Comparison of the burden of diarrhoeal illness among individuals with and without household cisterns in northeast Brazil

Abstract

BackgroundLack of access to safe and secure water is an international issue recognized by the United Nations. To address this problem, the One Million Cisterns Project was initiated in 2001 in Brazil’s semi-arid region to provide a sustainable source of water to households. The objectives of this study were to determine the 30-day period prevalence of diarrhoea in individuals with and without cisterns and determine symptomology, duration of illness and type of health care sought among those with diarrhoea. A subgroup analysis was also conducted among children less than five years old.MethodsA face-to-face survey was conducted between August 20th and September 20th, 2007 in the Agreste Central Region of Pernambuco State, Brazil. Households with and without a cistern that had at least one child under the age of five years were selected using systematic convenient sampling. Differences in health outcomes between groups were assessed using Pearson’s Chi-squared and two-way t-tests. Demographic variables were tested for univariable associations with diarrhoea using logistic regression with random effects. P-values of 0.05 or less were considered statistically significant.ResultsA total of 3679 people from 774 households were included in the analysis (1863 people from 377 households with cisterns and 1816 people from 397 households without cisterns). People from households with a cistern had a significantly lower 30-day period prevalence of diarrhoea (prevalence = 11.0%; 95% CI 9.5-12.4) than people from households without a cistern (prevalence = 18.2%; 95% CI 16.4-20.0). This significant difference was also found in a subgroup analysis of children under five years old; those children with a cistern had a 30-day period prevalence of 15.6% (95% CI 12.3-18.9) versus 26.7% (95% CI 22.8-30.6) in children without a cistern. There were no significant differences between those people with and without cisterns in terms of the types of symptoms, duration of illness and health care sought for diarrhoea.ConclusionsOur results indicate that the use of cisterns for drinking water is associated with a decreased occurrence of diarrhoea in this study population. Further research accounting for additional risk factors and preventative factors should be conducted.

A review on physicochemical and microbiological contamination of roof-harvested rainwater in urban areas

“…An example of this can be found in studies related to rural Thailand where the bacterial contamination of shallow well water was higher than that of harvested rainwater (Wirojanagud et al, 1989;Pinfold et al, 1993). This is also the case of the Semi Arid region of Brazil, where the use of rainwater cisterns for drinking purposes has been associated with a decreased occurrence of diarrhea (Marcynuk et al, 2013) and Giardia duodenalis (Fonseca et al, 2014) among rural sparse communities. However, even though in general terms it has been reported that the gastrointestinal diseases in these communities tend to decrease with the use of rainwater, in those cases where rainwater storage lacked from hygiene both coliforms and parasites were detected (Xavier et al, 2011).…”

A global review of the microbiological quality and potential health risks associated with roof-harvested rainwater tanks

“…In a study of diarrheal illness among individuals with and without RHRW tanks in northeast Brazil, Marcynuk and colleagues 84 assessed the 30-day period prevalence of diarrhea for 3,679 people from 774 households following the institution of the 2011"One Million Cisterns" project that has provided 351,000 RHRW cisterns to families throughout the semi-arid region of northeast Brazil as of 2011. 84 People residing in households with cisterns had a significantly lower 30-day period prevalence (11%) of diarrhea than people from households without a cistern (18%) with the trend remaining in a subgroup analysis of children under five. Children under five had a prevalence of 15.6% compared to 26.7% in children without a cistern.…”

Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water

“…From these results, 32 full texts were included, in addition to 56 identified through the snowballing method. The total number of studies included in this review are 88 [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ...…”