Introduction:
Chronic Kidney Disease (CKD) is a significant global health issue affecting 10-15% of the population, with cases surpassing 697.3 million in 2019, more than doubling since 1990. In Nepal, CKD prevalence has also surged, from 726,897 cases in 1990 to 1,895,080 in 2019. This increase is reflected in rising CKD-related deaths. Among Nepali migrant workers, harsh working conditions further elevate the risk of CKD and End-Stage Kidney Disease (ESKD). Despite this, specific data on CKD in this population is scarce. This study aimed to address this gap by examining the incidence of kidney transplants among Nepali returnee migrant workers, along with their socio-demographic characteristics, employment histories, working conditions, and health determinants.
Methods:
A descriptive cross-sectional study was conducted among returnee Nepali migrant workers who had undergone Kidney transplant surgery at a National Transplant Centre in Nepal between February 6, 2013 and September 30, 2023. A structured questionnaire was used, covering sociodemographic characteristics, employment histories, working conditions, and health behaviors such as smoking, alcohol use, diet, water intake, and urination practices. Non-probability purposive sampling was employed to collect data via telephone interviews from March 18, 2024, to May 17, 2024, using the Nepali version of the questionnaire, with responses recorded in the English version. The data were analyzed using IBM SPSS version 20.0. Ethical approval was obtained from the Nepal Health Research Council (protocol registration number 666/2023).
Results:
Of the 217 respondents, 41.5% were aged 30-39 years (mean age: 36.49 ± 8.63), and 94.5% were male. Nearly half (49.3%) were diagnosed with ESKD before returning to Nepal. Most workers had been employed in Gulf countries, primarily Qatar (25.3%), UAE (21.7%), and Saudi Arabia (9.2%). The majority of the migrants had worked in service jobs (54.8%) with long hours (41.9% worked 10 hours daily). Working conditions were harsh, with 40% exposed to temperatures of 41-50°C, and 21% to over 51°C. While 95.2% had access to drinking water, 39.5% reported skipping water intake, and 40.5% delayed urination despite the urge. Most drank 1-2 liters of water daily, with mineral water being the most common type (67.5%).
Conclusions:
Our study revealed that Nepali migrant workers face severe working conditions that significantly impact kidney health, contributing to high rates of ESKD and ultimately requiring kidney transplantation. The findings highlight the need for improved working conditions, including access to drinking water, reduced working hours, and education on hydration and kidney health. Governments and employers must take responsibility by enforcing policies that protect workers’ health. Pre-departure orientations and public awareness on kidney health are also essential to mitigate risks. Further research is necessary to explore long-term health outcomes and develop targeted interventions for this vulnerable population.
I have no potential conflict of interest to disclose.
I used generative AI and AI-assisted technologies in the writing process.
During the preparation of this work the author(s) used ChatGPT in order to make the text concise to meet the 3,400 characters count. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.