Research Article Spatial Analysis of Kidney ...

REVIEW OF INTERNATIONAL GEOGRAPHICAL EDUCATION

ISSN: 2146-0353 ● © RIGEO ● 11(4), WINTER, 2021

www.rigeo.org Research Article

Spatial Analysis of Kidney Failure Disease in

The Province of Najaf for The Period (2014-

2018)

Rahim M. Alabdali1

Department of Geography, College of Arts /University of Kufa, Iraq

[email protected]

Helen M. Abdul Hussein2

University of Kufa, College of Education for Girls, Iraq

Rasul Muslim3

University of Kufa, College of Education for Girls, Iraq

Abstract

The research aims to reveal the spatial and temporal distribution of kidney failure in the province of Najaf

for the period (2014-2018) and to clarify the geographical distribution according to the administrative

units in the province of Najaf, based on official data recorded from the relevant official departments,

and between researching cases of injury according to age groups as well as their classification by gender

(males and females), in addition to a comparison between the administrative units to find out any size of

injuries in them, as well as analyzing the data within the SPSS program to find out the significant differences

between the administrative units, gender and age based on the analysis of Kruskal Walls and Wutney.

The most important results of the research came that there is a variation in the rate of incidence of kidney

disability (kidney failure) for the duration of the study (2014-2018) mentioned in the body of the research.

Keywords Kidney, Najaf, SPSS, Geographic, Disease

To cite this article: Alabdali, R, M; Abdul Hussein, H, and Muslim, R. (2021) Spatial Analysis of Kidney Failure Disease

in The Province of Najaf for The Period (2014-2018). Review of International Geographical Education (RIGEO), 11(4), 1270-1281. doi: 10.48047/rigeo.11.04.122

Submitted: 20-03-2021 ● Revised: 15-04-2021 ● Accepted: 25-05-2021

http://www.rigeo.org/

mailto:[email protected]

Alabdali, R, M; Abdul Hussein, H, and Muslim, R. (2021) Spatial Analysis of Kidney Failure Disease in the …

Introduction

Population health is one of the foundations sought by governments in the world, as they are

concerned with the chronic disease phenomena that sweep their countries, as medical

geography is one of the fields of knowledge that includes a mixture of several different

environmental, health, geographic, sports, social, biological and natural sciences. Some of these

specialties are and behind it population diseases, so recent studies were seeking to delve into the

sciences that are in common with other disciplines to result in an important specialty, which is

medical geography. The importance of geography in the field of human health increases in terms

of the relationship of geography with other sciences, including natural and human. When the

doctor diagnoses the disease, its causes and methods of treatment, as for how and why the

disease spread, this is the duty of medical geography by making a map that determines the

encouraged the emergence and prominence of medical geography because it is one of the

branches of medical geography is the geographical interest in the close aspect between man

and his surroundings to find explanations for several diseases that afflict humans, to study

geographical distribution and search for the causes and geographical explanations that led to

the emergence of the disease in order to determine the level of its spread, about The path of

studying spatial relationships. Renal failure disease is one of the diseases that affect humans, it is

not defined by a specific age group, but rather affects different age groups, and this disease has

become a common disease prevalent in cities and rural areas, and this disease is divided into

grades in terms of severity and the stage to which it is reached. The researchers relied on data

that recorded disease cases with the Health Department of Najaf Governorate for the years (2014-

2018), on which statistical methods were applied for the purpose of knowing the variance and

correlation of the phenomenon. Therefore, the contribution to uncovering and defining the

problem, preventing its spread, eliminating it or limiting it, represents the main goal that academic

studies seek, which must provide service to society, because theoretical studies and research,

despite their importance, cannot amount to applied studies. Kidney failure disease is one of the

diseases that affect humans, and it is not defined by a specific age group, but rather affects

different age groups, and this disease has become a common disease spread in cities and rural

areas. This disease is divided into grades in terms of severity and the stage to which it is reached.

The Theoretical Framework of The Research

Research Problem: -

It is a question in the mind of the researcher trying to answer it through population data, as the

research problem centered on the following: -

1- How did the phenomenon differ spatially at the level of Najaf Governorate?

2- What is the temporal development of the phenomenon of kidney disability from a geographical

point of view?

3- What is the age distribution of the phenomenon of kidney deficiency in Najaf Governorate?

Hypothesis: -

1 - There is a large variation between administrative units in the size of kidney disability, and thus

the Najaf district center was the most affected by this disease.

2- The study phenomenon varied temporally and at the level of administrative units in Najaf

Governorate

3- There is a discrepancy in the age gradient, especially between the 15-19 age group.

Research Importance: -

1- To solve a problem that affects one aspect of the population’s life, which is the health aspect.

It also addresses the problem of increasing rates of infection with this disease, which is one of the

causes of death locally and at the country’s level. This is one of the important issues.

2- The society's need for such studies because it is one of the chronic diseases that the residents

of Ashraf governorate suffer from.

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location of the disease spread in the areas exposed to infection. One of the reasons that

© RIGEO ● Review of International Geographical Education 11(4), WINTER, 2021

3- This study contributes to providing hospitals, doctors, planners and those with interest with the

results of this study to benefit from in their programs and future plans.

4- A new scientific study is to be added to geographical studies so that everyone who is interested

can benefit from it in the future age to which it is reached.

Research Objective:

1- Explain and explain the variation and high incidence of kidney disability in Najaf governorate

for the period (2014-2018).

2- A study of the geographical distribution of patients with kidney failure in Najaf Governorate.

3- Reaching results and proposals that contribute to spreading awareness among the population

of the governorate regarding the causes and beginnings of disease development.

Reasons for choosing a topic:

1- The personal desire of researchers to provide a service to society and the importance of

medical geography, which has a role in determining the factors of spreading diseases and the

role of the environmental impact in that.

2- It is considered one of the diseases that must be focused on, as it affects the lives of the

population and their interaction with their environment directly.

3- The incidence of kidney failure is clearly increased among the residents of Najaf Governorate.

4- Submit proposals that contribute to reducing the incidence of kidney failure and reducing its

complications.

Research Methodology: -

Researchers have relied on statistical methods that help them access data, results and outputs

through which they can analyze the studied phenomena. Researchers have used the statistical

package for social sciences (SPSS) after classifying the data and entering it into the computer

using the Excel program. Percentages of all occurrences. The two non-parameter tests were used

to show the significant differences between the study variables.

1- The Mann-Whiteny test to reveal the significance of the differences between the averages of

months, administrative units, and years of study.

2- Kruskall-Wallis test to detect the significance of differences between the averages of months,

units and years of study.

Two levels of significant statistical significance were adopted, p≤ 0.01, to indicate the differences

at the 1% level, and one level to indicate the differences at the 5% level.

3- The Kruskal-Wallis test to reveal the significance of the differences between the averages of

ranks for the degrees of types of disability (visual, auditory, kinesthetic) with respect to the meaning

of life and cognitive distortions.

4- The Mann-Whitney test to reveal the significance of the dimensional differences between the

averages of the degrees of cognitive distortions measurement according to the type of disability

(visual, auditory, kinesthetic) (and Penny, 2012, p. 3).

Research Structure:

The need necessitated the division of the research into four basic aspects: The first dealt with the

theoretical framework of the research, while the second side dealt with the spatial distribution of

cases of kidney disability in the province of Najaf, while the third side focused on studying the

temporal variation of cases of kidney disability in the governorate of Najaf, and the research

ended with conclusions and recommendations.

The Boundaries of The Study Area

Spatial Boundaries:

Najaf province is one of the central Euphrates provinces, which is located on the western side of

Iraq and extends astronomically between two latitude circles (50, 29 -21, 32) north, and between

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longitudes (5042 -42, 44) east, and the area of the study area is (28824) km2), and constitutes (6.6%)

of the total area of Iraq, which is (435052 km2), and it is administratively composed of four districts

and six sub-districts. The study area is bordered on the north by Karbala governorate and on the

north-east by Babel Governorate, on the northwest by Al-Anbar Governorate, on the east by Al-

Diwaniyah Governorate, and on the southeast by Al-Muthanna Governorate, while it is bordered

from the southwest by the Kingdom of Saudi Arabia.

Map (1)

Geographical location of Najaf Governorate

Source: (Survey, 2010).

Temporal limits: -

The temporal limits of the study were represented for the period (2014-2018), after collecting

statistical data related to the numbers of cases of Renal Failure in the study area.

The scientific concept of kidney failure disease: -

Many definitions are given in kidney failure, including the following: -

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Known renal failure: It is the gradual loss of kidney function over a period of months or years (mehdi

& Et al, 2020, p. 36). Renal failure is also known: it is a deficiency in the kidneys, meaning the kidney

becomes unable to perform its functions to remove waste products from the blood and regulate

blood pressure, salts and water in the body, meaning that it becomes unable to purify the blood

and send urine to the bladder (Farhan). There are many reasons that lead to kidney failure,

including the following:

1- Chronic pyelonephritis ( Al-Sayegh, 1973, p. 42).

2- Blockage of the urinary tract, with stones in the bladder, ureter, or urethra.

3- Chronic diseases such as diabetes, high blood pressure and other genetic diseases that include

(polycystic kidneys and Port syndrome) (Al-Bahkali's, 2010, p. 33).

4- Excessive bleeding that results in a sudden drop in blood flow to the kidneys.

5- Excessive use of some medicines and analgesics, as using them in large doses or for a long time

leads to kidney failure

6- Medicines used to treat cancer in addition to kidney tumors.

7 - Exposure to some toxic substances such as mercury and lead, which cause kidney failure ( Al-

Dulaimi, 2009, p. 65).

Methods Of Prevention: -

There are some ways to prevent kidney failure, including: -

1- Performing urine and blood analysis for kidney function periodically.

2- Treatment for diabetics must be taken regularly and permanently to maintain the level of sugar

in the blood.

3- It is necessary to maintain the normal blood pressure rate in patients who suffer from high blood

pressure permanently, by reducing salt in food, adhering to medication, and periodically seeing

a specialist doctor.

4- Drinking water in appropriate quantities, as well as eating ginger, which is one of the important

herbs that help reduce kidney failure, as it works to rid the kidneys of toxins in them.

5- Stay away from taking the wrong medications without consulting a doctor.

Treating Kidney Failure:

Treatment for chronic kidney failure includes medications, nutritional loads, dialysis or kidney

transplantation: -

Dialysis Is of The Following Types:

1- Hemodialysis (enforcement)

2- Peritoneal dialysis.

3- Kidney transplant.

The Spatial Distribution of Patients with Kidney Failure (Kidney Deficiency) In Najaf

Governorate

The study of the geographical distribution of the population is one of the things that geographers

give great importance to, as it considers women in whom all geographical elements (natural and

human) appear together and interact with each other, and in more precise terms, it is the final

picture of the interaction between the elements of the natural environment and the human

elements, as it shows the disparity in the distribution of Population in administrative units according

to population movement (Al-Saadi, Variation in Population , 1993, p. 46). There is no doubt that

studying the distribution and density of population in the place is one of the basic matters that are

of great importance in geographical studies, especially the study of population geography,

because it reveals the method of population distribution in the natural place that gives them the

opportunity to invest and then settle in it (Al Saadi, 2002, p. 130). Population distribution is

characterized by being a dynamic process characterized by continuity that varies in terms of

causes and implications in time and space ( Abu Ayyana, 1993, p. 74). according to a set of

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natural characteristics and human variables that include economic, social and historical variables

that overlap and interact with each other to form a picture of the spatial distribution of the

population (Al-Saadi & source, Population Geography, 2002, p. 202). As for the study area, it is

clear from table (1), figure (1) and map (2) that the number of people with kidney failure disease

varies between administrative units, as the highest injuries were recorded in Najaf district, as the

number of injuries in it reached (2067) cases while the number increased. The injuries for the year

2018 reached (3053) cases, and the reason for this is due to the presence of only one kidney

center in Sadr Medical City, so the highest injuries are recorded in it. As for Al-Mishkhab district, it

came in second place, as the number of injuries reached (175) for the year 2015, while the rest of

the years were not recorded in it. Any case of injury.

Table (1)

Spatial Distribution of The Number of People with Kidney Disability, According to The Administrative

Units for The Years 2014-2018 In Najaf Governorate

Administrative

Unite 2014 2015 2016 2017 2018

Male Female Male Female Male Female Male Female Male Female

Najaf District 1124 943 3430 2595 2429 2260 1827 1038 1986 1067

Al-Haidarya

sub-district

0 0 0 0 0 1 0 0 0 0

Kufa District 0 0 0 0 0 0 0 0 0 0

Abbasiya sub-

district

1 0 0 0 0 0 0 0 0 0

Munadhirah

District

0 0 0 0 0 0 0 0 0 0

Al-Mishkhab

District 0 0 82 93 0 0 0 0 0 0

Governorate 1125 943 3512 2688 2429 2261 1827 1038 1986 1067

Source: - (Republic of Iraq, 2018).

Table (2)

Graphic Representation of People with College Disability, According to The Administrative Units

for The Years 2014-2018 In Najaf Governorate

Source: (Republic of Iraq, 2018).

Table (2) and the figure shows the number of patients with kidney disability according to the

administrative units for the years 2014-2018 in the province of Najaf, and it is clear that there is a

great variation in the rates of people with kidney disability according to the administrative units of

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Al-Mishkhab District

Najaf District

Al-Haidarya sub-district

Kufa district

Abbasiya sub-district

Munadhirah spend

4000 3500 3000 2500 2000 1500 1000 500 0

2018 2017 2016 2015

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales


Najaf governorate as well as according to the years of study, and Najaf district recorded the

highest rates of injury compared to the rest administrative units during the five years of study. All injuries were recorded in Najaf district over the course of four years of the five years of study

(2014, 2016, 2017, 2018) except for one injury in Al-Abbasiya district in 2014, and one injury in Al-

Haidariya district in 2016, but in 2015 it was most the injuries in Najaf district, which recorded 6025

(97.18%), and Al-Mishkhab district recorded the remaining 175 (2.82%).

Table (2)

Spatial Distribution of People with Kidney Disability, According to The Administrative Units for The

Years 2014-2018 In Najaf Governorate

Administrative Unite 2014 2015 2016 2017 2018 p-Value F (%) F (%) F (%) F (%) F (%)

Najaf District 2067(99.95) 6025(97.18) 4689(99.98) 2865(100) 3023(100) 0.002**

Al-Haidarya sub-district 0(0.0) 0(0.0) 1(0.02) 0(0.0) 0(0.0)

Kufa District 0(0.0) 0(0.0) 0(0.0) 0(0.0) 0(0.0)

Abbasiya sub-district 1(0.05) 0(0.0) 0(0.0) 0(0.0) 0(0.0)

Munadhirah District 0(0.0) 0(0.0) 0(0.0) 0(0.0) 0(0.0)

Al-Mishkhab District 0(0.0) 175(2.82) 0(0.0) 0(0.0) 0(0.0)

Total 2068 6200 4690 2865 3023 189987

p-Value <0.01**

** Significant differences at the 1% level, between administrative units and between years

Table (2)

Spatial Distribution of People with Kidney Disability, According to The Administrative Units for The

Years 2014-2018 In Najaf Governorat

Source: Table data (1).

Figure (2) The percentage of spatial distribution of people with a kidney disability by administrative

units for the years 2014-2018 in Najaf Governorate

1276

12000

10000

8000

2017

2018

2016

2015

2014

6000

4000

2000

0



The Temporal Distribution of Patients with Kidney Failure in Najaf Governorate

The temporal trend is a method studied by researchers in the human sciences in general, when

they study to follow the change in the phenomena that they study, and we have adopted it in

this study to follow up the reality of diseases during the study period (2014-2018) in the province of

Najaf, as this method reveals whether they are Movement is regular or irregular.

The temporal distribution of patients with kidney failure varies during the period of the study (2014-

2018), as well as between males and females, as Table (3) and Fig. (3) illustrate the temporal trend

of kidney disability disease and also shows through the table data that the movement of the

disease is characterized by irregularity. The highest rate for males was recorded in 2015 amounting

to (33.38%) of the total number, while for females, the highest rate was recorded for the same

year, it was (33.99%), and the lowest percentage for males was recorded in 2018, when it reached

(12.95%). While females have the lowest rate at (12.1%).

Table (3)

Number Of Patients with Kidney Deficiency for A Total of Months in Najaf Governorate

Year Male Female p-Value

Frequency % Frequency %

2014 19167 25.27 19666 23.14 <0.01**

2015 25316 33.38 28880 33.99

2016 11644 15.35 14192 16.70

2017 9892 13.04 12034 14.16

2018 9819 12.95 10202 12.01

Total 75838 100.00 84974 100.00

p-Value 0.297ns

** = significant differences at the 1% level between administrative units, based on the analysis of

Kruskal Walls

ns = non-significant differences at the level of 5% between males and females, based on Mann

and Tenny analysis

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2100

2080

2060

Famales %

Males %

the years

2040

2020

2000

1980

1960

5 4 3 2 1


Figure (3)

The Percentage of People with Total Disability for The Total Number of Months in Najaf

Governorate


Distribution Of Cases of Kidney Failure Patients According to Age Groups: -

The distribution of the population according to age groups is an important demographic factor

because it indicates the productive strength of the population, it also indicates the direction of

their growth and sheds light on the birth and death rates among them (Al-Saadi & source,

Population Geography, 2002, p. 738). It is noted from Table (4) and Fig. (4) that the number of

patients with kidney disability varies according to age groups and also by sex during the study

period. Through the data in the table, it was shown that the age group (15-19) has the highest

cases of injury in which it was recorded during the years of the study (2014). 2017), while the age

group (20-44) years recorded the highest rate of injury in 2018. The results of the table showed that

the age group had no injuries, only in 2015, only 7 cases were recorded for females.

Table (4)

Distribution Of Total Disability Cases According to Age Groups for The Period (2014-2018)

Intervals 2014 2015 2016 2017 2018

>year Male Female Male Female Male Female Male Female Male Female

1-4 0 0 0 7 0 0 0 0 0 0

5- 9 5 4 31 44 7 55 0 3 31 1

34_ 30 34 31 41 15 31 151 57 54 341 71

34_ 35 413 451 5375 3117 3441 714 431 415 543 331

44_ 50 501 500 75 44 0 71 154 535 774 454

14_ 45 175 501 711 551 514 170 457 534 570 511

<15 44 14 551 351 371 545 45 51 311 357

Source: The researcher's work based on: (Republic of Iraq, 2018).

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Figure (4)

People With Disability Kidney Disease by Age Groups for The Years (2018-2019) In Najaf

Governorate


Table (5) and Figure (5) show the distribution of rates of patients with kidney disability according

to age groups for the years 2014-2018 in Najaf Governorate. The incidence of total disability

showed a marked variation according to age groups and years of study, whether at the level of

the age group for years of study or age groups within any year of schooling, so the differences

were statistically significant at the level of 1% in terms of the analysis of Kruskal Walls. Despite this

variation, the age group (15-19 years) showed the highest incidence of kidney disability during

the study years (2014-2017), while the age group (20-44 years) recorded the highest incidence

rate in 2018. The results in Table (4) indicate that the age group (less than one year) had no injuries

except in 2015, as only 7 (0.12%) cases were recorded, and in general, the age groups up to 14

years did not constitute only very small percentages of injuries with renal impairment. As for the

rest of the groups, the age group (1-4) showed the highest rate recorded in 2015 with a

percentage of (1.0) cases, while the lowest rate was recorded in 2017 with a percentage of (0.04)

cases, while the age group (5-9) showed the highest percentage recorded in In 2015, a rate of

(4.50) cases was recorded, while the lowest rate was recorded in 2014 (0.674) cases, while the

age group (10-14) recorded (1,301) cases for the year 2014 and the rate began to gradually

increase until it reached (7.34) for the year 2016, after which the rate began With a decrease, it

reached (1.96) in 2017, then increased in 2018. As for Table (5) for statistical analysis and indicating

the significant differences, Table (6) indicated the distribution of the number of patients with

kidney deficiency according to age groups for the years 2014-2018 in Najaf Governorate. The

incidence of total disability showed a marked variation according to age groups and years of

study, whether at the level of the age group for years of study or age groups within any year of

schooling, so the differences were statistically significant at the level of 1% in terms of the Kruskal

Walls analysis. Despite this variation, the age group (15-19 years) showed the highest incidence of

kidney disability during the study years (2014-2017), while the age group (20-44 years) recorded

the highest incidence rate in 2018. The results in Table (5) indicate that the age group (less than

one year) had no injuries except in 2015, as only 7 (0.12%) cases were recorded, and in general,

the age groups up to 14 years did not constitute only very small percentages of injuries with renal

impairment, as in Figure (5).

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2500

less than one ywar 2000

1 _4 1500

5_9

10_14 1000

15-19

20-44 500

45-64 0

65 or more

2018 2017 2016 2015 2014

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

2500

2000

1500

2014

2015

2016

2017

2018

1000

500

0


Table (5)

Number Of Patients with Kidney Deficiency, According to Age Groups, For the Years 2014-2018 In

Najaf Governorate

Intervals 4002 4005 4002 4002 4002 p-Value

F (%) F (%) F (%) F (%) F (%)

>year 0(0.00) 7(0.12) 0(0.00) 0(0.00) 0(0.00) <0.01**

1 _4 9(0.434) 62(1.0) 59(1.27) 1(0.04) 26(0.84)

5 _9 14(0.674) 271(4.50) 217(4.69) 116(4.05) 110(3.55)

10 _14 27(1.301) 78(1.30) 341(7.34) 56(1.96) 219(7.08)

15 _19 859(41.38) 3809(63.29) 2287(49.19) 1375(48.03) 354(11.44)

20 _44 406(19.56) 119(1.98) 73(1.57) 571(19.94) 1238(40.00)

45 _64 583(28.08) 1261(20.95) 954(20.52) 676(23.61) 858(27.72)

> 15 178(8.574) 411(6.83) 718(15.44) 68(2.38) 290(9.37)

Total 2076(11.10) 6018(32.18) 4649(24.86) 2863(15.31) 3095(16.55) 18701

p-Value <0.01**

** = Significant differences at the 1% level between age groups and between years of study,

according to Kruskal Walls analysis

Figure (5)

The Percentage of Patients with Kidney Disability, According to Age Groups and Years, In Najaf

Governorate


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Conclusions

1- The variation in the incidence rate of kidney disability (kidney failure) was evident for the period

of the study (2014-2018), where (2067) cases were recorded in 2014 and then began to increase

until it reached (6,200) injuries in 2015, then the rate began to fluctuate. As it reached (3035) injuries

in 2018.

2- The incidence rate was characterized by a variation between the administrative units in Najaf

governorate, as the Najaf district center recorded the highest number of cases with (2,067) injuries,

while al-Mishkhab district ranked second (175) injuries.

3- Cases of infection varied between males and females in the study area, as males outnumbered

females in the study area, as the highest number of injuries was recorded for males (3430) for the

year 2015, while the highest number of injuries was (2595) for 2015.

4- Cases of infection included all age groups, but infection rates varied among themselves, as the

age group (15-19 years) ranked first during school years (2014-2017), while the age group (20-44

years) recorded the highest incidence rate in 2018.

Acknowledgment

The author acknowledges the financial support of the Kufa University, Iraq. The author is grateful

to Dr. Basim A. Almayahi, University of Kufa for assisting me throughout conducting the research.

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