ENVIRONMENTAL INTERVENTIONS IN DEVELOPING-COUNTRIES - INTERACTIONS AND THEIR IMPLICATIONS
ENVIRONMENTAL INTERVENTIONS IN DEVELOPING-COUNTRIES - INTERACTIONS AND THEIR IMPLICATIONS
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DOI：
10.1093/oxfordjournals.aje.a117401
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发表时间：
1995-01-15
影响因子：
5
通讯作者：
BRISCOE, J
中科院分区：
文献类型：
--
作者：
VANDERSLICE, J;BRISCOE, J
这项研究使用2355名出生一年的菲律宾婴儿的随机样本，评估了饮用水质量对卫生条件好和差的情况下腹泻疾病的影响。这项研究有力地证实了环境因素对腹泻的重要性：水质、家庭卫生和社区卫生的影响是强烈的、一致的，并且具有统计学意义。改善水质对生活在良好卫生条件下的家庭的积极影响最大，当在社区一级衡量卫生设施时，这种影响在统计上是显著的，但当在家庭一级衡量卫生设施时，这种影响并不显著。改善饮用水质量对环境卫生非常差的社区没有任何影响；然而，在社区卫生状况较好的地区，将粪大肠菌群浓度降低两个数量级将导致腹泻减少40%。提供私人排泄物处理预计将减少42%的腹泻，而消除家里周围的排泄物将导致腹泻减少30%。研究结果表明，如果要改善发展中国家的婴儿健康，就必须改善供水和卫生设施。他们还暗示，应该正确决定干预优先顺序的不是流行病学因素，而是行为、制度和经济因素。
This study assesses the effect of drinking water quality on diarrheal disease in good and poor sanitary conditions using a random sample of 2,355 Filipino infants over the first year of life. The study provides powerful confirmation of the importance of environmental factors on diarrhea: The effects of water quality, household sanitation, and community sanitation are strong, consistent, and statistically significant. The positive impact of improved water quality is greatest for families living under good sanitary conditions, with the effect statistically significant when sanitation is measured at the community level but not significant when sanitation is measured at the household level. Improving drinking water quality would have no effect in neighborhoods with very poor environmental sanitation; however, in areas with better community sanitation, reducing the concentration of fecal coliforms by two orders of magnitude would lead to a 40 percent reduction in diarrhea. Providing private excreta disposal would be expected to reduce diarrhea by 42 percent, while eliminating excreta around the house would lead to a 30 percent reduction in diarrhea. The findings suggest that improvements in both water supply and sanitation are necessary if infant health in developing countries is to be improved. They also imply that it is not epidemiologic but behavioral, institutional, and economic factors that should correctly determine the priority of interventions.