Chronic Kidney Disease with unknown etiology (CKDu) is one of the crucial health issues in North Central, Uva, North Western, North, Central, and Eastern Provinces of Sri Lanka and incapacitates the kidney function. T...Chronic Kidney Disease with unknown etiology (CKDu) is one of the crucial health issues in North Central, Uva, North Western, North, Central, and Eastern Provinces of Sri Lanka and incapacitates the kidney function. The main source for the CKDu has not yet been identified, though many scientists believed that the number of certain drinking water quality parameters is changed due to the contamination of water sources by agricultural activities. Hence, the government of Sri Lanka introduces electrically driven Brackish Water Reverse Osmosis (BWRO) plants with a capacity of 10 tones/day to supply safe drinking water for the impacted community though it is an energy-intensive process. Concurrently, a smaller version of an electrically driven BWRO plant was introduced to the rural farming community for their domestic use. However, it was not practically worked out due to various reasons such as high cost, unavailability of electrical power supply for those villages. In this study, an economical air operated domestic use BWRO plant with zero-emission was designed. This anticipated system significantly reduces the government expenditures to subsidize the water purification cost by 50% of the existing expenses. Besides, simple payback time was found to be 2.5 years, and the benefit-cost ratio to be more than 1. Evaluating the performance with the conventional values, it comprehends with more sustainable and economically viable system compared to the existing method of water purification.展开更多
Introduction: The occupational toxic risks from agricultural activities in El Salvador affect human and environmental health. The objective of this paper is to describe the management of pesticide by farmers confirmed...Introduction: The occupational toxic risks from agricultural activities in El Salvador affect human and environmental health. The objective of this paper is to describe the management of pesticide by farmers confirmed with a chronic kidney disease of uncertain etiology (CKDu) not associated to diabetes mellitus or hypertension. Methods: The study involved 42 male patients older than 18 years old with confirmed CKDu that have participated in different stages of pesticides management. This is a cross-sectional study;it was conducted from January to June 2011, in three communities of Bajo Lempa region, El Salvador. An interview was especially designed to investigate which pesticides were used and the farmer practices at different stages of pesticide use. Statistical descriptive analysis was carried out for the several studied variables. Results: All interviewed people had a direct relationship with agricultural activities. The majority of patients had poor education, 19% were illiterate and 55% only have primary education. Most farmers with CKDu had been exposed more than 10 years to hazardous pesticides. The most used pesticide was Hedonal/2, 4 D (100%). 95% interviewed patients mixed different pesticides and 63% dumped empty pesticide containers in the fields. Interviewees did not use appropriate personal protective equipment (100%). Conclusions: There is high use of hazardous pesticides by patients and some of these are banned and some are legal in El Salvador, but prohibited by other countries. Interviewed CKDu patients had high exposure to toxic pesticides due to the misuse in almost all stages. There is inadequate legislation and a poor law enforcement to prevent the misuse of pesticides in El Salvador.展开更多
Background Cystatin C(Cys-C)is an emerging biomarker of renal diseases and its clinical use,particularly for screening the communities affected by chronic kidney disease of unknown etiology(CKDu),is hindered due to th...Background Cystatin C(Cys-C)is an emerging biomarker of renal diseases and its clinical use,particularly for screening the communities affected by chronic kidney disease of unknown etiology(CKDu),is hindered due to the lack of reference intervals(RIs)for diverse ethnic and age groups.The present study aimed to define RIs for urinary Cys-C(uCys-C)for a healthy pediatric population in Sri Lanka and in turn compare the renal function of the residential children in CKDu endemic and non-endemic regions in Sri Lanka.Methods A cross-sectional study was conducted with 850 healthy children(10-17 years)from selected locations for reference interval establishment,while a total of 892 children were recruited for the comparative study.Urine samples were collected and analyzed for Cys-C,creatinine(Cr)and albumin.Cr-adjusted uCys-C levels were partitioned by age,and RIs were determined with quantile regression(2.5th,50th and 97.5th quantiles)at 90%confidence interval.Results The range of median RIs for uCys-C in healthy children was 45.94-64.44 ng/mg Cr for boys and 53.58-69.97 ng/mg Cr for girls.The median(interquartile range)uCys-C levels of children in the CKDu endemic and non-endemic regions were 58.18(21.8-141.9)and 58.31(23.9-155.3)ng/mg Cr with no significant difference(P=0.781).A significant variation of uCys-C was noted in the children across age.Conclusions Notably high uCys-C levels were observed in children with elevated proteinuria.Thus,uCys-C could be a potential biomarker in identifying communities at high risk of CKDu susceptibility.展开更多
文摘Chronic Kidney Disease with unknown etiology (CKDu) is one of the crucial health issues in North Central, Uva, North Western, North, Central, and Eastern Provinces of Sri Lanka and incapacitates the kidney function. The main source for the CKDu has not yet been identified, though many scientists believed that the number of certain drinking water quality parameters is changed due to the contamination of water sources by agricultural activities. Hence, the government of Sri Lanka introduces electrically driven Brackish Water Reverse Osmosis (BWRO) plants with a capacity of 10 tones/day to supply safe drinking water for the impacted community though it is an energy-intensive process. Concurrently, a smaller version of an electrically driven BWRO plant was introduced to the rural farming community for their domestic use. However, it was not practically worked out due to various reasons such as high cost, unavailability of electrical power supply for those villages. In this study, an economical air operated domestic use BWRO plant with zero-emission was designed. This anticipated system significantly reduces the government expenditures to subsidize the water purification cost by 50% of the existing expenses. Besides, simple payback time was found to be 2.5 years, and the benefit-cost ratio to be more than 1. Evaluating the performance with the conventional values, it comprehends with more sustainable and economically viable system compared to the existing method of water purification.
文摘Introduction: The occupational toxic risks from agricultural activities in El Salvador affect human and environmental health. The objective of this paper is to describe the management of pesticide by farmers confirmed with a chronic kidney disease of uncertain etiology (CKDu) not associated to diabetes mellitus or hypertension. Methods: The study involved 42 male patients older than 18 years old with confirmed CKDu that have participated in different stages of pesticides management. This is a cross-sectional study;it was conducted from January to June 2011, in three communities of Bajo Lempa region, El Salvador. An interview was especially designed to investigate which pesticides were used and the farmer practices at different stages of pesticide use. Statistical descriptive analysis was carried out for the several studied variables. Results: All interviewed people had a direct relationship with agricultural activities. The majority of patients had poor education, 19% were illiterate and 55% only have primary education. Most farmers with CKDu had been exposed more than 10 years to hazardous pesticides. The most used pesticide was Hedonal/2, 4 D (100%). 95% interviewed patients mixed different pesticides and 63% dumped empty pesticide containers in the fields. Interviewees did not use appropriate personal protective equipment (100%). Conclusions: There is high use of hazardous pesticides by patients and some of these are banned and some are legal in El Salvador, but prohibited by other countries. Interviewed CKDu patients had high exposure to toxic pesticides due to the misuse in almost all stages. There is inadequate legislation and a poor law enforcement to prevent the misuse of pesticides in El Salvador.
基金This research was funded by the Accelerating Higher Education Expansion and Development(AHEAD)Operation of the Ministry of Higher Education funded by the World Bank(No.AHEAD DOR 02/40).
文摘Background Cystatin C(Cys-C)is an emerging biomarker of renal diseases and its clinical use,particularly for screening the communities affected by chronic kidney disease of unknown etiology(CKDu),is hindered due to the lack of reference intervals(RIs)for diverse ethnic and age groups.The present study aimed to define RIs for urinary Cys-C(uCys-C)for a healthy pediatric population in Sri Lanka and in turn compare the renal function of the residential children in CKDu endemic and non-endemic regions in Sri Lanka.Methods A cross-sectional study was conducted with 850 healthy children(10-17 years)from selected locations for reference interval establishment,while a total of 892 children were recruited for the comparative study.Urine samples were collected and analyzed for Cys-C,creatinine(Cr)and albumin.Cr-adjusted uCys-C levels were partitioned by age,and RIs were determined with quantile regression(2.5th,50th and 97.5th quantiles)at 90%confidence interval.Results The range of median RIs for uCys-C in healthy children was 45.94-64.44 ng/mg Cr for boys and 53.58-69.97 ng/mg Cr for girls.The median(interquartile range)uCys-C levels of children in the CKDu endemic and non-endemic regions were 58.18(21.8-141.9)and 58.31(23.9-155.3)ng/mg Cr with no significant difference(P=0.781).A significant variation of uCys-C was noted in the children across age.Conclusions Notably high uCys-C levels were observed in children with elevated proteinuria.Thus,uCys-C could be a potential biomarker in identifying communities at high risk of CKDu susceptibility.
