Micro-Space Complexity and Context in the Space-Time Variation in Enteric Disease Risk for Three Informal Settlements of Port au Prince, Haiti
Micro-Space Complexity and Context in the Space-Time Variation in Enteric Disease Risk for Three Informal Settlements of Port au Prince, Haiti
复制标题
DOI：
10.3390/ijerph16050807
复制
发表时间：
2019-03-01
影响因子：
--
通讯作者：
Morris, John Glenn, Jr.
中科院分区：
文献类型：
--
作者：
Curtis, Andrew;Squires, Robert;Morris, John Glenn, Jr.
霍乱和其他腹泻疾病在非正式住区的传播是多种行为、环境和空间风险因素的产物。其中最重要的组成部分是供水点、排水沟、厕所和中间环境之间的空间联系。这种风险也是纵向的和可变的，因为水点随细菌污染而波动。在本文中，我们考虑了海地太子港三个非正式定居点的微空间复杂性。通过考虑单点位置波动的重要性以及记录每个采样点周围的微空间环境条件，我们扩展了对取水点、排水沟和海洋站点的粪便大肠菌群的更典型的流行病学分析。结果表明，肠道疾病风险的空间变化发生在社区内，虽然某些趋势是明显的，但个体站点波动的程度应该质疑横断面分析和更综合的分析的效用。各种因素会增加粪便大肠菌群的数量，包括取水点的类型、取水点的储水方式以及取水点与当地排水系统的接近程度。有些地点每月在安全和不安全之间波动很大。在这些环境中形成对肠道疾病风险更全面的背景理解的下一步应包括行为因素和当地见解的补充。
Diffusion of cholera and other diarrheal diseases in an informal settlement is a product of multiple behavioral, environmental and spatial risk factors. One of the most important components is the spatial interconnections among water points, drainage ditches, toilets and the intervening environment. This risk is also longitudinal and variable as water points fluctuate in relation to bacterial contamination. In this paper we consider part of this micro space complexity for three informal settlements in Port au Prince, Haiti. We expand on more typical epidemiological analysis of fecal coliforms at water points, drainage ditches and ocean sites by considering the importance of single point location fluctuation coupled with recording micro-space environmental conditions around each sample site. Results show that spatial variation in enteric disease risk occurs within neighborhoods, and that while certain trends are evident, the degree of individual site fluctuation should question the utility of both cross-sectional and more aggregate analysis. Various factors increase the counts of fecal coliform present, including the type of water point, how water was stored at that water point, and the proximity of the water point to local drainage. Some locations fluctuated considerably between being safe and unsafe on a monthly basis. Next steps to form a more comprehensive contextualized understanding of enteric disease risk in these environments should include the addition of behavioral factors and local insight.