Water usage habits and the incidence of diarrhea in rural Ankara, Turkey

Özkan, Seçil; Tüzün, Hakan; Görer, Nilgün; Ceyhan, Mustafa Nuri; Aycan, Sefer; Albayrak, Selda; Bumin, Mehmet Ali

doi:10.1016/j.trstmh.2007.05.011

Cited by 16 publications

(13 citation statements)

References 7 publications

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“…Nine studies investigated the effects of loss of hydraulic pipe integrity (Table 4) (Abu Amr and Yassin 2008; Abu Mourad 2004; Cifuentes et al 2002; Fewtrell et al 1997; Huang et al 2011; Hunter et al 2005; Nygård et al 2007; Özkan et al 2007; Yassin et al 2006). …”

Section: Resultsmentioning

confidence: 99%

“…The pooled analysis showed a significant increase in GII associated with water outages compared with normal operation without outages (random-effects pooled RR = 3.26; 95% CI: 1.48, 7.19) (Figure 4) with significant heterogeneity among studies ( p < 0.0005). Limiting the analysis to studies in developed countries (i.e., excluding Özkan et al 2007) somewhat reduced the pooled estimate (random-effects pooled RR = 2.34; 95% CI: 1.13, 4.86) but did not eliminate the heterogeneity ( p < 0.0005). Nygård et al (2007) reported increased GII when the outages lasted > 6 hr versus < 6 hr (OR = 1.90; 95% CI: 1.00, 3.40) in the group that had outages.…”

Section: Resultsmentioning

confidence: 99%

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Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis

Ercümen

Gruber

Colford

2014

Environ Health Perspect

104

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Background: Water distribution systems are vulnerable to performance deficiencies that can cause (re)contamination of treated water and plausibly lead to increased risk of gastrointestinal illness (GII) in consumers.Objectives: It is well established that large system disruptions in piped water networks can cause GII outbreaks. We hypothesized that routine network problems can also contribute to background levels of waterborne illness and conducted a systematic review and meta-analysis to assess the impact of distribution system deficiencies on endemic GII.Methods: We reviewed published studies that compared direct tap water consumption to consumption of tap water re-treated at the point of use (POU) and studies of specific system deficiencies such as breach of physical or hydraulic pipe integrity and lack of disinfectant residual.Results: In settings with network malfunction, consumers of tap water versus POU-treated water had increased GII [incidence density ratio (IDR) = 1.34; 95% CI: 1.00, 1.79]. The subset of nonblinded studies showed a significant association between GII and tap water versus POU-treated water consumption (IDR = 1.52; 95% CI: 1.05, 2.20), but there was no association based on studies that blinded participants to their POU water treatment status (IDR = 0.98; 95% CI: 0.90, 1.08). Among studies focusing on specific network deficiencies, GII was associated with temporary water outages (relative risk = 3.26; 95% CI: 1.48, 7.19) as well as chronic outages in intermittently operated distribution systems (odds ratio = 1.61; 95% CI: 1.26, 2.07).Conclusions: Tap water consumption is associated with GII in malfunctioning distribution networks. System deficiencies such as water outages also are associated with increased GII, suggesting a potential health risk for consumers served by piped water networks.Citation: Ercumen A, Gruber JS, Colford JM Jr. 2014. Water distribution system deficiencies and gastrointestinal illness: a systematic review and meta-analysis. Environ Health Perspect 122:651–660; http://dx.doi.org/10.1289/ehp.1306912

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis

Ercümen

Gruber

Colford

2014

Environ Health Perspect

104

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“…Diarrhea is a serious public health problem related to hygiene conditions and quality of water used 9 . It is the second most common cause of childhood deaths, representing around 1.5 million deaths/year in children under five years c .…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon

et al. 2016

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OBJECTIVE To analyze the contributions of the socioeconomic, hygienic, and sanitation improvements in reducing the prevalence of diarrhea in a city of the Amazon.METHODS In this population-based cross-sectional study, we analyzed data from surveys conducted in the city of Jordão, Acre. In 2005 and 2012, these surveys evaluated, respectively, 466 and 826 children under five years old. Questionnaires were applied on the socioeconomic conditions, construction of houses, food and hygienic habits, and environmental sanitation. We applied Pearson’s Chi-squared test and Poisson regression to verify the relationship between origin of water, construction of homes, age of introduction of cow’s milk in the diet, place of birth and the prevalence of diarrhea.RESULTS The prevalence of diarrhea was reduced from 45.1% to 35.4%. We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow’s milk in the first month after birth, and in those living in houses made of paxiúba. Children born at home presented lower risk of diarrhea when compared to those who were born in hospital, with this difference reversing for the 2012 survey.CONCLUSIONS Sanitation conditions improved with the increase of bathrooms with toilets, implementation of the Programa de Saúde da Família (PSF – Family Health Program), and water treatment in the city. The multivariate regression model identified a statistically significant association between use of water from the public network, construction of houses, late introduction of cow’s milk, and access to health service with occurrence of diarrhea.

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“…Therefore, decreasing the morbidity is the most fundamental and effective approach to minimize the impact of diarrhea. A variety of risk factors have been identified in previous studies, including food contaminate, distance between the septic tank and well water, drink contaminate, household behaviors, restaurant sanitation, and environmental hygiene [7-12]. Medical examination and treatment including gastrointestinal endoscopy and early use of a pacifier have been found to lead to diarrhea [13,14].…”

Section: Introductionmentioning

confidence: 99%

“…Medical examination and treatment including gastrointestinal endoscopy and early use of a pacifier have been found to lead to diarrhea [13,14]. In addition, total monthly household income is an influence factor for diarrhea [12]. The contribution of individual factors influencing the onset of diarrhea varies in different areas or regions due to cultural differences, eating habits and behaviors, economic status, among others.…”

Section: Introductionmentioning

confidence: 99%

Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing, China

Yang

et al. 2014

BMC Public Health

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BackgroundTo date, a large proportion of people still suffer from diarrhea diseases. In addition to the burden of diarrhea, there are substantial social and economic costs caused by the high incidence of diarrheal diseases. Therefore, the purpose of this study was to explore the self-reported prevalence of diarrhea and associated risk factors of diarrhea among adults in Beijing, China.MethodsA multistage, stratified study based on cross-sectional data was performed using randomized and systematic sampling, recruiting 12,936 adults over 18 years of age in Beijing. All adults were requested to complete a questionnaire, including information such as demographic characteristics, incidence of diarrhea, and behaviors related to the diarrhea.ResultsThe self-reported prevalence of diarrhea was 17.5% during the last year prior to the survey. Six behavioral factors were significantly associated with diarrhea in our study including: (1) washing hands before meals and after defecation (Adjusted Odds Ratio (AOR) 0.707, 95% CI 0.597 ~ 0.837), (2) washing hands with soap and running water (AOR 0.872, 95% CI 0.786 ~ 0.967), (3) consuming raw seafood (AOR 1.285, 95% CI 1.138 ~ 1.450), (4) using the same chopping block and knife when processing raw and cooked food (AOR 1.375, 95% CI 1.225 ~ 1.542), (5) using the same chopsticks to handle raw and cooked food (AOR1.149, 95% CI 1.041 ~ 1.268), and (6) regularly participating in physical exercise (AOR 0.719, 95% CI 0.651 ~ 0.793).ConclusionGood health habits, good eating habits, and regular exercise can prevent the episodes of diarrhea, and thus decrease the potential for disease occurrence.

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Water usage habits and the incidence of diarrhea in rural Ankara, Turkey

Cited by 16 publications

References 7 publications

Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis

Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis

Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon

Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing, China

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