Water-related factors and childhood diarrhoea in African informal settlements. A cross-sectional study in Ouagadougou (Burkina Faso)

Abstract

Improved access to water is a key factor in reducing diarrhoeal diseases, a leading cause of death among children in sub-Saharan Africa. In terms of water access, sub-Saharan African cities are some of the worst off in the world, with 20% of populations supplied by an unimproved water source. This situation is even worse in informal settlement areas. Using cross-sectional data on access to water from a survey implemented in three informal neighbourhoods of the Ouagadougou Health and Demographic Surveillance System, logistic regressions are modelled to test the effect of different modalities of access to water on childhood diarrhoea. Our results show that the prevalence of diarrhoea in children is high: one-third of households with a child under 10 experienced an episode of childhood diarrhoea during the 2 weeks preceding the survey, even though 91% of the households surveyed have access to an improved water source. The results show that efforts to reduce childhood morbidity would be greatly enhanced by strengthening piped water access in informal settlement areas in Africa. In addition, this study confirms that, beyond the single measure of the main access to water, accurate variables that assess the accessibility to water are needed.

On-plot drinking water supplies and health: A systematic review

“…All other included studies used binary water variables in the analysis to compare households with on-plot and off-plot water supplies; some specified the water source types. Five studies investigated household use of multiple water sources; one reported exclusive use of the on-plot water source (Devoto et al, 2011), one reported rainwater as an alternative source (Dos Santos et al, 2015), and three reported use of multiple on-and off-plot sources (Brown et al, 2013;Henry, 1981;Wang et al, 1989).…”

“…[ Figure 4] Among the ten rigorous studies on self-reported diarrhea, five studies found a significant association between on-plot water supplies and lower risk of diarrhea (Brown et al, 2013;Bukenya et al, 1991;Dos Santos et al, 2015;Molbak et al, 1997;van der Hoek et al, 2001). Households in Vietnam with on-plot water supplies had significantly lower longitudinal diarrhea prevalence than households with access to improved sources off plot (longitudinal prevalence ratio (LPR)=0.59, 95% CI: 0.39-0.91 (p=0.018)) (Brown et al, 2013).…”

“…Children from households lacking on-plot water supply in Papua New Guinea had significantly higher diarrhea incidence compared to children from households with on-plot supply (incidence density ratio (IDR)=1.56, 95% CI: 1.25-1.87, p<0.01) (Bukenya et al, 1991). Households with on-plot water access in Burkina Faso had lower odds of child diarrhea than households collecting water from sources between 5-30 minutes away (OR=0.57, p<0.10), but significantly lower odds of diarrhea than households with over 30-minute collection time (OR=1.29, p<0.01) (Dos Santos et al, 2015).…”

“…Prevalence of trachoma increased with distance to water source in Mali, although it was unclear if distance to source was measured or reported by study participants (Schemann et al, 2002). Odds of diarrhea were significantly lower among households with on-plot access compared to households with walk times between 5-30 minutes to source (p<0.10) and over 30 minutes (p<0.01), but odds of diarrhea were not significantly different among households with walk times under 5 minutes and between 5-30 minutes (Dos Santos et al, 2015). Households using public taps in Morocco had average distance of 112 m to their water source at baseline and spent 7.2 hours per week collecting water, but collection time and distance were not analyzed as risk factors for diarrhea (Devoto et al, 2011).…”

“…Prevalence of trachoma decreased progressively with increasing quantities of water used for face washing; statistical significance was not reported (Schemann et al, 2002). Households using between 20-50 L of water per capita per day experienced lower odds of diarrhea than households using under 10 L per capita per day in Burkina Faso (OR=0.70, p<0.01) (Dos Santos et al, 2015).…”