Factors associated with diarrheal disease in the rural Caribbean region of Colombia
DOI:
https://doi.org/10.11606/s1518-8787.2020054002054Keywords:
Diarrhea, Infantile, epidemiology, Diarrhea, epidemiology, Risk Factors, Socioeconomic Factors, Rural Sanitation, Rural HealthAbstract
OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07–0.85), children under five years old (PR = 4.05; 95%CI 1.70–9.68), water from deep wells (PR = 16.90; 95%CI 2.45–116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27–103.29), toilets availability (PRA = 0.23; 95%CI 0.06–0.96), and swine presence (PR = 0.20; 95%CI 0.05–0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.
References
Ruiz-Díaz MS, Mora-García GJ, Salguedo-Madrid GI, Alario Á, Gómez-Camargo DE. Analysis of health indicators in two rural communities on the Colombian Caribbean coast: poor water supply and education level are associated with water-related diseases. Am J Trop Med Hyg. 2017;97(5):1378-92. https://doi.org/10.4269/ajtmh.16-0305
Daniels DL, Cousens SN, Makoae LN, Feachem RG. A case-control study of the impact of improved sanitation on diarrhoea morbidity in Lesotho. Bull World Health Organ. 1990;68(4):455-63.
Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM Jr. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis. 2005;5(1):42-52. https://doi.org/10.1016/S1473-3099(04)01253-8
Esrey SA, Potash JB, Roberts L, Shiff C. Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. Bull World Health Organ. 1991;69(5):609-21.
Luby SP, Halder AK, Huda T, Unicomb L, Johnston RB. The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: an observational study. PLoS Med. 2011;8(6):e1001052. https://doi.org/10.1371/journal.pmed.1001052
Zambrano LD, Levy K, Menezes NP, Freeman MC. Human diarrhea infections associated with domestic animal husbandry: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg. 2014;108(6):313-25. https://doi.org/10.1093/trstmh/tru056
Organización Mundial de la Salud. Enfermedades diarreicas. Ginebra: OMS; 2017 [cited 2019 Aug 20]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/diarrhoeal-disease
UNICEF Press Centre. 2.4 billion people will lack improved sanitation in 2015: joint press release. New York: UNICEF; 2013 [cited 2019 Aug 20]. Available from: https://www.unicef.org/media/media_69091.html
Departamento Administrativo Nacional de Estatística (COL). Tercer Censo Nacional Agropecuario – 2014: microdatos. Bogotá (COL): DANE; 2017 [cited 2019 Aug 20]. Available from: http://microdatos.dane.gov.co/index.php/catalog/513/get_microdata
Programa de las Naciones Unidas para el Desarrollo. Objetivos e Desarrollo del Milenio: informe de 2015. Nova York: PNUD; 2015 [cited 2019 Aug 20]. Available from: https://www.undp.org/content/undp/es/home/librarypage/mdg/the-millennium-developmentgoals-report-2015/
Celis Zapata LP. Análisis de la política pública de agua potable y saneamiento básico para el sector rural en Colombia - período de gobierno 2010 - 2014. Bogotá (COL): Pontificia Universidad Javeriana; 2013 [cited 2019 Aug 20]. Available from: http://hdl.handle.net/10554/15314
Tzeng GH, Huang JJ. Multiple attribute decision making: methods and applications. Boca Raton, FL: CRC Press; 2011.
Diakoulaki D, Mavrotas G, Papayannakis L. Determining objective weights in multiple criteria problems: the critic method. Comput Oper Res. 1995;22(7):763-70. https://doi.org/10.1016/0305-0548(94)00059-H
Aznar Bellver J, Guijarro Martínez F. Nuevos métodos de valoración: modelos multicriterio. 2. ed. Valencia: Universitat Politècnica; 2012 [cited 2019 Aug 20]. Available from: https://riunet.upv.es/bitstream/handle/10251/19181/nuevos MÉtodos de dvaloraciÓN-20modelos multicriterio.pdf?sequence=1
Departamento Administrativo Nacional de Estatística (COL). 3er Censo Nacional Agropecuario. Formulario de unidades productoras agropecuarias y predios con actividad na agropecuária. Bogotá (COL): DANE; 2014 [cited 2019 Aug 20]. Available from: http://www.fao.org/3/I9833ES/i9833es.pdf
Wedgworth J. Survey of drinking water quality and health in Alabama’s Black Belt [thesis]. Tuscaloosa, AL: University of Alabama; 2014 [cited 2019 Aug 20]. Available from: https://ir.ua.edu/handle/123456789/2209
Imhoff B, Morse D, Shiferaw B, Hawkins M, Vugia D, Lance-Parker S, et al. Burden of self-reported acute diarrheal illness in FoodNet Surveillance Areas, 1998-1999. Clin Infect Dis. 2004;38 Suppl 3:S219-26. https://doi.org/10.1086/381590
Instituto Nacional de Salud (COL). Manual de instrucciones para la toma, preservción y transporte de muestras de agua de consumo humano para análisis de laboratorio. Bogotá, DC: INS; 2011 [cited 2019 Aug 20]. Available from: https://www.ins.gov.co/sivicap/Documentacin SIVICAP/2011 Manual toma de muestras agua.pdf
Ministerio de la Protección Social (COL); Ministerio de Ambiente, Vivienda y Desarrollo Territorial. Resolución Nº 2115 de 22 de junio de 2007. Se señalan características, instrumentos básicos y frecuencias del sistema de control y vigilancia para la calidad del agua para consumo humano. Bogotá, DC; 2007 [cited 2019 Aug 20]. Available from: http://www.minambiente.gov.co/images/GestionIntegraldelRecursoHidrico/pdf/normativa/Res_2115_de_2007.pdf
Textor J, Zander B, Gilthorpe MS, Liśkiewicz M, Ellison GT. Robust causal inference using directed acyclic graphs: the R package ‘dagitty’. Int J Epidemiol. 2017;45(6):1887-94. https://doi.org/10.1093/ije/dyw341
Razzolini MTP, Günther WMR. Impactos na saúde das deficiências de acesso a água. Saude Soc. 2008;17(1):21-32. https://doi.org/10.1590/S0104-12902008000100003
Bitew BD, Woldu W, Gizaw Z. Childhood diarrheal morbidity and sanitation predictors in a nomadic community. Ital J Pediatr. 2017;43(1):91. https://doi.org/10.1186/s13052-017-0412-6
Rajgire AV. Open defecation: a prominent source of pollution in drinking water in villages. Int J Life Sci Biotechnol Pharma Res. 2013;2(1):238-46.
Alqahtani JM, Asaad AM, Ahmed EM, Qureshi MA. Drinking water quality and public health in Southwestern Saudi Arabia: the need for a national monitoring program. J Family Community Med. 2015;22(1):19-24. https://doi.org/10.4103/2230-8229.149581
Trevett AF, Carter RC, Tyrrel SF. Mechanisms leading to post - supply water quality deterioration in rural Honduran communities. Int J Hyg Environ Health. 2005;208(3):153-61. https://doi.org/10.1016/j.ijheh.2005.01.024
Fuller JÁ, Clasen T, Heijnen M, Eisenberg JNS. Shared sanitation and the prevalence of diarrhea in young children: evidence from 51 countries, 2001-2011. Am J Trop Med Hyg. 2014;91(1):173-80. https://doi.org/10.4269/ajtmh.13-0503
Wilopo SA, Soenarto Y, Bresee JS, Tholib A, Aminah S, Cahyono A, et al. Rotavirus surveillance to determine disease burden and epidemiology in Java, Indonesia, August 2001 through April 2004. Vaccine. 2009;27 Suppl 5:F61-6. https://doi.org/10.1016/j.vaccine.2009.09.004
Vargas M, Gascón J, Casals C, Schellenberg D, Urassa H, Kahigwa E, et al. Etiology of diarrhea in children less than five years of age in Ifakara, Tanzania. Am J Trop Med Hyg. 2004;70(5):536-9. https://doi.org/10.4269/ajtmh.2004.70.536
Duarte JL, Diaz-Quijano FA, Batista AC, Duarte AF, Melchior LAK, Giatti LL. Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira. Cienc Saude Coletiva. 2019;24(8):2959-70. https://doi.org/10.1590/1413-81232018248.21232017
Arnold BF, Galiani S, Ram PK, Hubbard AE, Briceño B, Gertler PJ, et al. Optimal recall period for caregiver-reported illness in risk factor and intervention studies: a multicountry study. Am J Epidemiol. 2013;177(4):361-70. https://doi.org/10.1093/aje/kws281
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Revista de Saúde Pública
This work is licensed under a Creative Commons Attribution 4.0 International License.
