Letters to the Editors

Chronic kidney disease among patients from gold-mining communities in southeastern Senegal: A call for further investigation

Modou Ndongo, Ibrahima L. Sarr, Sidy M. Seck

Received: 14 May 2026; Accepted: 22 May 2026; Published: 25 June 2026

Copyright: © 2026. The Author(s). Licensee: AOSIS.
This work is licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).

Dear Editor,

Chronic kidney disease (CKD) is an increasing public health challenge in sub-Saharan Africa, where its determinants remain insufficiently characterised, particularly in rural and environmentally exposed populations. In southeastern Senegal, the Kedougou region has experienced rapid expansion in artisanal and industrial gold mining over the past decade. In May 2023, the region established its first nephrology and haemodialysis unit at the Amath Dansokho Regional Hospital, providing an opportunity to describe the geographic origin of patients initiating chronic dialysis. Gold-mining activities in Kedougou are concentrated in specific municipalities, particularly within the Saraya and Kedougou departments (Figure 1). Major mining areas include Bembou, Sabodala, Khossanto and Tomboronkoto, whereas the Salemata department has comparatively limited mining activity. Between August 2023 and August 2025, according to data from the haemodialysis registry of the nephrology and haemodialysis unit at Amath Dansokho Regional Hospital, 59 patients initiated chronic haemodialysis for end-stage kidney disease (ESKD). Among them, 38 (64.4%) were residents of the Kedougou region (Table 1). Among these regional residents, 19 patients (50.0%) originated from the Kedougou department, 16 (42.1%) from Saraya and 3 (7.9%) from Salemata.

FIGURE 1: Geographic distribution of gold-mining sites in the Kedougou region.5

An apparent geographic concentration of dialysis patients was observed in several mining municipalities. Bembou accounted for 26.3% of dialysis patients in the region, despite representing 10.9% of the regional population, while Tomboronkoto accounted for 15.8% of dialysis patients and 7.5% of the population. Similar observations were noted in Sabodala. In contrast, several municipalities with limited mining activity reported few or no dialysis patients despite larger population shares.

These descriptive observations raise concerns about potential environmental and occupational contributors to CKD in mining communities. Artisanal gold extraction in the region commonly involves the use of mercury and other potentially nephrotoxic substances, which may contaminate water, soil and food chains. Chronic exposure to such toxicants has been associated with kidney damage in other mining contexts.^1,2 Environmental dispersion of nephrotoxic metals from mining activities may also affect nearby communities through chronic contamination of water and agricultural ecosystems.^3,4 This raises concern that the renal health impact of artisanal mining may extend beyond occupationally exposed workers to the broader rural population.

However, these findings should be interpreted cautiously because of the descriptive, single-centre design, the limited sample size and the possibility of healthcare-access biases. No causal relationship can be inferred from these observations. Nevertheless, the apparent spatial overlap between mining areas and the origins of dialysis patients highlights the need for further longitudinal investigation to ascertain causation.

Population-based studies integrating environmental monitoring, biomarker assessment and spatial epidemiology are needed to better characterise the burden of CKD and potential mining-related exposures in southeastern Senegal.

In conclusion, the apparent clustering of ESKD cases in gold-mining municipalities of southeastern Senegal raises concern about potential environmental and occupational contributors to CKD. While causal inference is not possible from these descriptive observations, strengthening environmental surveillance, occupational health measures, and early CKD detection in mining communities may represent important public health priorities.

Acknowledgements

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Modou Ndongo: Conceptualisation, Data curation, Investigation, Methodology, Project administration, Resources, Validation, Visualisation, Writing – original draft, Writing – review & editing. Ibrahima L. Sarr: Conceptualisation, Methodology, Validation, Visualisation. Sidy M. Seck: Conceptualisation, Project administration, Supervision, Validation, Visualisation. All authors reviewed the article, contributed to the discussion of results, approved the final version for submission and publication and take responsibility for the integrity of its findings.

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

The data that support the findings of this study are available on request from the corresponding author, Modou Ndongo.

The views and opinions expressed in this article are those of the authors and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings and content.

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