title: Deficiencies in education and experience in the management of acute kidney injury among Malawian healthcare workers.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common but under-recognised disease process, which carries a high risk of mortality or chronic complications, such as chronic kidney disease and other organ dysfunction. Management of AKI, however, is suboptimal, both in developed settings and in Malawi. This is partly because of deficiencies in AKI education and training.
  
  
  OBJECTIVE
  To establish current levels of AKI education in a range of healthcare workers in Malawi.
  
  
  METHODS
  An AKI symposium was held in Blantyre in March 2015. Delegates were asked to complete a survey at the start of the symposium to assess their clinical experience and education in the management of AKI.
  
  
  RESULTS
  From 100 delegates, 89 nurses, clinical officers, and physicians, originating from 11 different districts, responded to the survey. Twenty-two percent of healthcare workers (including 28% of district workers of the various cadres and 31% of nurses) had never received teaching on any aspect of renal disease, and 50% (including 63% of district workers and 61% of nurses) had never received teaching specifically on AKI. Forty-four percent did not feel confident managing AKI, and 98% wanted more support managing patients with renal disease. Thirty-four percent (including 55% of district workers) were unaware that haemodialysis was available at Queen Elizabeth Central Hospital (QECH) for the treatment of AKI and 53% (74% of district workers) were unaware that peritoneal dialysis was available for the treatment of AKI in children. Only 33% had ever referred a patient with AKI to QECH.
  
  
  CONCLUSIONS
  There are deficiencies in education about, and clinical experience in, the management of AKI among Malawian healthcare workers, in addition to limited awareness of the renal service available at QECH. Urgent action is required to address these issues in order to prevent morbidity and mortality from AKI in Malawi.
authors.affiliation: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi ; Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: R
authors.initials: R
authors.lastname: Evans
authors.affiliation: Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: P
authors.initials: P
authors.lastname: Rudd
authors.affiliation: Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: U
authors.initials: U
authors.lastname: Hemmila
authors.affiliation: Nephrology Department, Bart's Health, London, United Kingdom.
authors.forename: H
authors.initials: H
authors.lastname: Dobbie
authors.affiliation: Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi ; Nephrology Department, Bart's Health, London, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Dreyer
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D003226:Congresses as Topic; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008295:Malawi; D008297:Male; D009398:Nephrology / Q000193:education*; D006435:Renal Dialysis; D011795:Surveys and Questionnaires