Utilizing a One Health approach for identifying risk factors associated with an epidemic of chronic kidney disease of unknown etiology (CKDu) in the North Central region of Sri Lanka

Abstract

Background: The Kenya Association of Physicians and medical workers for social responsibility is an affiliate of the broader International Physicians for the Prevention of Nuclear War (IPPNW). The Association is Non e governmental and its main objectives are to improve the quality of human life through the provision of good health based on the understanding that its members' responsibility as medical workers goes beyond treating patients in hospitals and include tackling the primary causes of human suffering. The association has its members in different medical schools spread across Kenya. Each year, the members in the respective schools are tasked with the responsibility of coming up with a project which will promote social responsibility among the communities around them. The students are well trained in a workshop to equip them with the right skills which will enable them to do this. Students of the medical school at Moi University realized that there was a lot of littering taking place around the school and hospital environs. As a result, they came up with project "Environment ni Mimi", which when translated means 'the environment is my responsibility'. The project entailed ensuring the environment is better taken care of. It portrays; the responsibility of the environment begins with an individual and then becomes a collective responsibility. Method: The main objectives of the project were to create more awareness on the environment, to curb the excessive dumping of litter around the school and hospital environment and to promote social responsibility among the health workers and students. Students organized an anti-litter campaign and designed posters and T-shirts which were advertised all around school. In addition, there was a major clean-up day organized which saw the picking up of litter and placing of dust bins in strategic places within the school compound. Outcome and Evaluation: The school environs is more litter free. The dust bins are well used and there has been awareness created on the importance of a litter free environment.

Two decades of chronic kidney disease of unknown aetiology (CKDu) research: Existing evidence and persistent gaps from epidemiological studies in Sri Lanka

“…The failure to find a definitive cause has led to several review papers concluding that the disease is multifactorial. 28,60,68,69 Previous CKDu epidemics, such as Itai-Itai disease in Japan (cadmium) required decades of research before a consensus on aetiology was achieved showing a singular aetiological agent. 2 Positive findings from research are that the disease is most common in male agricultural workers, that there may be exposures through some drinking water sources, and that there is probably a relation between acute episodes and chronic renal disease of unknown cause.…”

“…The current body of evidence for any aetiological agent as the proximate cause of CKDu in Sri Lanka is limited. The failure to find a definitive cause has led to several review papers concluding that the disease is multifactorial 28,60,68,69 . Previous CKDu epidemics, such as Itai‐Itai disease in Japan (cadmium) required decades of research before a consensus on aetiology was achieved showing a singular aetiological agent 2 .…”