The Imo State (Nigeria) Drinking Water Supply and Sanitation Project, 2. Impact on dracunculiasis, diarrhoea and nutritional status

Abstract

Morbidity due to dracunculiasis (guinea worm disease) and diarrhoea in persons of all ages, and nutritional status of young children, were used as health impact indicators in the evaluation of the Imo State Drinking Water Supply and Sanitation Project in south-eastern Nigeria. Data were collected using repeated cross-sectional surveys and longitudinal follow-up. The study area was found to have a low level of endemicity of dracunculiasis. While no impact could be demonstrated on overall period or point prevalence rates in the cross-sectional surveys, a prospective longitudinal survey showed a significant reduction in the percentage of person-fortnights positive for dracunculiasis in areas served by the project, while the control areas showed no such change. In the cross-sectional surveys it was found that, in the project villages, those persons drinking only borehole water had significantly lower period prevalence rates one year later than others. Moreover, those living further from the nearest borehole had higher rates of dracunculiasis. An impact of the project on diarrhoea morbidity was found only in limited sub-groups of the population. A greater association with water availability rather than quality was suggested for rates in young children. The prevalence of wasting (less than 80% weight-for-height) among children aged less than 3 years decreased significantly over time in all 3 intervention villages; there was no such decline in the control villages.

Guinea worm disease in Ayod, Upper Nile Province, southern Sudan: a cross‐sectional study

“…There was greater prevalence among adults than children, suggesting that Guinea worm disease was associated with the use of water from sources outside the villages. Our study demonstrates the clear association between source of water for drinking and Guinea worm disease found in other studies (Huttly et al 1990;Tayeh et al 1993). There are two wells in Ayod which are both in the centre of town, giving people in two sections easy access to clean drinking water.…”

Environmental sanitation, food and water contamination and diarrhoea in rural Bangladesh

“…Food and drinking water appeared to be less important [19]. There is growing support for the theory that water quantity is more important than quality in reducing diarrhoea transmission [20][21][22] and the results from the final analysis of this project also support this concept [9].…”

Water and sanitation associated with improved child growth

“…Stunting in children is associated with increased risk of morbidity (el Samani et al, 1988;Kossmann et al, 2000), mortality (Bhutta et al, 1997;Fawzi et al, 1997a;Yoon et al, 1997) and cognitive impairment (Berkman et al, 2002). Poor water and sanitation has been associated with increased risk of infections in children (Daniels et al, 1990;Huttly et al, 1990;Mertens et al, 1990) and increased malnutrition (Adair & Guilkey, 1997); improved water and sanitation was related to lower risk of malnutrition (Huttly et al, 1990;Daniels et al, 1991;Ricci & Becker, 1996). In sub-Saharan Africa, the burden of disease attributable to malnutrition is 32.7% and to poor water and sanitation 10.1% (Murray & Lopez, 1997); improved access to safe water and sanitation facilities may therefore have enormous potential to reduce the burden of disease in this region.…”