- js reader version
- view hidden posts
- tags and related articles
Thursday, Jan. 13, 2011 at 1:58 PM
It's a compelling public health mystery: Thousands of people in Northwestern Nicaragua are dying from chronic kidney failure, and no one knows why.
Now, an interdepartmental team of Boston University School of Public Health [BUSPH] researchers is on the case, sifting for answers.
"The disease has, essentially, been a death sentence once you get it," said BUSPH researcher Daniel Brooks, an associate professor of epidemiology who leads the group. "We don't often have public health epidemics [where] we really have no idea what the cause is. In this case, that is the situation."
Since 2009, Brooks has led a research team from BU to probe why residents of two regions of northwestern Nicaragua -- Chinandega and Leon -- are contracting chronic kidney disease at a rate more than 10 times that in the U.S. Under the auspices of the World Bank's Office of the Compliance Advisor/Ombudsman (CAO), the team has developed a strategy to probe possible reasons for the epidemic and is conducting a wide-ranging study to try to pinpoint causes.
The scientists are working with a few clues that they hope may lead them to answers. Previous studies indicate that deaths are more common among men than women, and that the disease is striking people as young as 20 or 30 years old.
Among those with the disease are a large number of former agricultural workers at a sugar cane plantation owned by the largest employer in the area, Nicaragua Sugar Estates Limited (NSEL). A group of former NSEL employees have alleged that the company was exposing workers to something that was causing the epidemic -- a claim disputed by the company. The workers formed a group, ASOCHIVIDA, which lodged a complaint in 2008 with the CAO (the World Bank's private sector arm, IFC, provided a million loan to the sugarcane operation in 2006).
In response, the CAO brought together workers and sugarcane company management to try to find answers, with the BU interdisciplinary team retained to develop a strategy for studying possible causes.
To date, the BUSPH team has done studies on everything from the work processes used at NSEL, to the agrichemicals used on crops, to screening water samples for contaminants known to cause chronic kidney disease. Nothing, so far, has been shown to explain the excess occurrence of chronic kidney disease.
The research team and other stakeholders spoke of their challenges and progress at a recent forum at Boston University Medical Campus, headlined "An Epidemic of Chronic Kidney Disease in Nicaragua: BUSPH Responds to a Public Health Crisis." Attendees included Juan Jose Amador, a Nicaraguan health professional who is working in the affected community; Amar Inamdar, a CAO representative who is overseeing the conflict between the Nicaraguan sugarcane company and the organization of former workers; and Juan Dumas, an expert in conflict management who is mediating the complex dialogue process that is central to the study of this epidemic.
"Nicaragua Sugar Estates Limited may be conducting itself in accordance with work practices that we say [are] okay," said Inamdar, principal specialist, ombudsman at the World Bank's Office of the Compliance Advisor/Ombudsman. "But does that tell you why or how kidney disease is happening among a good 30 percent of the workforce? No."
"People have been looking for an answer for a number of years and they haven't found one," said Brooks. "There have been various theories, from heat to infectious disease to toxin exposure. It's very much still a mystery."
Besides Brooks, other members of the research team include: Ann Aschengrau, professor of epidemiology; Michael McClean, associate professor of environmental health; Madeleine Scammell, assistant professor of environmental health; Kate Applebaum, assistant professor of epidemiology; Bruce Cohen, adjunct assistant professor of epidemiology and director of research and epidemiology at the Massachusetts Department of Public Health; and James Kaufman, MD, a renal specialist at the BU School of Medicine. Also working with the team is Daniel Weiner, a renal specialist at Tufts University School of Medicine, and Oriana Ramirez, a specialist in preventive medicine studying at Universidad Autónoma de Madrid.
While the main goal of the researchers is to identify causes and end the epidemic, Brooks said that the study process itself has fostered important advances, including a growing trust and collaboration between the various stakeholders involved.
"How do we make them work as a group to fight [chronic kidney disease]?" said Dumas, a conflict management expert. "I believe that is our main challenge. This is about people cooperating."
For now, the researchers plan to continue testing sugar cane workers, interviewing local physicians, and examining other possible occupational and nonoccupational exposures.
For his part, Brooks, whose regular areas of research center on tobacco-related disease and cancer epidemiology, said he is hopeful that the combined skills of epidemiologists, environmental health professionals, renal disease specialists, and global health scholars eventually will lead to answers.
"This may be the most challenging, but also the most meaningful, work I've undertaken," Brooks said. "It's not often that we have a chance to do work that could have such a profound and direct impact on people's lives."
Submitted by Lisa Chedekel and Elana Zak
Report this post as:
Change Links 2018 July posted
More Pix: "Families Belong Together," Pasadena
"Families Belong Together" March, Pasadena
Short Report on the Families Belong Together Protest in Los Angeles
Summer 2018 National Immigrant Solidarity Network News Alert!
Watch the Debate: Excluded Candidates for Governor of California
Change Links June 2018 posted
The Montrose Peace Vigil at 12 Years
Unity Archive Project
Dianne Feinstein's Promotion of War, Secret Animal Abuse, Military Profiteering, Censorshi
CA Senate Bill 1303 would require an independent coroner rather than being part of police
Three years after OC snitch scandal, no charges filed against sheriffs deputies
California police agencies violate Brown Act (open meetings)
Insane Company Wants To Send Nuke Plant Waste To New Mexico
Change Links May 2018
Worker-Owned Car Wash on Vermont Closed
GUIDE TO REBEL CITY LOS ANGELES AVAILABLE
lausd whistle blower
Help KCET and UCLA identify 60s-70s Chicano images
UCLA Luskin: Casting Youth Justice in a Different Light
Change Links April 2018
Nuclear Shutdown News March 2018
Join The Protest Rally in Glendale on April 10, 2018!
Spring 2018 National Immigrant Solidarity Network News Alert!
Anti-Eviction Mapping Project Shows Shocking Eviction Trends in L.A.
Steve Mnuchin video at UCLA released
Actress and Philanthropist Tanna Frederick Hosts Project Save Our Surf Beach Clean Ups
More Local News...
Fbi fears this post
Disabled Folks among the extreme poorest in US counts
Banks Enriched By Trump Deficit Increase Of 4 to 5 Trillion $
Illegal Russians Receiving Land and Homes in West Bank 2018
Un monde de pauvreté
14 Disturbing Facts About Scott Gottlieb, Trump's FDA Head
Behind the scenes at fbi National Academy
Treasury Takes Aim at Shell Companies
Paraphysique de l'intelligence
Oklahoma GOP Senator Jim Inhofe's Bloody Record
Globalization: hope on the horizon despite Fake Liberals.
Sorry President Trump,Ted Cruz Texas Judicial System,is Worse Than Many Shithole Countries
The Shortwave Report 07/20/18 Listen Globally!
The System Question as a Survival Question
Nation's Largest Voting Machine Co., ESS, Admits Lying Re Having Installed Remote Control
Du pain et des jeux
Paraphysique de martyrologie
Children Incorporated Earns 4-Star Rating on Charity Navigator
Democratic Socialists of America
Leonard Peltier Non Violent Native American Political Prisoner since 1970's
Paraphysique miscellanées de l'aggiornamento
FBI Investigated LA County Sheriff Baca,Why Not Hank Skinner's Persecution?
Updated Partial List Of Famous Vegetarians, Vegans, & Fruitarians
The Shortwave Report 07136/18 Listen Globally!
Social Policy as Social Infrastructure
Vol I: 84 Varieties Of GOP Election Fraud
Texas Can Call it An Execution,But It is A State Sponsored Murder of Hank Skinner..
June 2018 Honduras coup update
More Breaking News...