Decreasing incidence of CKD/CKDu in North Central Province of Sri Lanka: is it related to provision of drinking water reverse osmosis plants?

Abstract

Abstract Background We assess the impact of provision of reverse osmosis (RO) water on the incidence of CKD/CKDu in North Central Province (NCP) of Sri Lanka. Methods A cross sectional survey was conducted on data from 2010–2020 on the incidence of CKD/CKDu, CKD/CKDu screening and provision of drinking water reverse osmosis (RO) plants in NCP. Analysis was conducted using descriptive statistics, ANOVA and chi-square test. Results The incidence of CKD/CKDu (per 100 000 population) in 2010–2013, 2014–2016 and 2017–2020 periods in Anuradhapura district were 129.07, 331.06 and 185.57 (p = 0.002) while in Polonnaruwa district these were 149.29, 326.12 and 296.73 (p = 0.04) respectively. In NCP provision of Reverse Osmosis (RO) plants commenced after 2011 and the decline in the incidence of CKD/CKDu occurred in 25 of the 29 Divisional Secretary Divisions when more than 20% of the families received access to drinking RO water projects. In both districts mean time taken to reduce the incidence rate of CKD/CKDu after reaching 20% of family coverage is 0.8 years. Conclusions CKD/CKDu incidence increased in NCP from 2010 to 2016 and continuously decreased thereafter. Continuous declining of CKD/CKDu incidence was observed after more than 20% of the families received access to drinking water RO plants.