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DIARRHEA INCIDENCE AND TUBEWELL DENSITY IN RURAL BANGLADESH

Friday, 17th of June 2011

 

‘Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh.’

 

Abstract below; provisional .pdf file with full text is accessible from

http://www.ij-healthgeographics.com/content/10/1/41/abstract

 

Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis

Margaret Carrel, Veronica Escamilla, Jane Messina, Sophia Giebultowicz, Jennifer Winston, Mohammad Yunus, P. KIM Streatfield and Michael Emch

International Journal of Health Geographics 2011, 10:41 doi:10.1186/1476-072X-10-41

Published: 15 June 2011

Abstract (provisional)

Background

This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence.

Results

In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate.

Conclusions

Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world.