Trends in ESRD Turks and Caicos Is Dr

Trends in ESRD Turks and Caicos Is Dr Vancelee Forbes, Nephrologist TCI Hospital

Outline 1. History of ESRD 2. Current Demographics 3. Causes of ESRD in TCI 4. Trend of ESRD in TCI 5. ESRD in the Haitian population 6. Employment among HD patients 7. Vascular access

History • Turks and Caicos Is is an archipelago of 40 islands and Cays, 8 inhabited, 41, 369 in 2018, BOT • Prior to 1995, persons with ESRD received treatment overseas • The first HD unit opened in Grand Turk in 1995 (6 - Bahamas) • In 2006, a second HD unit opened in Providenciales with 6 chairs and 6 patients • In 2010 – TCI Hospitals, Interhealth Canada, a public private partnership opened with 2 new HD units Grand Turk - 3 chairs , 8 patients Providenciales – 6 chairs, 17 patients • December 2019 49 haemodialysis patients Providenciales – 38, 6 chairs, 8 RNs Grand Turk – 11, 4 chairs (1 temp), 3 RNs 1 Technician in Providenciales

Demographics As of December, 2019 • Forty-nine persons on haemodialysis • Males – 67% • Average 55 years • Race: 94% black

Causes of ESRD in TCI Causes of ESRD 60, 00 50, 00 40, 00 30, 00 20, 00 10, 00 HTN T 2 DM/HTN Lupus Other

Trend in ESRD No with ESRD 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 New Total 2016 2017 2018 2019

ESRD in the Haitian Population New starters in the Haitian Population 120 100 80 60 40 2011 2012 2013 2014 2015 Haitians 2016 Other 2017 2018 2019

Employment among HD patients under 65 years Employment Status 70 60 50 40 30 20 10 0 Employed Unemployed

Vascular Access Vascular access 33% Catheter AVF/AVG 67%

Challenges • • • Growth in ESRD population Capacity Young demographic Pre-dialysis care Vascular access Combating ESRD in Haitian population

Cheshire Hall Medical Centre

Thank You Dr Vancelee Forbes vtforbes@interhealthcanada. tc www. interhealthcanada. tc