Abstract:
The prevalence of Chronic Kidney Disease of Uncertain Etiology (CKDu) in the Uva
Province of Sri Lanka has received much attention over the past two decades. Many
scientists have proposed that prolonged consumption of groundwater with high levels of
contaminants notably fluoride is the root cause of the CKDu. Thus, the prime objective
of this study is to develop a water quality index (WQI) to identify the relationship
between drinking water quality and the prevalence of CKDu in the Uva Province.
For this, 230 groundwater samples were collected and subjected to spectrophotometric
analysis for their major cations and anions covering the entire province. To get
a comprehensive overall quality of the groundwater in the study area, the weighted
arithmetic WQI method was applied based on the recommended guidelines for drinking
water quality by the SLS 614:2013 (Sri Lankan Standard). The spatial distribution
maps of individual water quality parameters and WQI were developed by using the
Inverse distance weighted (IDW) method of interpolation with power 2 in ArcGIS 10.4
mapping software. Further, a spatial map of CKDu patients was developed based on
the data collected from the regional hospitals and previously published data to assess
the geospatial correlation between the water quality and CKDu. According to the WQI
calculation, 21.5%, 21.2%, 20.0%, 10.0%, and 27.3% of water samples were categorized
under excellent, good, poor, very poor, and unsuitable categories, respectively. The
most significant geospatial correlation was recorded between fluoride content in the
groundwater samples and WQI (0.96). Further, the statistical analysis showed that the
WQI has a strong positive correlation (0.68) with the spatial distribution of CKDu
patients inferring that groundwater quality has a significant effect on the prevalence of
CKDu in the Uva Province, Sri Lanka. This study highlights that effective interventions
are required to be implemented to enhance the availability of pure drinking water to
combat CKDu.
