Opinion

On Cases Of Rising Diabetes And Kidney Disease In Children

THE recent alert, on the prevalence of diabetes and the rising cases of chronic kidney diseases in Nigerian children demands prompt but firm action from the government. This emergency is informed by the fact that, children – the future of the nation – are the victims of this dreadful health situation. Therefore, any intervention from the government, besides enlightenment on preventive healthcare and multilateral support from both private and public institutions, should be comprehensive.

  In response to an earlier alarm raised by the World Health Organisation (WHO) on the worsening state of health in Nigeria, particularly the shocking revelation on prevalence of diabetes among Nigerians, including children, the Federal Government recently ordered the Ministry of Health to commence immediate free treatment of diabetic children in all government-owned hospitals across the country.

  Diabetes is a chronic disease occasioned by the inability of the pancreas to produce insulin, a hormone produced by the pancreas for the regulation of glucose in the blood (blood sugar), or when the body cannot effectively make use of the insulin so produced. With the aid of insulin, glucose, which is the body’s source of energy, passes from the blood to the body cells. However, without insulin, glucose will build up in the blood, resulting in what is medically termed hyperglycemia (raised blood sugar), while starving the body cells of the required glucose. Thus the lack of insulin or a resistance to insulin is the cause of diabetes.

  Of the two types of diabetes, namely, Type 1 Diabetes, which is characterised by deficient insulin production, thereby requiring daily administration of insulin, and Type 2 diabetes, also known as non insulin-dependent, the latter presents the higher set of risks to health and wellbeing.

  Owing to the debilitating effects of Type 2 diabetes (largely responsible for 90 per cent of diabetic situations worldwide), and the propensity for a prolonged diabetic situation to seriously impair the heart, kidney, blood vessels, nerves, eyes, and other body systems, the government’s prompt intervention is emblematic of a genuine concern.

  Although so much comments have been made about the newly acknowledged prevalence of Type 2 diabetes in children, the revelation of the study concerning chronic kidney disease in children is equally worrisome, being all the more so because, except for hereditary factors, it has been blamed on preventable infections and such common diseases as diarrhoea, malaria, hepatitis and HIV/AIDS.

  Medical experts in the Department of Paediatrics of the Lagos University Teaching Hospital (LUTH) who carried out a study covering a four-year period (2008 to 2011), noted that, kidney disease otherwise known as renal disease, accounted for 8.9 per cent of paediatric admissions with prevalence of 22.3 admissions per 1, 000 child-admission per year, adding that yearly incidence doubled over the study period. 

  Another study related to this finding drew a link between HIV infection and renal disease. Researchers from the Department of Child Health, University of Benin, Edo State, who published their research finding in the Saudi Journal of Disease and Transplantation, stated that the prevalence of renal disease in Highly Active Anti-Retroviral Therapy (HAART)-treated Nigerian children is high. It added that majority of those with the disease, although asymptomatic, were at the advanced stages of HIV infection. 

  In a country whose human development indices rank as some of the lowest in the world, begging to raise money for the procurement of insulin may be considered an unnecessary luxury for a child whose family members can barely feed. It is for this reason that the gesture of the Federal Government, which is a fallout of its earlier promise to provide free diabetes treatment for children is commendable.

  Parents and guardians of affected children should, however, not rest on the gesture that treating children free of charge in government hospitals is a fail-safe solution. Indeed, can the government genuinely sustain the free treatment exercise even if it starts it? The management and treatment of diabetes is a very expensive venture.

  Just like the management of diabetes, the management of kidney diseases, presently not subsidised for children by the government, is equally expensive as the medical researchers noted. Apart from the financial commitment, which the researchers put at approximately N300,000 monthly for dialysis, facilities for renal replacement care are limited since they are overbooked owing to the rising prevalence in chronic kidney disease. 

  Given the urgency of this situation, therefore, the need arises for aggressive awareness creation, so that the all-important preventive strategy of early detection of renal damage could be pursued in order to institute measures early enough to “reverse or slow down the progression of kidney disease to End Stage Renal Disease (ESRD)”.

  Parents and guardians, teachers and proprietors of schools should also stress preventive healthcare for children and their wards by ensuring that the latter participate in regular physical activities in the form of sports and exercise in school. Children should also be encouraged to maintain a healthy weight by eating a healthy diet of vegetables and fruits, rather than having food packs of high carbohydrate diets loaded with fat and sugar. Beyond individual efforts, schools, municipal authorities and corporate organisations could develop recreational facilities and organise annual medical screening for children.

  The future of young people in Nigeria is under threat and this seems heightened by the further decimation through preventable diseases. The trend must be halted now.