This paper identifies groups vulnerable to the effect of flooding on hospital visits due to diarrhoea during and after a flood event in 1998 in Dhaka, Bangladesh. The number of observed cases of cholera and non-cholera diarrhoea per week was compared to expected normal numbers during the flood and post-flood periods, obtained as the season-specific average over the two preceding and subsequent years using Poisson generalised linear models. The expected number of diarrhoea cases was estimated in separate models for each category of potential modifying factors: sex, age, socio-economic status and hygiene and sanitation practices. During the flood, the number of cholera and non-cholera diarrhoea cases was almost six and two times higher than expected, respectively. In the post-flood period, the risk of non-cholera diarrhoea was significantly higher for those with lower educational level, living in a household with a non-concrete roof, drinking tube-well water (vs. tap water), using a distant water source and unsanitary toilets. The risk for cholera was significantly higher for those drinking tube-well water and those using unsanitary toilets. This study confirms that low socio-economic groups and poor hygiene and sanitation groups were most vulnerable to flood-related diarrhoea.
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Research Article|
March 01 2008
Factors determining vulnerability to diarrhoea during and after severe floods in Bangladesh
Masahiro Hashizume;
1Research Center for Tropical Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-12-4, Nagasaki City, Nagasaki, 852-8523, Japan
Tel.: (81) 95 819 7808 Fax: (81) 95 819 7808; E-mail: [email protected]
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Yukiko Wagatsuma;
Yukiko Wagatsuma
2Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Abu S. G. Faruque;
Abu S. G. Faruque
3Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Taiichi Hayashi;
Taiichi Hayashi
4International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
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Paul R. Hunter;
Paul R. Hunter
5Disaster Prevention Research Institute, Kyoto University, Gokasho, Uji, Kyoto, 611-0011, Japan
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Ben Armstrong;
Ben Armstrong
6School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK
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David A. Sack
David A. Sack
3Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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J Water Health (2008) 6 (3): 323–332.
Article history
Received:
July 11 2007
Accepted:
September 13 2007
Citation
Masahiro Hashizume, Yukiko Wagatsuma, Abu S. G. Faruque, Taiichi Hayashi, Paul R. Hunter, Ben Armstrong, David A. Sack; Factors determining vulnerability to diarrhoea during and after severe floods in Bangladesh. J Water Health 1 September 2008; 6 (3): 323–332. doi: https://doi.org/10.2166/wh.2008.062
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