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An ecological study of chronic kidney disease in five Mesoamerican countries : associations with crop and heat

Hansson, Erik LU ; Mansourian, Ali LU ; Farnaghi, Mahdi LU ; Petzold, Max and Jakobsson, Kristina LU (2021) In BMC Public Health 21(1).
Abstract

BACKGROUND: Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors.

METHODS: CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee.

RESULTS: There are... (More)

BACKGROUND: Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors.

METHODS: CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee.

RESULTS: There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries.

CONCLUSION: Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic Kidney Disease of unknown origin (CKDu), Mesoamerican countries, Associations with crop and heat, Ecological study
in
BMC Public Health
volume
21
issue
1
article number
840
publisher
BioMed Central (BMC)
external identifiers
  • pmid:33933045
  • scopus:85105209915
ISSN
1471-2458
DOI
10.1186/s12889-021-10822-9
language
English
LU publication?
yes
id
636f17a6-1c97-4d1f-a893-0c16eb1caf89
date added to LUP
2021-05-05 11:43:41
date last changed
2022-10-02 08:24:40
@article{636f17a6-1c97-4d1f-a893-0c16eb1caf89,
  abstract     = {{<p>BACKGROUND: Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors.</p><p>METHODS: CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee.</p><p>RESULTS: There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries.</p><p>CONCLUSION: Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.</p>}},
  author       = {{Hansson, Erik and Mansourian, Ali and Farnaghi, Mahdi and Petzold, Max and Jakobsson, Kristina}},
  issn         = {{1471-2458}},
  keywords     = {{Chronic Kidney Disease of unknown origin (CKDu); Mesoamerican countries; Associations with crop and heat; Ecological study}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Public Health}},
  title        = {{An ecological study of chronic kidney disease in five Mesoamerican countries : associations with crop and heat}},
  url          = {{http://dx.doi.org/10.1186/s12889-021-10822-9}},
  doi          = {{10.1186/s12889-021-10822-9}},
  volume       = {{21}},
  year         = {{2021}},
}