中美洲自我报告的慢性肾脏病患病率及地理分布和潜在危险因素。

Prevalence and Geographic Distribution of Self-Reported Chronic Kidney Disease and Potential Risk Factors in Central America.

机构信息

Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX 77030, USA.

Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in San Antonio, San Antonio, TX 78229, USA.

出版信息

Int J Environ Res Public Health. 2023 Jan 11;20(2):1308. doi: 10.3390/ijerph20021308.

DOI:10.3390/ijerph20021308

PMID:36674063

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9859154/

Abstract

BACKGROUND

Cases for chronic kidney disease of unknown etiology (CKDu) are increasing in specific disease hotspots located in rural agricultural communities over Central America. The goal of the study was to estimate the prevalence and geographic distribution of self-reported work-related CKD and associated risk factors for CKDu by industry sector in Central America.

METHODS

We calculated the prevalence and distribution of self-reported CKD, work-related CKD, and suspected CKDu risk factors among the 9032 workers in the Second Central American Survey of Working Conditions and Health (II ECCTS, 2018). We mapped the distribution of suspected CKDu risk factors to work-related CKDu and weather conditions using average annual temperatures.

RESULTS

The primary and secondary industry sectors showed the highest proportion of males, suspected CKDu risk factors, and work-related CKD. Age (30-49 years: OR = 2.38, 95% CI 1.03-5.51), ethnicity (mestizo: OR, 7.44, 95% CI: 2.14-25.82), and exposure to high physical work demands (OR = 2.45, 95% CI: 1.18-5.09) were associated with work-related CKD. The majority of work-related CKD were reported in the western parts of Honduras and Nicaragua, in hot temperature regions, and overlapped with those areas with a high density of CKDu risk factors. Finally, some areas clustered CKDu risk factors without any work-related CKD points, mainly in the western part of Guatemala.

CONCLUSION

Our findings supplement prior CKDu findings regarding a high prevalence of work-related CKD among 30- to 49-year-old mestizo males in the primary and secondary sectors, in hot temperature areas, in the central and western region, and overlapping with persons reporting two or more CKDu risk factors. Moreover, several geographic areas with CKDu risk factor clusters had no reported work-related CKD. These areas represent new industries and sectors to be monitored for possible future increases of CKDu cases.

摘要

背景

在中美洲的一些农村农业社区的特定疾病热点地区，不明原因的慢性肾脏病（CKDu）病例正在增加。本研究的目的是估计中美洲按行业部门划分的自我报告与工作相关的慢性肾脏病（CKDu）的患病率和地理分布，以及与 CKDu 相关的危险因素。

方法

我们在第二届中美洲工作条件和健康调查（II ECCTS，2018 年）的 9032 名工人中计算了自我报告的慢性肾脏病、与工作相关的慢性肾脏病和疑似 CKDu 危险因素的患病率和分布。我们使用平均年温度将疑似 CKDu 危险因素的分布映射到与工作相关的 CKDu 和天气条件。

结果

第一和第二产业部门的男性比例、疑似 CKDu 危险因素和与工作相关的慢性肾脏病比例最高。年龄（30-49 岁：OR=2.38，95%CI1.03-5.51）、族裔（混血儿：OR=7.44，95%CI：2.14-25.82）和暴露于高体力工作需求（OR=2.45，95%CI：1.18-5.09）与与工作相关的慢性肾脏病相关。大多数与工作相关的慢性肾脏病报告发生在洪都拉斯和尼加拉瓜的西部、高温地区，与 CKDu 危险因素密度较高的地区重叠。最后，一些地区聚集了 CKDu 危险因素，但没有任何与工作相关的慢性肾脏病点，主要在危地马拉的西部。

结论

我们的发现补充了之前关于中美洲 30-49 岁混血男性在第一和第二产业、高温地区、中西北部地区工作相关慢性肾脏病患病率较高的 CKDu 发现，并且与报告有两个或更多 CKDu 危险因素的人群重叠。此外，一些有 CKDu 危险因素聚集的地理区域没有报告与工作相关的慢性肾脏病。这些地区代表了新的行业和部门，需要进行监测，以观察未来 CKDu 病例可能增加。