2020 involving 10 public dialysis units randomly selected in eight regions of Senegal. After seeking their consent, we included 303 patients aged ≥ 18 years and hemodialysis for ≥ 3 months. Clinical symptoms and biological parameters were collected from medical records. Patients' blood samples were tested with Abbott SARS-CoV-2 Ig G assay using an Architect system. Statistical tests were performed with STATA 12.0. RESULTS: Seroprevalence of SARS-CoV-2 antibodies was 21.1% (95% CI = 16.7-26.1%). We noticed a wide variability in SARS-CoV-2 seroprevalence between regions ranging from 5.6 to 51.7%. Among the 38 patients who underwent nasal swab testing, only six had a PCR-confirmed infection and all of them did seroconvert. Suggestive clinical symptoms were reported by 28.1% of seropositive patients and the majority of them presented asymptomatic disease. After multivariate analysis, a previous contact with a confirmed case and living in a high population density region were associated with the presence of SARS-CoV-2 antibodies. CONCLUSION: This study presents to our knowledge the first seroprevalence data in African hemodialysis patients. Compared to data from other continents, we found a higher proportion of patients with SARS-CoV-2 antibodies but a lower lethality rate.

Hexanuclear copper(II) complex of 2-hy-droxy-N,N'-bis-[1-(2-hy-droxy-phen-yl)ethyl-idene]propane-1,3-di-amine incorporating an open-cubane core.

The title mol-ecular structure, namely, di-aqua-tris-(µ3-1,3-bis-{[1-(2-oxidophen-yl)ethyl-idene]amino}-propan-2-olato)-µ3-hydroxido-dinitrato-hexa-copper(II) ethanol tris-olvate, [Cu6(C19H19N2O3)3(NO3)2(OH)(H2O)2]·3C2H5OH, corres-ponds to a non-symmetric hexa-nuclear copper complex. The complex exhibits one core in which three CuII metal centres are mutually inter-connected, two by two, via three phenolato oxygen anions acting in a µ2-mode. These three copper cations are inter-connected in a µ3-mode by one hydroxyl group. An open-cube structure is generated in which each of the CuII cations of the three CuO4N units is connected by two µ2-O anions from phenolate groups and one µ3-O atom from a hy-droxy anion. Each of the three penta-coordinated CuII cations situated in the open-cube unit has a distorted NO4 square-pyramidal environment. Each of these three CuII centres is inter-connected with another CuII cation via one enolate O atom in µ2-mode, yielding one CuNO4 unit and two CuNO3 units. The penta-coordinated CuII atom has a distorted square-pyramidal environment while the two tetra-coordinated copper(II) cations are situated in a square-planar environment. A series of intra-molecular O-H⋯O hydrogen bonds are observed. In the crystal, the units are connected two by two by inter-molecular C-H⋯O and O-H⋯O hydrogen bonds, thus forming sheets parallel to the ac plane.

Decompressive craniectomy: indications and results of 24 cases at the neurosurgery clinic of Fann university hospital of Dakar.

Decompressive craniectomy is a surgical technique considered to be the last step in the management of intracranial hypertension. The objective of our study was to evaluate our results in the management of intracranial hypertension by decompressive craniectomy. This was a retrospective study of 24 cases of decompressive craniectomy performed over a 9-year period (from January 2010 to December 2019) at the Fann Neurosurgery Clinic. The mean age of the patients was 33.82 years, there was a male predominance with a sex ratio of 2.42. The most frequent indication was severe cranioencephalic trauma with 50%. The cerebral computed tomography (CT) scan was the key examination and was performed in all our patients. Complications were entirely infectious and were the cause of 73.33% of deaths. Thirty-five percent of the patients had received prior treatment before the decompressive craniectomy. The functional prognosis was good in 44.44% of cases, moderate in 33.33% of cases, 1 (11.11%) patient had a severe disability and 1 (11.11%) patient was in a vegetative state. Mortality rate was 62.5% of patients in our study series. Despite the lack of sophisticated techniques for diagnosis and monitoring of intracranial hypertension, our results remain acceptable with 37.5% survival. The early completion of this surgery allows us to be more efficient with a significant reduction in morbidity and mortality.

[Nephrology in Sub-saharan Africa: Past, present, future]. / Néphrologie en Afrique subsaharienne : passé, présent, futur.

Nephrology was a relatively poorly known specialty in sub-Saharan Africa until the early 1980s, because of low awareness and lack of access to diagnosis and renal replacement therapies. Nephrology has seen progress on the continent despite an unfavourable economic and geopolitical environment. With a prevalence of fewer than five nephrologists per million inhabitants, the training of nephrologists, now carried out on the continent, allowed to have more than 200 specialists trained in the last decade in French-speaking sub-Saharan Africa. Clinical and basic research is developing with quality work published from the continent in major international journals. The population receiving haemodialysis remains small, between 0 and 200 per million inhabitants. Kidney transplantation, with a prevalence between 0 and 5 per million inhabitants, is only well structured in South Africa. In this context of scarce resources, a strategy based on the prevention of non-communicable diseases in general, and chronic kidney disease in particular, should be prioritised.

Evaluation of blood pressure profile in chronic hemodialysis patients using two measurement methods: Home blood pressure measurement and conventional measurement.

The monitoring of hypertension (HTN) in dialysis is often delicate with potentially false measurements due to the white coat effect on the one hand and masked HTN (M-HTN) on the other hand. In this population, there is much controversy over the ideal moment for taking blood pressure (BP) and the target values. An answer to these questions is given by home BP measurement that can detect white coat HTN (WC-HTN) and M-HTN. The aim of this study was to determine the respective prevalence of permanent HTN (P-HTN), WC-HTN, M-HTN, and permanently normotensive (P-NTN) in this population and to analyze the risk factors of M-HTN and WC-HTN in hemodialysis (HD) centers in sub-Saharan Africa. This was a multicenter, descriptive, and analytical cross-sectional study conducted over a period of one month and 23 days. Data collection was performed using a home BP measurement form, conventional BP measurement form, and clinical and laboratory data collection form. The study included all patients who could take their BP at home using an electronic BP machine and record results on the BP forms. All analyses were performed using the Sphinx plus software version 5. The significance level for all statistical tests was set at 5%. The mean age of patients was 45.57 years ± 14.11, with a sex ratio of 1.42. The mean duration in dialysis was 57.96 months ± 34.86. Adherence to the home BP measurement was 100% in 71.7%. P-NTN patients were 15.2% (7 patients), WC-HTN patients were 13% (6 patients), M-HTN patients were 17.5% (8 patients), and P-HTN patients were 54.3% (25 patients). A statistically significant association was observed between WC-HTN and age (P = 0.01). In this work, we noted an important proportion of M-HTN and WC-HTN. This result confirms the need for home BP measurement in the follow-up of BP in HD patients.

Unavoidable Risks: Local Perspectives on Water Contact Behavior and Implications for Schistosomiasis Control in an Agricultural Region of Northern Senegal.

Human schistosomiasis is a snail-borne parasitic disease affecting more than 200 million people worldwide. Direct contact with snail-infested freshwater is the primary route of exposure. Water management infrastructure, including dams and irrigation schemes, expands snail habitat, increasing the risk across the landscape. The Diama Dam, built on the lower basin of the Senegal River to prevent saltwater intrusion and promote year-round agriculture in the drought-prone Sahel, is a paradigmatic case. Since dam completion in 1986, the rural population-whose livelihoods rely mostly on agriculture-has suffered high rates of schistosome infection. The region remains one of the most hyperendemic regions in the world. Because of the convergence between livelihoods and environmental conditions favorable to transmission, schistosomiasis is considered an illustrative case of a disease-driven poverty trap (DDPT). The literature to date on the topic, however, remains largely theoretical. With qualitative data generated from 12 focus groups in four villages, we conducted team-based theme analysis to investigate how perception of schistosomiasis risk and reported preventive behaviors may suggest the presence of a DDPT. Our analysis reveals three key findings: 1) rural villagers understand schistosomiasis risk (i.e., where and when infections occur), 2) accordingly, they adopt some preventive behaviors, but ultimately, 3) exposure persists, because of circumstances characteristic of rural livelihoods. These findings highlight the capacity of local populations to participate actively in schistosomiasis control programs and the limitations of widespread drug treatment campaigns. Interventions that target the environmental reservoir of disease may provide opportunities to reduce exposure while maintaining resource-dependent livelihoods.

Traitement par la technique de Latarjet des instabilités antérieures de l'épaule au centre hospitalier de l'Ordre Malte de Dakar

Introduction : Le but de cette étude était d'évaluer les résultats cliniques et radiologiques des patients ayant une instabilité antérieure traitée par la technique de Latarjet. Patients et méthodes : Dans cette étude rétrospective 14 patients (15 épaules) ont été opérés entre janvier 2013 et décembre 2016 pour une luxation récidivante de l'épaule selon la technique de Latarjet à foyer ouvert. La fonction de l'épaule a été appréciée selon les cotations de Rowe, Duplay , et WOSI (the Western Ontario ShoulderInstability). Les résultats radiographiques ont concerné la consolidation du greffon et la position de la butée. Résultats : Le recul moyen était de 34 mois (7- 64). Douze patients étaient très satisfaits de la stabilité et de la fonction de leur épaules. il n'y avait pas de récidive. Selon la cotation de Walch et Duplay les résultats étaient bons (n=13) et moyen (n=1). Selon Rowe ils étaient bons (n=13) et mauvais ( n=1). Selon la cotation WOSI ils étaient excellents ( n=8), bons ( n=4), et moyens (n=2). Toutes les butées ont consolidées. Elles étaient sous l'équateur. Elles étaient affleurantes (n=14), médiale (n=1). Conclusion : Ce travail suggère que la technique de Latarjet réalisée à foyer ouvert offre aux patients une stabilisation de l'épaule, des mobilités quasi-normales, et la possibilité de reprendre dans de bonnes conditions des activités professionnelles et sportives

Prevalence and risk factors of chronic kidney disease in an african semi-urban area: Results from a cross-sectional survey in Gueoul, Senegal.

Chronic kidney disease (CKD) is a public health priority worldwide; however, its prevalence and incidence are difficult to assess. In Africa, few studies have been conducted on the prevalence of CKD. This study sought to describe the epidemiological characteristics and profile of CKD, as well as the related risk factors in Guéoul, a semi-urban zone in Senegal. An observational, cross-sectional, and descriptive study was conducted in Guéoul city in Senegal from November 1, 2012, to December 10, 2012, according to the WHO STEPS approach. People older than 35 years living in Guéoul city were included in the study. Cardiovascular and renal disease risk factor screening was conducted for this population. Data were analyzed using the 3.5.1 version of Epi Info software. The significance level was a P <0.05. One thousand four hundred and eleven participants with a mean age of 48 ± 12.68 years and a sex ratio of 0.34 were included in the study (359 men/1052 women). The prevalence of renal disease was 36.5%. Sixty-eight people showed proteinuria greater than two cross with urinary dipsticks. Two hundred and six people had a glomerular filtration rate <60 mL/min, and among them, 201 were in stage III, two in stage IV, and three in stage V according to the modification of diet in renal disease formula. Ninety-eight participants had morphological abnormalities. Cardiovascular risk factors found among participants with renal disease were obesity (25.2%), hypertension (55.5%), diabetes (2.3%), and renal and metabolic syndrome (32.43%). Those that statistically significantly correlated with renal disease were obesity (P = 0.0001), hypertension (P = 0.0001), and diabetes (P = 0.021). This study assessed the extent of renal disease in the population of Guéoul city. Being aware of the prevalence of CKD in the general population of Senegal is mandatory for defining appropriate strategies for the management of these risk factors and progression of renal diseases.

[Profile of diabetic nephropathy at the National Reference General Hospital of N'Djamena (Chad)]. / Profil de la néphropathie diabétique à l'Hôpital Général de Référence Nationale de N'Djamena (Tchad).

INTRODUCTION: Diabetes mellitus is a real health problem and its complications affect many organs including the kidneys. Early diagnosis of diabetic nephropathy allows to treat patients more effectively and with a multidisciplinary approach, to slow its progression in chronic renal failure. Few studies have been conducted in Africa in this field of study. In Chad, we have no statistics on renal disease related to diabetes. That is why we propose to study diabetic nephropathy with the aim of analyzing the profile of diabetic nephropathy in patients at the National Reference General Hospital of N'Djamena (CHAD). METHODS: We conducted a descriptive cross-sectional study at the National Reference General Hospital in N'Djamena from April to September 2012. All patients with diabetes hospitalized or treated in the department of nephrology and endocrinology were included in the study. RESULTS: There were 54 cases of diabetic nephropathy out of a total of 181 patients (29.80%). The patients over the age of 50 years accounted for 87%, masculine gender dominated (67%), diabetes' progression time at the moment of nephropathy discovery was 10.25 years, mean blood pressure was 138 mm Hg, HbA1c was greater than 6.5% in 74.5%, end-stage renal disease (ESRD) was found in 26.90%, proteinuria 2.65 g / 24 h was found in 60.30%. 57.4% of patients had stage III diabetic retinopathy. CONCLUSION: In Chad, the frequency of diabetic nephropathy is approximately 29.83%. This is a condition that affects men with an average age of 58.7 years. Type 2 diabetes is the most common (90.7% of cases). Poorly controlled risk factors might lead to diabetic nephropathy progression in impaired renal function, namely hypertension (70.8%), in glycemic control (66.7%) and in proteinuria (62.5%).

Scleroderma renal crisis in tropical region: two senegalese cases.

Scleroderma renal crisis (SRC) is defined as the new onset of accelerated arterial hypertension and /or rapidly progressive oliguric renal failure during the course of systemic sclerosis. It is a rare but life-threatening complication. This formerly serious complication has got a considerable brighter outlook since the introduction of angiotensin converting enzyme inhibitors (ACE) however the mortality is still remaining high. We report two cases of SRC which to our knowledge are the firsts described in Dakar. They were two women aged 45 and 32 years, one of them was previously following for systemic sclerosis. Both of them had malignant hypertension associated with rapidly progressive renal failure, the other was put under corticosteroid therapy four months before SRC occurrence. The histological and laboratory finding showed thrombotic microangiopathy. The height blood pressure returned to normal value after treatment with ACE inhibitors. The final outcome was undesirable with the death of one after two months due to the hemodialysis discontinuation and persistence of renal failure in the other.

Foliar interception of radionuclides in dry conditions: a meta-analysis using a Bayesian modeling approach.

Uncertainty on the parameters that describe the transfer of radioactive materials into the (terrestrial) environment may be characterized thanks to datasets such as those compiled within International Atomic Energy Agency (IAEA) documents. Nevertheless, the information included in these documents is too poor to derive a relevant and informative uncertainty distribution regarding dry interception of radionuclides by the pasture grass and the leaves of vegetables. In this paper, 145 sets of dry interception measurements by the aboveground biomass of specific plants were collected from published scientific papers. A Bayesian meta-analysis was performed to derive the posterior probability distributions of the parameters that reflect their uncertainty given the collected data. Four competing models were compared in terms of both fitting performances and predictive abilities to reproduce plausible dry interception data. The asymptotic interception factor, applicable whatever the species and radionuclide to the highest aboveground biomass values (e.g. mature leafy vegetables), was estimated with the best model, to be 0.87 with a 95% credible interval (0.85, 0.89).

Hemophagocytic Syndrome, an Uncommon Complication of Microscopic Polyangitis: A Case Report From Senegal.

INTRODUCTION: We reported a case of hemophagocytic syndrome complicating microscopic polyangitis presented by crescentic glomerulonephritis. CASE PRESENTATION: A 22-year-old female patient originated from Dakar, Senegal presented with nephrotic syndrome and rapidly progressive glomerulonephritis. On physical examination, we noticed hyperchromic diffuse punctilious purpura skin lesions predominant on the trunk, the neck and the upper thigh. Immunology investigations revealed strongly positive anti SSA/Ro and anti-SSB. Anti-neutrophil cytoplasmic antibodies had positive results with a peri-nuclear type fluorescence, specific to myeloperoxidase. In optic microscopy, renal biopsy showed a crescentic glomerulonephritis with circumferential cellular and fibrous proliferation affecting 85% of glomeruli. The diagnosis of microscopic polyangitis with renal and skin involvement was retained. The patient received methylprednisolone and cyclophosphamide 700 mg/m(2) every 15 days for the first 3 pulses and every 21 days thereafter. After the 5(th) month, she developed obnubilation, fever and central pancytopenia. Bone marrow aspiration was performed, which showed medullary invasion by macrophages with signs of hemophagocytosis. Diagnosis of hemophagocytic syndrome complicating a microscopic polyangitis was retained and methylprednisolone pulses started. The patient was under hemodialysis after follow-up of about 9 months with stable clinical state. CONCLUSIONS: The occurrence of SAM in pauci-autoimmune vasculitis is rarely described, particularly in Africa. Our case is an illustration of the reality of this association.

1,5-Bis(2-hy-droxy-3-meth-oxy-benzyl-idene)carbonohydrazide methanol 0.47-solvate.

In the title compound, C17H18N4O5·0.47CH3OH, the virtually planar (r.m.s. deviation = 0.128 Å) carbonohydrazide mol-ecule is located on a twofold axis and conformation of its C=N bonds is E. There are short intra-molecular O-H⋯N hydrogen bonds between the hy-droxy groups and hydrazide N atoms. In the crystal, bifurcated N-H⋯(O,O) hydrogen bonds assemble the carbonohydrazide mol-ecules into a three-dimensional network. There are C 2 symmetric voids in this network, 47% of which are occupied by disordered methanol mol-ecules.

Pilot experience in senegal with peritoneal dialysis for end-stage renal disease.

UNLABELLED: ♦ INTRODUCTION: Peritoneal dialysis (PD) is occasionally used in western sub-Saharan Africa to treat patients with end-stage renal disease (ESRD). The present study is a retrospective review of the initial six years' experience with PD for ESRD therapy in Senegal, a West African country with a population of over 12 million. ♦ MATERIAL AND METHODS: Single-center retrospective cohort study of patients treated with PD between March 2004 and December 2010. Basic demographic data were collected on all patients. Peritonitis rates, causes of death and reasons for transfer to hemodialysis (HD) were determined in all patients. ♦ RESULTS: Sixty-two patients were included in the study. The median age was 47 ± 13 years with a male/female ratio of 1.21. Nephrosclerosis and diabetic nephropathy were the main causes of ESRD. The mean Charlson score was 3 ± 1 with a range of 2 to 7. Forty five peritonitis episodes were diagnosed in 36 patients (58%) for a peritonitis rate of 1 episode/20 patient-months (0.60 episodes per year). Staphylococcus aureus and Pseudomonas aeruginosa were the most commonly identified organisms. Touch contamination has been implicated in 26 cases (57.7%). In 23 episodes (51%), bacterial cultures were negative. Catheter removal was necessary in 12 cases (26.6%) due to mechanical dysfunction, fungal or refractory infection. Sixteen patients died during the study. ♦ CONCLUSION: Peritoneal dialysis is a suitable therapy which may be widely used for ESRD treatment in western sub-Saharan Africa. A good peritonitis rate can be achieved despite the difficult living conditions of patients. Challenges to the development of PD programs include training health care providers, developing an infrastructure to support the program, and developing a cost structure which permits expansion of the PD program.