Renal Failure among Women of Reproductive Age in Burundi: Estimating the Prevalence and Associated Factors Using Population-Based Data.

backgroundRenal failure is a leading cause of morbidity and mortality in many resource-constrained settings. In developing countries, little has been known about the prevalence and predisposing factors of renal failure using population-based data. The objective of this study was to examine the prevalence and associated factors of renal failure among women of reproductive age in Burundi.

methodsWe used nationally representative cross-sectional data from the 2016-2017 Burundi Demographic and Health Survey (BDHS). Data on 17,269 women of reproductive age were included. The outcome variable was a renal failure as determined by the patient's report. Percentage, chi-square test, and multivariable logistic regression model were used to analyze the data. The results from the logistic regression model were presented as adjusted odds ratio (AOR) and confidence interval (95% CI). The significance level was set at

resultsThe overall prevalence of renal failure was 5.0% (95% CI: 4.4%, 5.7%). Higher-aged women were more likely to have a renal failure when compared with women aged 15-19 years. Rural dwellers were 1.65 times as likely to have a renal failure when compared with women in the urban residence (AOR = 1.65; 95% CI: 1.24, 2.20). Women who had secondary + education had a 39% reduction in the odds of renal failure when compared with women with no formal education (AOR = 0.61; 95% CI: 0.46, 0.81). Health insurance coverage accounted for a 23% reduction in the odds of renal failure when compared with women who were not covered by health insurance (AOR = 0.77; 95% CI: 0.63, 0.93). Women who had a terminated pregnancy were 1.50 times as likely to have a renal failure when compared with women with no history of terminated pregnancy (AOR = 1.50; 95% CI: 1.24, 1.82). Furthermore, women with a history of contraceptive use were 1.32 times as likely to have a renal failure when compared with women without a history of contraceptive use (AOR = 1.32; 95% CI: 1.11, 1.57).

conclusionLack of formal education, having no health insurance coverage, and ever used anything or tried to delay or avoid getting pregnant were the modifiable risk factors of renal failure. The nonmodifiable risk factors were old age, rural residence, certain geographical regions, and having a history of pregnancy termination. Understanding the risk factors of renal failure will help to instigate early screening, detection, and prompt treatment initiation. In addition, early detection of the risk factors can help to reduce the adverse health impact including maternal death.