Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis Public Deposited

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Creator
  • Winston, Jennifer
    • Affiliation: College of Arts and Sciences, Department of Geography, Carolina Population Center
  • Yunus, Mohammad
    • Other Affiliation: International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
  • Escamilla, Veronica
    • Affiliation: College of Arts and Sciences, Department of Geography, Carolina Population Center
  • Messina, Jane P
    • Affiliation: College of Arts and Sciences, Department of Geography, Carolina Population Center
  • Carrel, Margaret
    • Other Affiliation: Department of Geography, University of Iowa, Iowa City, IA, USA
  • Emch, Michael
    • Affiliation: College of Arts and Sciences, Department of Geography, Carolina Population Center
  • Giebultowicz, Sophia
    • Affiliation: College of Arts and Sciences, Department of Geography, Carolina Population Center
  • Streatfield, P Kim
    • Other Affiliation: International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
Abstract
  • Abstract Background This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence. Results In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate. Conclusions Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world.
Date of publication
Identifier
  • doi:10.1186/1476-072X-10-41
  • 21676249
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Margaret Carrel et al.; licensee BioMed Central Ltd.
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Journal title
  • International Journal of Health Geographics
Journal volume
  • 10
Journal issue
  • 1
Page start
  • 41
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1476-072X
Bibliographic citation
  • International Journal of Health Geographics. 2011 Jun 15;10(1):41
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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