Tunisia
Tunisia (تونس)
The Tunisian national team has had a rough go of it in the World Cup. Having made six appearances beginning in 1978, Tunisia has never made it past the group stage. And while they have only won two matches in those six appearances, they have the unique distinction of being the first African nation to ever win a World Cup match (defeating Mexico in 1978) (Video 1).
In fact, The Carthage Eagles enter both the World Cup and NephroWorldCup as an unlikely favorite from amongst the five teams representing Africa. The Eagles field a team focused on peritoneal dialysis (PD): a valuable and yet persistently un-/under-recognized tool for the management of end-stage kidney failure (Video 2).
Video 1: Tunisia wins its first World Cup match and the first match by an African nation in 1978
Figure 1: Trends in peritoneal dialysis in select nations | Presented by Dr. Martin Wilkie at the 2021 ISN annual meeting | Courtesy of Dr. Hector Madariaga (zoom in for details)
The Tunisian NephroWorldCup team looks at a nearly three-decades long single-center experience with peritoneal dialysis. Specifically, the researchers focus on the incidence of peritonitis: a devastating complication of PD. Just over 300 hundred peritoneal dialysis patients were enrolled in this study: a prevalence of 4.5% of all dialysis patients in this center (Figure 1). Just over half of the patients (170; 56%) experienced at least one episode of peritonitis in the 27-year study period! This corresponds to an event rate of 0.68 episodes per patient-year (Figure 2).
Figure 2: Event rate of peritonitis in the PDOPPS database | Presented at the 2019 Euro PD meeting | Courtesy of Dr. Martin Wilkie (zoom in for details)
PD rates are low in Tunisia and peritonitis rates are high - a less-than-optimal combination. What is lacking in this 27-year look is if the rates of peritonitis have been decreasing over time. Perhaps in the early days of peritoneal dialysis in Tunisia, the rate of peritonitis was significantly higher than in modern times. Could the event rate of 0.68 episodes per patient-year be skewed by early infections? It would also be interesting to know what interventions were enacted to combat the high rate of infection.
Video 2: Peritonits | Courtesy of Dr. Jeff Perl
The Eagles are a respectable unit but we need more data before we can make them the African favorite in the NephroWorldCup