GEONEFROSALVA, GIS platform to identify possible environmental risk factors of CKDnt in El Salvador
Alexandre Ribó (1), Edgar Quinteros (1), Roberto Mejía (1), David Alfaro (1), Eduardo Vela, Alejandro López, Julio C. Alvarado, Carlos M. Orantes (1), Dina L. López (2)
(1) National Institute of Health, Ministry of Health of El Salvador
(2) Department of Geological Science, Ohio University
Presentation: Video available since 23.08.2014, [Video]
Discussion: 26.08.2014, [Discussion]
The National Institute of Health of Ministry of Health of El Salvador (INS-MINSAL) generated GEONEFROSALVA, a Geographical Information Systems (SIG) platform as a tool to study the possible environmental risk factors associated to chronic kidney disease of nontraditional causes, a disease affecting the agricultural population of El Salvador. This platform was built using free software (PostgreSQL, PostGIS and Quantum GIS) following Ministry of Health guidelines about using of non-corporate software. GEONEFROSALVA is a tool to control the heterogeneous and multidisciplinary data set (pollutant content in the different environmental phases, different types environmental data, pollutant content in food, surveys on population exposure to toxics, cartographic coverages, etc.). These data are necessary for the characterization of possible environmental risk factors of Chronic Kidney Disease of nontraditional causes. The information was obtained from different sources (new data acquired by INS-MINSAL, data from MINSAL, data from Environmental Ministry, data from scientific literature, etc). All data were georreferenced in the standard projection system WGS 84, and harmonized in a homogeneous ready-to-use format. Data were completed with metadata with all information in the available sources allowing for its use in future studies dealing with environmental or health issues. Platform architecture is open to input new data and updates as might be needed for future health or environmental studies. A preliminary analysis of environmental data compiled in GEONEFROSALVA allowed identifying, at national scale, the most polluted basins according to the levels of pollution in the main rivers and lakes. At local level, this platform also allowed identifying high levels of nephrotoxic pollutants in several environmental phases in communities heavily affected by chronic kidney disease of nontraditional causes, as Ciudad Romero in Usulután department, Loma del Gallo in La Paz department and Las Brisas in San Miguel department. In the next step, a database of epidemiological and clinical information on kidney patients will be added to the platform. This database will use the geographical coordinates of the home patients as common link among the different tables. This implementation will allow establishing geographical correlations among environmental data, epidemiological data and clinical data to define risk factors and causal relationships.
