208648 Water consumption and childhood diarrheal prevalence in a water scarce country

Sunday, November 8, 2009

M.E. Perla, MS , Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA
Hamed Bakir , Centre for Environmental Health Activities, World Heatlh Organization, Regional Office for the Eastern Mediterranean, Amman, Jordan
Amer S. Jabarin, PhD , Dept. of Agricultural Economics and Agribusiness, University of Jordan, Amman, Jordan
Annette L. Fitzpatrick, PhD, MA , Departments of Epidemiology and Global Health, University of Washington, School of Public Health, Seattle, WA


The discussion on the water public health linkage is dominated by the issues of water quality and accessibility of water supply, which is defined at a minimum as a borehole within 1km of a dwelling. As water supplies decrease worldwide, it is important to reconsider the role of water quantity consumed and public health, particularly in developing countries.


Using data available from the government of Jordan (population/family health, household water billing, and water quality) we developed a profile of 34 administrative study zones in Amman to ecologically assess the explanatory role of traditional risk factors (quantity [ingestion/hygiene] and quality of water consumed, excreta disposal, and hygienic behaviours) for two-week diarrheal prevalence among children < five years old. Linear regression was used to investigate the relationship of household water consumption, housing characteristics, and diarrheal disease.


Diarrheal prevalence varied 0 33% amongst study zone averages; and average water consumption ranged from 15 187 liters per capita per day. Over 90% of households reported having electricity, a refrigerator, a washing machine, and household piped water. In unadjusted regression, water consumption was the single statistically significant variable associated with diarrheal prevalence (B=-0.11, p=0.00). The association remained significant after adjustment for wealth, household density, toilet type, and drinking water source.


For water scarce countries, like Jordan, the quantity of water consumed may play a dominant role in public health beyond known risk factors and water supply service levels. Research on programs targeting behaviors in response to water shortages should be considered.

Learning Objectives:
1. Describe water consumption factors associated with diarrheal disease. 2. Understand limitations of access to improved water sources, in describing population health issues & developing water supply goals for water scarce countries. 3. Recognize data limitations/needs of MENA countries regarding environmental/public health linkages

Keywords: Water, Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Student research, studies in epidemiology
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.