Chronic kidney disease in sugarcane workers in Cameroon: a cross-sectional study

Abstract

Background: Agricultural workers especially in sugarcane plantations have a high risk of chronic kidney disease (CKD). Little is known about CKD among sugarcane plantation workers in Cameroon. This study sought to evaluate the prevalence and identify factors associated with CKD in sugarcane plantation workers in Cameroon.

Methods: We conducted an analytic cross-sectional study including 204 adult workers at the sugarcane plantation complex in Mbandjock, Cameroon; over 500 m above sea level. Chronic kidney disease (proteinuria as estimated by urine dipstick analysis and/or estimated glomerular filtration rate < 60 ml/min/1.73 m² persistent after 3 months) was the outcome of interest. Those with abnormal results were seen again after 3 months to confirm the diagnosis. We evaluated the association between CKD and participant age, sex, contract-type, duration of employment, socio-economic status, workspace, exposure to agrochemicals, heavy metals and heat, selected risk factors and co-morbid conditions.

Results: The overall prevalence of CKD was 3.4%. The factory workers were the most affected (7%), compared to the field (2.4%) and office workers (0%). 2.9% of the participants had persistent proteinuria, mild in every case, and 0.5% of them had an estimated glomerular filtration rate < 60 ml/min/1.73 m². Age ≥ 40 years was an independent predictor of CKD.

Conclusion: The prevalence of CKD among employees of the Mbandjock sugarcane plantation is low, probably reflecting the preventive measures against heat stress and dehydration in place.

Keywords: Cameroon; Chronic kidney disease; Sub-Saharan Africa; Sugarcane plantation workers.

Fig. 1

Participant recruitment flowchart – To make our sample population representative of the general working population we randomly selected pre-numbered workers such that the proportions, with respect to workspace, were respected at every stage. In the first stage, we selected 250 participants. After excluding 46, we retained 204 participants, ensuring that the proportions remained approximately the same

Fig. 2

Prevalence of urine abnormalities: The figure shows the change in prevalence of urine abnormalities (proteinuria, hematuria and leucocyturia) over time, from baseline to 3 months later after control tests were done