The Geography of Groundwater Quality and Childhood Diarrheal Disease in Bangladesh Public Deposited

Downloadable Content

Download PDF
Last Modified
  • March 22, 2019
  • Escamilla, Veronica
    • Affiliation: College of Arts and Sciences, Department of Geography
  • Childhood diarrhea persists in Bangladesh despite efforts to shift from surface water to groundwater for drinking. It is unknown whether shallow aquifer groundwater extracted through tubewells is a significant source of disease or if other sources such as surface water and local sanitation are driving transmission. Using the disease ecology framework, this study explores the influence of poor sanitation on diarrheal disease transmission. Specific questions addressed in this study include: 1) Does poor sanitation influence shallow tubewell water quality? 2) Does fecal contamination of tubewells influence diarrheal disease? 3) Does the neighborhood water and sanitation infrastructure affect childhood diarrheal disease incidence above and beyond household factors? 4) Does poor sanitation influence diarrheal disease via bathing ponds? 5) Does obtaining drinking water from deep tubewells have a protective effect against childhood diarrhea incidence? This study integrates groundwater microbial data, health and demographic surveillance data, and detailed spatial data of the water and sanitation infrastructure in six villages in Matlab, Bangladesh. The relationship between groundwater quality and poor sanitation is measured at multiple scales using geographic analysis tools. Direct and indirect sanitation influences on childhood diarrheal disease (2002-2006) are explored using neighborhood latrine metrics, and bathing pond latrine metrics. A deep tubewell arsenic mitigation intervention is also examined to determine whether children drinking from deep tubewells experience less diarrhea than children drinking from shallow wells. Results suggest that poor sanitation is predictive of both groundwater contamination and diarrheal disease. Children living in neighborhoods with insufficient access to septic latrines experience higher diarrhea incidence. Additionally, children living near bathing ponds surrounded by latrines leaking effluent also have a higher incidence. While deep tubewells were installed for arsenic mitigation, they are also protective against diarrheal disease. These results shed light on the importance of integrating population and environment data to identify particular circumstances in which groundwater is compromised and children are at risk of contracting diarrheal diseases. These results suggest that poor sanitation diminishes the effect of improved drinking water sources and improvements to the built sanitation infrastructure are needed to reduce diarrheal disease incidence.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Emch, Michael
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2011

This work has no parents.