Water consumption and childhood diarrheal prevalence in a water scarce country

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.