Joint National and International Workshop on CKDu to Recommend a CKDu Policy, Research Agenda, and an Action Plan

CKDu 国家和国际联合研讨会将推荐 CKDu 政策、研究议程和行动计划

• 批准号: 9194916
• 负责人: Tissa Illangasekare
• 金额: $ 2万
• 依托单位: COLORADO SCHOOL OF MINES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9194916
• 关键词: Agricultural Workers; Agriculture; Area; Arsenic; Bangladesh; Behavior; Behavioral Sciences; Cadmium; Central America; Chronic; Chronic Kidney Failure; Consensus; Country; Diabetes Mellitus; Diagnosis; Disease; Ecology; Educational workshop; Environmental Engineering technology; Epidemic; Etiology; Exposure to; Family member; Farming environment; Fertilizers; Geographic Information Systems; Goals; Health; Heavy Metals; Hypertension; India; International; Irrigation; Joints; Knowledge; Laboratories; Laboratory Study; Lead; Medicine; Mexico; Nephritis; Nephrology; Nephrotoxic; Paper; Pesticides; Policies; Policy Research; Positioning Attribute; Province; Psychology; Public Health; Recording of previous events; Reporting; Research; Rice; Risk; Risk Factors; Science; Scientist; Site; Social Environment; Soil; Sri Lanka; Surface; System; Time; Tsunami; Visit; World Health Organization; base; design; drinking water; expectation; experience; farmer; field study; health economics; hydrology; information gathering; inorganic phosphate; killings; meetings; member; metal complex; multidisciplinary; research study

Project Summary Since 1994, the rice paddy farmers in Northern Central Province (NCP) of Sri Lanka have been experiencing an unusual epidemic of Chronic Kidney Disease (CKD) that is not caused by traditionally known causes such as diabetes, hypertension or glomerular nephritis. As of today, CKDu has already killed 23,500 farmers and their family members. Another 69,000 have been diagnosed with the disease. Similar epidemics of CKDu among agricultural workers have been reported in Andra Pradesh in India, in Bangladesh and in Mexico and Central America. A number of research groups including the World Health Organization (WHO) have conducted research studies to determine the etiology of this unique type of CKDu in Sri Lanka. While there is the consensus that this is a multi-factorial disease, main factors include chronic exposure to Arsenic, Cadmium and nephrotoxic pesticides. Additional risk factors such as drinking water from shallow wells and the use of pesticides and contaminated triple phosphate fertilizer have been identified. However, how these factors interact in the specific hydrologic, geochemical and social environment al settings has not been systematically studied. We propose to take a multidisciplinary team of scientist from the US to Sri Lanka for a site field visit to NCP and conduct two workshops. The team members will be selected to represent the following areas of expertise: medicine and nephrology, public health, environmental sciences and engineering, surface and subsurface hydrology, soil science, geochemistry, behavioral sciences and environmental psychology, and geographic information systems. The workshops have two primary goals: (1) to gather information from Sri Lankan scientists who are active both in field and laboratory studies, and (2) to synthesize the gathered knowledge and identify key knowledge gaps through discussions and analysis. The final product of these workshops will be to develop a framework that integrates our understanding of the different factors that contribute to CKDu risk. A position paper, research agenda, and an action plan that could lead to a national CKDu policy in Sri Lanka will be developed. It is our expectation that this framework and plan will become the basis to develop strategies for both short and long-term interdisciplinary collaborative research efforts between not only Sri Lankan and US scientists, but will also from other countries where CKDu has become a health crisis that needs scientists to conduct research on the main risk factors leading to CKDu while delineating the similarities and the differences in the two geographical regions.

项目摘要 自1994年以来，斯里兰卡北方中央省（NCP）的稻田农民一直在 经历了一种不寻常的流行性慢性肾脏病（CKD），这不是由 传统上已知的原因如糖尿病、高血压或肾小球肾炎。从今天开始， CKDu已经杀害了23 500名农民及其家庭成员。另有69，000人被 被诊断出患有这种疾病。在农业工人中， 在印度的安德拉邦、孟加拉国、墨西哥和中美洲都有报告。一 包括世界卫生组织（世卫组织）在内的一些研究小组已经进行了 研究，以确定斯里兰卡这种独特类型的CKDu的病因。虽然 是共识，这是一个多因素的疾病，主要因素包括慢性暴露于 砷、镉和肾毒性农药。其他风险因素，如饮用水 从浅威尔斯井和使用杀虫剂和受污染的三重磷肥， 被识别。然而，这些因素如何在特定的水文，地球化学和 社会环境尚未得到系统的研究。我们建议采取 来自美国的多学科科学家团队前往斯里兰卡对NCP进行实地考察， 举办两个研讨会。团队成员将被选中代表以下领域： 专长：医学和肾病学、公共卫生、环境科学和工程， 地表和地下水文学、土壤科学、地球化学、行为科学和 环境心理学和地理信息系统。车间有两个 主要目标：（1）从斯里兰卡科学家那里收集信息，这些科学家活跃在该领域， 和实验室研究，（2）综合收集的知识，并确定关键 通过讨论和分析发现知识差距。这些讲习班的最后成果将是 开发一个框架，整合我们对不同因素的理解， CKDu风险。一份立场文件、研究议程和行动计划， 将制定斯里兰卡的国家CKDu政策。我们希望这个框架 和计划将成为制定短期和长期战略的基础 不仅斯里兰卡和美国科学家之间的跨学科合作研究努力， 但也将来自其他国家，在这些国家，CKDu已成为一个健康危机，需要科学家 对导致CKDu的主要风险因素进行研究，同时描述相似性 以及两个地理区域的差异。