Abstract
Background/Aim: Chronic Kidney Disease of unknown origin (CKDu) has affected many patients in Sri Lanka over the last 20 years but as yet no firm risk factors have been associated with it, making public health interventions difficult. Currently two hypotheses exist for this disease: heat stress and exposure to water borne environmental toxins and/or infectious agents.
Methods: Data was gathered from the Sri Lankan Census 2012 and mapped via GIS at the Grama Niladhari (village) level. Counts of cases of CKDu collected secondary health centres over the period 2008-11 were applied to each Grama Niladhari and prevalence calculated by dividing case number by population derived from Census. Spatial conditional autoregressive models were applied.
Results: The consumption of well water as a drinking source and individuals with secondary or lower levels of educational attainments were comparatively higher in Grama Niladharis with high CKDu prevalence. The spatial autoregression reported that a point percent increase in pipe-borne water reduces the prevalence of CKDu by 0.003 (95% CI 0.004, 0.0002) percent point in a Grama Niladhari. Estimations were made of influence on the result from surrounding areas by calculating spillover effects.
Conclusions: Access to piped water reduced the risk of CKDu. Low influence of adjacent areas via spillover effects suggests localised risk factors. Further research is required to establish if this is a real effect or confounded by rurality/socioeconomic status.
Methods: Data was gathered from the Sri Lankan Census 2012 and mapped via GIS at the Grama Niladhari (village) level. Counts of cases of CKDu collected secondary health centres over the period 2008-11 were applied to each Grama Niladhari and prevalence calculated by dividing case number by population derived from Census. Spatial conditional autoregressive models were applied.
Results: The consumption of well water as a drinking source and individuals with secondary or lower levels of educational attainments were comparatively higher in Grama Niladharis with high CKDu prevalence. The spatial autoregression reported that a point percent increase in pipe-borne water reduces the prevalence of CKDu by 0.003 (95% CI 0.004, 0.0002) percent point in a Grama Niladhari. Estimations were made of influence on the result from surrounding areas by calculating spillover effects.
Conclusions: Access to piped water reduced the risk of CKDu. Low influence of adjacent areas via spillover effects suggests localised risk factors. Further research is required to establish if this is a real effect or confounded by rurality/socioeconomic status.
| Original language | English |
|---|---|
| Pages (from-to) | 297 |
| Number of pages | 1 |
| Journal | Environmental Epidemiology |
| Volume | 3 |
| Issue number | Supplement 1 |
| DOIs | |
| Publication status | Published - Oct 2019 |
| Externally published | Yes |
| Event | 2019 Annual Conference of the International Society for Environmental Epidemiology - Utrecht, Netherlands Duration: 25 Aug 2019 → 28 Aug 2019 |