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Integrating disease control strategies: Balancing water sanitation and hygiene interventions to reduce diarrheal disease burden

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  • Eisenberg, J.N.S.
  • Scott, J.C.
  • Porco, T.

Abstract

Objectives. Although the burden of diarrheal disease resulting from inadequate water quality, sanitation practices, and hygiene remains high, there is little understanding of the integration of these environmental control strategies. We tested a modeling framework designed to capture the interdependent transmission pathways of enteric pathogens. Methods. We developed a household-level stochastic model accounting for 5 different transmission pathways. We estimated disease preventable through water treatment by comparing 2 scenarios: all households fully exposed to contaminated drinking water and all households receiving the water quality intervention. Results. We found that the benefits of a water quality intervention depend on sanitation and hygiene conditions. When sanitation conditions are poor, water quality improvements may have minimal impact regardless of amount of water contamination. If each transmission pathway alone is sufficient to maintain diarrheal disease, single-pathway interventions will have minimal benefit, and ultimately an intervention will be successful only if all sufficient pathways are eliminated. However, when 1 pathway is critical to maintaining the disease, public health efforts should focus on this critical pathway. Conclusions. Our findings provide guidance in understanding how to best reduce and eliminate diarrheal disease through integrated control strategies.

Suggested Citation

  • Eisenberg, J.N.S. & Scott, J.C. & Porco, T., 2007. "Integrating disease control strategies: Balancing water sanitation and hygiene interventions to reduce diarrheal disease burden," American Journal of Public Health, American Public Health Association, vol. 97(5), pages 846-852.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2006.086207_4
    DOI: 10.2105/AJPH.2006.086207
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    Cited by:

    1. World Bank, 2010. "Uganda - Environmental Sanitation : Addressing Institutional and Financial Challenges," World Bank Publications - Reports 2882, The World Bank Group.
    2. Avishek Bhunia & Amalendu Sahoo & Uday Chatterjee, 2023. "Geostatistical analysis of quality of life (QoL) with particular emphasis on the basic amenities and services in urban West Bengal, India," Asia-Pacific Journal of Regional Science, Springer, vol. 7(3), pages 807-843, September.
    3. Kathleen A. Alexander & Marcos Carzolio & Douglas Goodin & Eric Vance, 2013. "Climate Change is Likely to Worsen the Public Health Threat of Diarrheal Disease in Botswana," IJERPH, MDPI, vol. 10(4), pages 1-29, March.
    4. Balobanov, Alexandr (Балобанов, Александр) & Atnashev, Timur (Атнашев, Тимур) & Moreeva, Sofia (Мореева, София) & Shulman, Ekaterina (Шульман, Екатерина), 2018. "Methodological and Regulatory Approaches to the Completion of the Strategic Management Loop and its Integration with the Software and Budget Management Contours [Методологические И Нормативно-Право," Working Papers 061818, Russian Presidential Academy of National Economy and Public Administration.
    5. Jamie Bartram & Clarissa Brocklehurst & Michael B. Fisher & Rolf Luyendijk & Rifat Hossain & Tessa Wardlaw & Bruce Gordon, 2014. "Global Monitoring of Water Supply and Sanitation: History, Methods and Future Challenges," IJERPH, MDPI, vol. 11(8), pages 1-29, August.
    6. McBain, Florence, 2014. "Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services," Working Papers 179200, University of Bonn, Center for Development Research (ZEF).

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