Uddanam is a lush green region in the Srikakulam district of the state of Andhra Pradesh, located on the eastern coast of India with rich coconut and cashew plantations. The survey conducted by the Harvard Medical School of USA under Screening and Early Evaluation of Kidney diseases (SEEK) project revealed that about 3,200 people died in the last eight years due to renal failure (Times of India, 2009). This is India’s highest at 20% against the national average of 6%. The cause is generally attributed to a claim made by the specialists on excessive usage of pain killers and less water consumption. Leading newspapers have published numerous articles on various studies taken up by several organizations in addition to a number of news articles frequently found in the local editions of vernacular newspapers (Times of India, 2009; The Hindu, 2008 and 2009; and Deccan Chronicle, 2009). Although many agencies and individuals are working to unearth the mystery behind this killer disease, the real cause seems to be elusive. This indicated the absence of serious attention towards systematic investigation that necessitated the present study (Sasibhushan et al., 2010; and Sasibhushan, 2010).

In this regard, the authors conducted a preliminary study to lay down a scientific basis for the individuals and agencies willing to carry out a systematic investigation. Initial survey revealed that the disease is highly concentrated in 15 villages. These are Metturu, Gunupalli, Vonkuluru, Deppuru, Gaduru and Akkupalli of Vajrapu-kotturu mandal; Gollagangi, Chapalagollagongi and Ekuvuru of Sompeta mandal; B Gonaputtuga, Balliputtuga, Varaka, Kapasakuddi, Mutyalapeta and Jagati of Kaviti mandal. The first six of these villages are presented as one cluster (Cluster 1), and the remaining nine villages as another cluster (Cluster 2). The disease claimed at least one life from each household in these villages. It is not an exaggeration to mention that atleast one person out of every two in these villages have some kind of kidney-related ailment. All these villages are located just a few kilometers away from the sea coast.

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