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Protective benefits of deep tube wells against childhood diarrhea in Matlab, Bangladesh - PubMed

Protective benefits of deep tube wells against childhood diarrhea in Matlab, Bangladesh

Jennifer Jane Winston et al. Am J Public Health. 2013 Jul.

Abstract

Objectives: We investigated whether deep tube wells installed to provide arsenic-free groundwater in rural Bangladesh have the added benefit of reducing childhood diarrheal disease incidence.

Methods: We recorded cases of diarrhea in children younger than 5 years in 142 villages of Matlab, Bangladesh, during monthly community health surveys in 2005 and 2006. We surveyed the location and depth of 12,018 tube wells and integrated these data with diarrhea data and other data in a geographic information system. We fit a longitudinal logistic regression model to measure the relationship between childhood diarrhea and deep tube well use. We controlled for maternal education, family wealth, year, and distance to a deep tube well.

Results: Household clusters assumed to be using deep tube wells were 48.7% (95% confidence interval = 27.8%, 63.5%) less likely to have a case of childhood diarrhea than were other household clusters.

Conclusions: Increased access to deep tube wells may provide dual benefits to vulnerable populations in Matlab, Bangladesh, by reducing the risk of childhood diarrheal disease and decreasing exposure to naturally occurring arsenic in groundwater.

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Figures

FIGURE 1—
FIGURE 1—

Schematic representation of deep tube well use definition.

FIGURE 2—
FIGURE 2—

Distributions of childhood diarrhea counts for shallow and deep tube well users: Matlab, Bangladesh, 2005–2006. Note. Width of plots corresponds to probability densities, white dots represent medians, and black rectangles correspond to interquartile ranges of observed distributions. The longer tails associated with the distribution of childhood diarrhea cases among shallow tube well users across both years indicate that disease incidence is both higher and more variable among baris (patrilineal clusters) that primarily used shallow tube wells than is that among those that primarily used deep tube wells.

FIGURE 3—
FIGURE 3—

Full longitudinal logistic regression model odds ratios: Matlab, Bangladesh, 2005–2006. Note. CI = confidence interval; OR = odds ratio. Baris (patrilineal clusters) assumed to be using shallow tube wells are the reference category.

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