Piped water supply interruptions and acute diarrhea among under-five children in Addis Ababa slums, Ethiopia: A matched case-control study.
Piped water supply interruptions and acute diarrhea among under-five children in Addis Ababa slums, Ethiopia: A matched case-control study.
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DOI：
10.1371/journal.pone.0181516
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Mulat W
中科院分区：
文献类型：
--
作者：
Adane M;Mengistie B;Medhin G;Kloos H;Mulat W
中低收入国家存在的管道供水断断续续的问题在撒哈拉以南非洲的贫民窟尤为严重。然而，人们对家庭一级间歇性自来水供应的微生物质量是否恶化以及这是否是减少或增加阿迪斯贫民窟五岁以下儿童急性腹泻发生率的一个因素知之甚少。本研究旨在确定间歇性自来水供应和家庭储存水的使用点（POU）污染大肠杆菌（E。阿迪斯贫民窟五岁以下儿童急性腹泻。于2014年11月至12月进行了一项以社区为基础的配对病例对照研究。病例被定义为在调查前两周内患有急性腹泻的五岁以下儿童。对照组按年龄和邻居与个体匹配的病例相匹配。数据收集使用预测试的结构式问卷和E。自来水和家庭储存水的大肠杆菌分析。采用最大可能数（MPN）/100 ml标准程序的五管法测定E. coli分析。通过控制所选社会人口学特征的潜在混杂效应，采用95%置信区间（CI）的多变量条件Logistic回归进行数据分析。在调查前两周内，87.9%的病例家庭和51.0%的对照家庭分别有平均4.3天和3.9天的间歇性自来水供应。POU污染家庭储存水的E。大肠杆菌阳性率为83.3%，对照组为52.1%。在完全校正模型中，定期间歇性自来水供应（校正匹配比值比（校正莫尔）= 4.8; 95%CI：1.3-17.8），POU水污染的家庭储存水由E。杆菌（调整后的莫尔比= 3.3; 95% CI：1.1-10.1），使用无菌容器从储水容器中回收水（调整后的莫尔比= 16.3; 95% CI：4.4-60.1），通过交替使用带手柄和不带手柄的血管回收水（校正的莫尔比= 5.4; 95% CI：1.1-29.1）与急性腹泻独立相关。我们的结论是，提供持续可用的自来水供应和教育的照顾者正确的水检索方法的家庭储存的水可以有效地减少POU污染的水在家庭层面，从而减少急性腹泻的5岁以下儿童在阿迪斯的贫民窟。在该市水务局能够持续提供管道供水之前，还大力鼓励促进家庭水处理。
The problem of intermittent piped water supplies that exists in low- and middle-income countries is particularly severe in the slums of sub-Saharan Africa. However, little is known about whether there is deterioration of the microbiological quality of the intermittent piped water supply at a household level and whether it is a factor in reducing or increasing the occurrence of acute diarrhea among under-five children in slums of Addis Ababa. This study aimed to determine the association of intermittent piped water supplies and point-of-use (POU) contamination of household stored water by Escherichia coli (E. coli) with acute diarrhea among under-five children in slums of Addis Ababa. A community-based matched case-control study was conducted from November to December, 2014. Cases were defined as under-five children with acute diarrhea during the two weeks before the survey. Controls were matched by age and neighborhood with cases by individual matching. Data were collected using a pre-tested structured questionnaire and E. coli analysis of water from piped water supplies and household stored water. A five-tube method of Most Probable Number (MPN)/100 ml standard procedure was used for E. coli analysis. Multivariable conditional logistic regression with 95% confidence interval (CI) was used for data analysis by controlling potential confounding effects of selected socio-demographic characteristics. During the two weeks before the survey, 87.9% of case households and 51.0% of control households had an intermittent piped water supply for an average of 4.3 days and 3.9 days, respectively. POU contamination of household stored water by E. coli was found in 83.3% of the case households, and 52.1% of the control households. In a fully adjusted model, a periodically intermittent piped water supply (adjusted matched odds ratio (adjusted mOR) = 4.8; 95% CI: 1.3–17.8), POU water contamination in household stored water by E. coli (adjusted mOR = 3.3; 95% CI: 1.1–10.1), water retrieved from water storage containers using handle-less vessels (adjusted mOR = 16.3; 95% CI: 4.4–60.1), and water retrieved by interchangeably using vessels both with and without handle (adjusted mOR = 5.4; 95% CI: 1.1–29.1) were independently associated with acute diarrhea. We conclude that provision of continuously available piped water supplies and education of caregivers about proper water retrieval methods of household stored water can effectively reduce POU contamination of water at the household level and thereby reduce acute diarrhea among under-five children in slums of Addis Ababa. Promotion of household water treatment is also highly encouraged until the City’s water authority is able to deliver continuously available piped water supplies.
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影响因子：
3.7
作者：
Ercumen, Ayse;Naser, Abu Mohd.;Luby, Stephen P.
通讯作者：
Luby, Stephen P.
影响因子：
12.8
作者：
Erickson, John J.;Smith, Charlotte D.;Nelson, Kara L.
通讯作者：
Nelson, Kara L.
影响因子：
15.8
作者：
Bain R;Cronk R;Wright J;Yang H;Slaymaker T;Bartram J
通讯作者：
Bartram J
影响因子：
2.3
作者：
Copeland, Curtis C.;Beers, Benjamin B.;Guerrant, Richard L.
通讯作者：
Guerrant, Richard L.
DOI：
10.2471/blt.11.094284
发表时间：
2012-03-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Bain, Rob ES;Gundry, Stephen W;Bartram, Jamie K
通讯作者：
Bartram, Jamie K