SAMANTHA b. .pptx.

1. KNOWLEDGE AND PRACTICES OF CHRONIC KIDNEY DISEASE PREVENTION AMONG HYPERTENSIVE AND DIABETIC OUTPATIENTS AT NYAMATA LEVEL ΙΙ TEACHING HOSPITAL, EASTERN PROVINCE, BUGESERA DISTRICT, RWANDA RESEACH PRESENTATION BY: IYIZIRE Samantha

2. INTRODUCTION AND BACKGROUND Chronic kidney disease (CKD) is a growing global health burden Resulting from uncontrolled hypertension and diabetes Early prevention through patient knowledge and self-care is essential, particularly in low-resource settings Kidney Disease Deaths in Rwanda reached 2.08% of total deaths

3. PROBLEM STATEMENT Rwanda has made notable improvements in health status indicators over the past decade. A study done at Rwanda Military Hospital revealed a substantial gap in awareness, with only 42% of patients able to associate hypertension and diabetes with CKD risk significant gaps persist in understanding the knowledge and practices related to CKD prevention among at-risk groups. CKD causes numerous public health problems There are only a few studies in knowledge and practices towards CKD among high-risk individuals

4.   OBJECTIVES OF THE STUDY To determine the knowledge about CKD prevention To identify the practices related to CKD prevention To determine the relationship between the level of knowledge and preventive practices related to CKD

5. CONCEPTUAL FRAMEWORK The Health Promotion Model (HPM) by Pender was utilized to underpin this study . According to Pender, health promotion is motivated by the desire to increase well-being

6. RESEARCH DESIGN AND METHODOLOGY A quantitative research approach was used Data were collected through a structured questionnaire A cross-sectional design was adopted The study was conducted at Nyamata Level II Teaching Hospital Targeting outpatients diagnosed with hypertension and/or diabetes

7. RESEARCH DESIGN AND METHODOLOGY Convenience sampling was used to select participants The questionnaire was available in both English and Kinyarwanda Assistance was provided to participants with low literacy The sample size was calculated using Yamane formula The data collection tool comprised four distinct sections

8. RESEARCH DESIGN AND METHODOLOGY Data were collected using self-administered questionnaire, adapted from a validated tool Ethical approvals given by the Institutional Review Board (IRB) of the University of Rwanda Ethics and Research Committee of Nyamata Level II Teaching Hospital

9. RESEARCH DESIGN AND METHODOLOGY Written informed consent was obtained. A pilot test was conducted with a small subset of patients Data obtained from the questionnaires were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21 Each participant was informed about the study’s purpose, risks, and confidentiality.

10. RESULTS A total of 178 patients participated. The frequency and percentage distribution of the participants' demographics characteristics are presented  Most respondents were female (55.6%, n=99), Nearly half of the participants (50.0%, n=89)

11. RESULTS (54%, n=96) had both hypertension and diabetes. Those with only diabetes accounted for 25% (n=44), 21% (n=38) had only hypertension. 

12. RESULTS

13. RESULTS

14. RESULTS The association of demographic data and mean knowledge score shows that there are significant association of some demographic characteristic to the mean knowledge score (P < 0.05). Education level, employment and family history shows association with mean knowledge scores regarding CKD prevention (P<0.05). the means knowledge score, those who have family history of these chronic conditions either diabetes or hypertension shows to have more knowledge than does who don’t have

15. RESULTS To assess the normality of the data distribution, the Kolmogorov–Smirnov test was applied, given that the sample size exceeded 50 participants The Practice Score exhibited a P-value of 0.060, which was greater than 0.05, indicating that it followed a normal distribution The Knowledge Score had a P-value of 0.050, which was precisely on the threshold, leading to its classification as not normally distributed.

16. RESULTS The p-value of <0.001 indicates that the observed association between knowledge level and practice level is highly statistically significant This means there is very strong evidence to conclude that knowledge and practice levels are not independent but are significantly related. The high Pearson Chi-Square value further underscores the strength of this observed association.

17. RESULTS Only the level of knowledge demonstrated a statistically highly significant effect on CKD preventive practices (P<0.001). The findings revealed that the knowledge score was a strong and statistically significant predictor of the outcome. Family history of diabetes ( aOR = 0.8, p = 0.22), did not demonstrate statistically significant associations with the outcome

18. DISCUSSION Our findings revealed that only 11.4% of participants had good knowledge of CKD prevention. Rather than viewing this in isolation, these figures point to structural and contextual influences on patient education in rural Rwanda. 16.2% of our participants showed poor preventive practices, which is lower than the 22.53% reported in a rural community in West Bengal, India.

19. CONCLUSION The study identified moderate knowledge and practice levels regarding CKD prevention. Improved knowledge was positively associated with better practices. However, key gaps remain, especially in awareness of modifiable risk factors.

20. RECOMMENDATIONS Develop structured CKD prevention education sessions specifically for hypertensive and diabetic patients Integrate CKD-focused training modules into ongoing professional development for nurses and primary care staff Use community health workers (CHWs) to follow up with patients post-clinic visit. Future research should employ random sampling across multiple healthcare facilities to enhance generalizability

21. REFFERENCE Wilson S, Mone P, Jankauskas SS, Gambardella J, Santulli G. Chronic kidney disease: Definition, updated epidemiology, staging, and mechanisms of increased cardiovascular risk. J Clin Hypertens . 2021;23:831–4. Ngendahayo F, Mukamana D, Ndateba I, Nkurunziza A, Adejumo O, Chironda G. Chronic Kidney Disease (CKD): knowledge of risk factors and preventive practices of CKD among students at a University in Rwanda. Rwanda J Med Heal Sci. 2019;2:185. Evans PD, Taal MW. Epidemiology and causes of chronic kidney disease. Medicine (Baltimore). 2011;39:402–6.

22. THANKS