Impact of Hermetically Sealed Wells on Diarrheal Illness Among Flood-affected Rural Communities

Background

Frequent flooding compromises access to clean water in rural communities. Water sources are frequently contaminated potentially increasing the risk of diarrheal illness. In October 2007, widespread flooding occurred in the Bajo Lempa region of El Salvador. An international NGO provided emergency assistance followed by disaster risk reduction (DRR) interventions. The DRR programs aimed to mitigate the negative health effects of flooding and improve access to potable water by installing hermetically sealed wells in at-risk communities.

The efficacy of hermetically sealed wells on diarrheal illness is unknown. This retrospective cohort study aimed to determine the odds of diarrheal illness among communities exposed to hermetically sealed wells during flooding.

Methods

A retrospective cohort of households in exposed and unexposed flood-affected communities was chosen in a two-stage systematic random sample design. Exposed communities were defined as those with hermetically sealed wells. 85 households representing 402 individuals were surveyed during floods in October 2008.

Results

Hermetically sealed wells demonstrated a significant protective effect among exposed individuals compared to unexposed (OR 0.18; CI 0.06-0.53). Adjusting for latrine use and hand washing the protective effect remained (OR 0.21;CI 0.06-0.72). Latrine use by type did not show a protective effect when individuals reported pit or composting latrine use compared to open defecation.

Discussion

Hermetically sealed wells are protective against diarrheal illness among flood-affected communities in rural El Salvador. Further studies are necessary to evaluate sustainability of this type of hermetically sealed well. Investigating factors that maintain this protective effect will likely improve long-term DRR strategies.

strategies.