Chronic kidney disease (CKD) is a progressive and irreversible condition that contributes substantially to global morbidity and mortality. In Africa, the burden of CKD is compounded by limited healthcare resources, poverty, and the dual challenge of communicable and non-communicable diseases. The economic impact of end-stage renal disease (ESRD) is considerable, yet evidence from the region remains scarce. This systematic review, conducted in accordance with PRISMA 2020 guidelines, examined the economic burden of ESRD in Africa. Data were extracted on study characteristics, patient populations, cost components, and financing mechanisms. All reported costs were standardized to 2025 USD. Eighteen studies, involving 2,634 patients, were included. The majority received haemodialysis (HD) (95.9%), with limited data on peritoneal dialysis (PD) (2.7%) and kidney transplantation (1.4%). Annual HD costs varied widely, from $2,003.48 in Burkina Faso to $41,957.69 in South Africa, with a pooled median of $18,741.00. PD costs, reported in three studies, ranged from $11,161.98 in Egypt to $47,837.05 in South Africa. First-year transplantation costs plus follow-up varied between $33,120.18 in Cameroon and $46,293.59 in Nigeria. Direct medical costs dominated expenditures, with drugs and laboratory investigations representing major cost drivers. Renal replacement therapy in Africa is costly, heterogeneous, and predominantly financed out-of-pocket. These findings highlight profound affordability challenges and underscore the urgent need for financial protection strategies, expanded insurance coverage, and sustainable models of kidney care.

Background Telemedicine has been recognized as a viable solution for addressing the shortage of medical professionals in developing countries such as Nigeria. Tele-neurology has the potential to provide remote consultations and care for patients with neurological conditions, thereby reducing the burden of travel and improving access to medical care. Despite its growing popularity, there is a lack of research on patient’s views on this mode of care delivery in Nigeria. This study was conducted to investigate patient's perspectives on the use of tele-neurology in Nigeria. Methodology A descriptive cross-sectional study was conducted among 398 neurology patients at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria. The data obtained were analyzed using descriptive statistics and a chi-square test using p < 0.05. Results Only 3% of our respondents had previously used telemedicine, with 78.1% of the respondents open to using telemedicine as a means of consultation. The disadvantages of telemedicine noted include limitations in assessing neurological status (94.7%), difficulty in explaining health conditions (84.4%), and lack of technical support (14.6%). The majority of respondents (96.5%) believed telemedicine will help in saving time. There was a statistically significant association between propensity to use telemedicine and time spent in the hospital (0.045) and time off work (<0.001). The propensity to use telemedicine was statistically significant to the use of email (0.001) and type of email address (0.001). Conclusion The findings suggested that there is a need for healthcare providers and policymakers to invest in developing telemedicine to improve access to care.

Background Teleneurology has been in existence for decades, and the COVID-19 pandemic has escalated its widespread usage. Neurological conditions are a leading cause of death globally, with sub-Saharan Africa bearing the bulk of the burden. Nigeria has few trained neurologists with the few available concentrated in an urban region. The adoption of teleneurology will help close this treatment gap. Despite evidence of its advantage, the adoption and state of teleneurology in Nigeria are very low. This study aims to determine the state and perception of teleneurology in the care of neurological patients in Nigeria and identify challenges to its wide usage. Methods The primary research method was a descriptive cross-sectional survey among 48 neurologists in Nigeria across the six geo-political zones of the country. Descriptive statistics such as frequency and percentage were used to summarize and present the results. Results A total of 48 neurologists participated, of which 46 (95.8%) specialized in general neurology. Videoconferencing is the most preferred means of telemedicine (24, 50%), followed by phone calls (16, 33.3%) and short messages (6, 12.5%). Three-quarters of the respondents are concerned about legal actions from telemedicine use. The majority (34, 70.9%) are not familiar with telemedicine tools, and 40 (83.3%) indicate low telemedicine seminar attendance. More than 90% (46) of neurologists believe that it is a viable approach and can save time and money. Barriers to telemedicine included the lack of incentive to use the technology (38, 79.2%), poor Internet connectivity (36, 75%), and the lack of exposure to telemedicine (36, 75%). Conclusions It is important to overcome the existing barrier to teleneurology in order to fully harness its potential in addressing the shortage of health professionals in Nigeria as most neurologists are open to using it.