Serological evidence of hantavirus infection in Girandurukotte, an area endemic for chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka

Gamage, Chandika D.; Yoshimatsu, Kumiko; Sarathkumara, Yomani D.; Kulendiran, Thiviyaaluxmi; Nanayakkara, Nishantha; Arikawa, Jiro

doi:10.1016/j.ijid.2017.02.004

Cited by 43 publications

(33 citation statements)

References 7 publications

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“…In collaboration with a research group at Kyoto University, we tested aforementioned sera samples (approximately 600) for anti-hantarvirus antibodies. The antibody-positive rate was almost similar as previously reported [1]. The first author of this study, Dr. S. Nanayakkara, statistically analyzed the data and found no significancant differeneces between the epidemiological data collected and anti-hantavirus antibody-positivity, although a significant association was found being a CKDu patient.…”

supporting

confidence: 88%

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Reply to Comments by Yih et al. (Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross-Sectional Study)

Sarathkumara

Gamage

Lokupathirage

et al. 2019

Viruses

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supporting

confidence: 88%

“…In 2017, we reported high seroprevelance of 54.5% for hantavirus antibodies among CKDu patients than healthy controls (13.5%) from a CKDu hotspot, Girandurukotte [1]. It was the first evidence of exposure to hanatavirus infection in CKDu patients in Sri Lanka.…”

mentioning

confidence: 97%

Reply to Comments by Yih et al. (Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross-Sectional Study)

Sarathkumara

Gamage

Lokupathirage

et al. 2019

Viruses

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“…Both infections have similar clinical presentations and epidemiological features likely to be clinically misdiagnosed and indistinguishable due to non-specific presentation [28,45]. Recent report indicates higher hantavirus seropositivity among CKDu patients in Sri Lanka [46]. Therefore, both diseases await extensive study.…”

Section: Ckdu: a Neglected Tropical Disease With An Infectious Etiology?mentioning

confidence: 99%

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

Yang¹

2017

Nephron

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Leptospirosis is the most prevalent zoonosis affecting more than 1 million populations worldwide. Interestingly, leptospirosis endemic regions coincide with chronic kidney disease (CKD) hotspots largely due to flooding and agricultural overlaps. Acute leptospirosis induces multiple organ dysfunction including acute kidney injury and may predispose to CKD and end-stage renal disease, if not treated timely. Asymptomatic infection may carry the bacteria in the kidney and CKD progresses insidiously. Histologic finding of leptospirosis renal disease includes tubulointerstitial nephritis, interstitial fibrosis, and tubular atrophy. Proximal tubule dysfunction and hypokalemia are observed in adult male workers with leptospirosis, a characteristic similarity to CKD unknown etiology (CKDu). CKDu is a form of CKD that is not attributable to traditional risk factors clustering in agricultural communities affecting young male farmers. Kidney pathology shows a chronic tubulointerstitial disease. CKDu is being reported as an endemic nephropathy across the globe. Recent surveys suggest that asymptomatic leptospira renal colonization is an overlooked risk for renal fibrosis and CKDu. Population with anti-leptospira seropositivity is associated with lower estimated glomerular filtration rate in endemic regions and carrier may progress to CKD. Leptospirosis has been considered as a risk factor for CKDu in Sri Lanka and in Mesoamerican area. Sugarcane workers in Nicaragua showed increased anti-leptospira seropositivity and higher urinary biomarkers for kidney injury. Emerging evidence with signs of infection were reported in these endemic population, indicating that leptospira exposure could play a role in CKDu as a cause of primary kidney disease or a susceptible factor when secondary injury such as heat stress or dehydration aggravates kidney disease. Therefore, leptospirosis as an emerging culprit of CKDu deserves further in-depth investigation.

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“…Mammalian pests in households may also be carriers of infectious disease that leads to increased susceptibility to CKDu. There is an emerging hypothesis that Hanta virus could be the possible causative agent for CKDu in Sri Lanka’s dry zone [26, 56]. Humans infected with Hanta virus show clinical signs similar to those of Leptospirosis, and Hanta virus infection in humans was first described in Sri Lanka in the mid-eighties [57].…”

Section: Discussionmentioning

confidence: 99%

A pilot study of behavioral, environmental, and occupational risk factors for chronic kidney disease of unknown etiology in Sri Lanka

Pry

Jackson

Rupasinghe

et al. 2019

Preprint

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23Mobile. +260 96 3088750 | +1 936-661-6885 24 ABSTRACT 25 Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 26 1990s, and since then it has reached epidemic levels in the North Central Province of the country.27 The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy 28 farming, which is most often practiced in the dry zone including the North Central and East Central 29 Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of 30 CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate 31 study designs, sample populations, and methodologies. The goal of this pilot case-control study 32 was to evaluate the relationships between key demographic, cultural, and occupational variables 33 as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and 34 through its potential use as an ingredient in brewed kasippu alcohol. A total of 56 CKDu cases 35 and 54 control individuals were surveyed using a proctored, self-reported questionnaire. 36 Occupational pesticide exposure and alcohol consumption were not found to be significant risk 37 factors for CKDu. However, a statistically significant association with CKDu was observed with 38 chewing betel (OR: 6.11, 95% CI: 1.93, 19.35), age (OR: 1.07, 95% CI: 1.02, 1.13), owning a pet 39 dog (OR: 3.74, 95% CI: 1.38, 10.11), water treatment (OR: 3.68, 95% CI: 1.09, 12.43) and pests 40 in the house (OR: 5.81, 95% CI: 1.56, 21.60). The findings of this study suggest future research 41 should focus on practices associated with chewing betel, potential animal interactions including 42 pests in the home and pets, and risk factors associated with water.

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Serological evidence of hantavirus infection in Girandurukotte, an area endemic for chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka

Cited by 43 publications

References 7 publications

Reply to Comments by Yih et al. (Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross-Sectional Study)

Reply to Comments by Yih et al. (Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross-Sectional Study)

Leptospirosis Renal Disease: Emerging Culprit of Chronic Kidney Disease Unknown Etiology

A pilot study of behavioral, environmental, and occupational risk factors for chronic kidney disease of unknown etiology in Sri Lanka

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