Naslov
Endemic nephropathy and upper urothelial carcinomas

Autori
Cvitković, Ante ; Jurišić, Irena

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
One Health Symposium / - Slavonski Brod, 2014, 4-4

Skup
One Health Symposium

Mjesto i datum
Slavonski Brod, Hrvatska, 05.06.2014. - 07.06.2014

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
endemic nephropathy ; upper urothelial carcinomas

Sažetak
Background/Aims: Endemic nephropathy (EN) is a chronic tubulointerstitial disease. Strong association between EN and urothelial carcinoma was noted as early as 40-50 ago. The aim of the study was to compare specific mortality and morbidity of renal pelvis and ureter (upper urothelium) carcinoma among Croatia as a whole, Brod-Posavina County and Croatian endemic area, as well as to determine the prevalence in the endemic villages. Methods: Data on renal pelvis and ureter carcinoma (UUC) mortality and morbidity were analyzed. Indirect standardization was employed on data comparison by calculating standardized mortality ratio and morbidity ratio. Field researches were conducted in six endemic villages. A total of 2487 adult farmers from six endemic villages (Slavonski Kobaš, Živike, Pričac, Šumeće, Zbjeg, Dubočac), and three non-endemic villages (Klakar, Donja Bebrina, Rastušje) were enrolled. Extensive epidemiological questionnaire, clinical examination and laboratory analysis of blood and urine were performed. According to the modified WHO criteria, participants were classified into diseased, suspected of having EN, those at risk to develop EN. Results: The prevalence of EN ranges between 0.3% and 2.3 % in different EN villages. The overall prevalence of EN in the Croatian area was 1.0%, and suspected of having EN amounted to 3.9 %. It could be estimated that in the Croatian endemic area approximately 593 farmers have EN or are suspected of having EN. In the majority of endemic villages a decreasing trend in the prevalence of EN was observed comparable to the results obtained in the previous surveys. It is interesting to note that no endemic nephropathy patients were recorded in the endemic village of Dubočac. Specific mortality rate in the endemic area was 26.3-fold and 7.3-fold the rate recorded in Croatia and Brod-Posavina County, respectively. The mean standardized mortality ratio obtained by indirect standardization yielded an 8-fold and 32-fold risk of death from UUC in the endemic area versus Brod- Posavina County and Croatia as a whole, respectively. Data revealed the specific morbidity in the Croatian endemic area and Brod-Posavina County to be 13.95-fold and 3.78-fold morbidity recorded at the national level, respectively. The standardized morbidity ratio also showed the risk of developing UUC in the Croatian endemic area to be 3.75-fold the risk in Brod-Posavina County and 16.4-fold risk in Croatia. Conclusion: The prevalence of EN in the Croatian endemic area appears to be decreasing. For the first time we failed to detect any of endemic nephropathy patients in a village that was previously considered as endemic, which might indicate that EN is diminishing. These results also showed that specific mortality and morbidity as well as standardized morbidity ratio and standardized mortality ratio were higher in Croatian endemic area than in Brod-Posavina County and Croatia.

Izvorni jezik
Engleski

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