文章基本信息

标题：Chronic kidney disease in Central American agricultural communities: challenges for epidemiology and public health
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作者：Silva, Luis Carlos ; Ordúñez, Pedro
期刊名称：MEDICC Review
印刷版ISSN：1555-7960
电子版ISSN：1527-3172
出版年度：2014
卷号：16
期号：2
页码：66-71
语种：English
出版社：Medical Education Cooperation with Cuba
摘要：This paper contextualizes the chronic kidney disease epidemic and related burden of disease affecting Central American farming communities. It summarizes the two main causal hypotheses (heat stress and agrochemicals), draws attention to the consequences of dichotomous reasoning concerning causality, and warns of potential conflicts of interest and their role in "manufacturing doubt." It describes some methodological errors that compromise past study findings and cautions against delaying public health actions until a conclusive understanding is reached about the epidemic's causes and underlying mechanisms. It makes the case for a comprehensive approach to the historical, social and epidemiological facts of the epidemic, for critically assessing existing studies and for enhanced rigor in new research.
关键词：Epidemiology;public health;chronic kidney disease;causality;epidemic;agriculture;environment;agrochemicals;pesticides;heat stress;social determinants of health;Central America