Abstract
In early nineties investigators noticed an alarmingly high incidence of an apparently new form of chronic kidney disease of unknown aetiology (CKD-U) in some parts of Sri Lanka. The aim of the study was to investigate the geographical distribution of CKD-U using GIS and GPS mapping. Community based information was collected from 11,630 patients for GIS mapping using ARC 9.2 software. Based on GIS mapping, two locations were selected for GPS mapping to locate the households of 863 CKD-U patients with reference to reservoirs, irrigation canals and the topography of the areas. GIS mapping indicated five high prevalence areas of CKD-U. Communities who consumed water from natural springs showed a low prevalence of the disease. GPS mapping showed that most of the affected villages were located below the reservoirs and canals with stagnant irrigated water. Epidemiological data on geographical distribution infers that while older foci of CKD-U are persisting, there is an emergence of new foci with time. The location of the affected villages below the level of the reservoirs/canals may indicate the possibility of draining of irrigated water to the shallow wells of the households, which is the source of drinking water.
Highlights
Chronic kidney disease (CKD) is defined as either kidney damage or decreased kidney function for a period of three months or more [1]
geographic position system (GPS) mapping showed that most of the affected villages were located below the reservoirs and canals with stagnant irrigated water
Epidemiological data on geographical distribution infers that while older foci of chronic kidney disease of unknown aetiology (CKD-U) are persisting, there is an emergence of new foci with time
Summary
Chronic kidney disease (CKD) is defined as either kidney damage or decreased kidney function for a period of three months or more [1] It is characterised by progressive destruction of renal mass with irreversible sclerosis and loss of nephrons over a long period of time depending on the underlying aetiology. CKD is a slowly progressive disease, which requires dialysis or transplantation at the end-stage. It is an emerging health problem all over the world [2]. Dry zone has a rainfall of about 2,000 mm and encompases 2/3 of the country. CKD is abundant only in one part of the dry zone namely North Central region of the country. Despite substantial progress in most health indicators, undernutrition remains high in Sri Lanka, with recent trends being unclear, owing to methodological differences in national surveys
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