Children's Health Deficits due to Diarrhoea: Effects of Water Supply and Sanitation Systems in Slums with Different Water Logging Conditions

Abstract

This population-based epidemiologic study investigated the associations of individuals' sociodemographic statuses, sanitary systems and habits, water supply and drainage conditions with diarrhoea incidences among 707 children younger than 5 years who were living in slum communities with various water logging patterns in Dhaka, Bangladesh. We conducted a homevisiting survey during the pre-monsoon period from December 2006 to April 2007. Nine slum communities were selected that had been experiencing five different water logging conditions. One non-water logging community was selected as a control. The Disability Adjusted Life Years (DALYs) were calculated using data on diarrhoea morbidity and mortality. Although DALYs lost because of diarrhoea were very small in a non-inundation type community, but were the highest in persistent drainage inundation type communities. Among the factors correlated with DALYs, control variables for mother's illiteracy and household income strongly attenuated most of these correlations to statistical null, except for mother's age (less than 15 years-old), using hanging latrine and not washing hands before eating, and after defecation. In conclusion, water logging conditions and socio-economic statuses may strongly contribute to diarrhoea incidence in the city's slum communities. In such communities, interventions to address both water logging and socio-economic conditions may be critical for reducing diarrhoea incidences.

Assessing the relationship between inundation and diarrhoeal cases by flood simulations in low-income communities of Dhaka City, Bangladesh

“…First, we found that there were predisposing causes for contracting diarrhoea in the non-flooded areas because the morbidity was present in the pre-and post-monsoon season, even though flooding did not occur at that time. As Mollah et al (2009) mentioned in their paper, this risk might be due to food, drinking water or hand-washing customs, which were not related to the flooding. Second, we found that flooding has an influence on diarrhoeal incidence because morbidity increased in the mid-monsoon season when flooding occurred, and this increase was observed in almost all com- munities (9 out of 10).…”

“…Data related to epidemiology were obtained through home visit surveys by Mollah et al (2009). They conducted a biweekly survey in April (pre-monsoon), September (mid-monsoon) 2007 and January (post-monsoon) 2008 via questionnaires and interviews of mothers of children under five years of age.…”

“…10). Flooding data were also obtained by Mollah et al (2009) from interviews with authorities and the residents concerned, as well as through onsite measurements. In this study, each 'low-income community' was located within 1 km of the Urban Development Centre Project offices of the Slum Development Department of Dhaka City Corporation, and the number of children in the study totaled 707 from 350 households.…”

“…Furthermore, Mollah et al (2009) also discussed the relationship between socioeconomic status and more severe flooding conditions. People in lower socioeconomic positions tend to live in worse flooding conditions, and this is a Figure 1.…”

“…However, only a few studies have focused on low-income-community areas. Mollah et al (2009) targeted only people living in low-income communities, and their results indicated that diarrhoeal incidence is more severe in flood-prone areas than in other areas. However, the study was unable to evaluate the risk based on quantitative flood data.…”