Influence of sanitation facilities on diarrhea prevalence among children aged below 5 years in flood-prone areas of Bangladesh: a multilevel analysis

Environmental Science and Pollution Research International · 1 author, 1 centre

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TL;DR

The implications suggest that the health impact of sanitation is context-dependent, heavily influenced by environmental flood risk, and that simply installing improved facilities may not be sufficient for diarrhea prevention in all flood-prone regions.

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public health

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ORIGINAL PAPER

PMC10495509

Influence of sanitation facilities on diarrhea prevalence among children aged below 5 years in flood-prone areas of Bangladesh: a multilevel analysis

Environmental Science and Pollution Research International

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ABSTRACT

Although the improvement of sanitation facilities has been a major contributor to improving public health, it is not guaranteed to prevent negative health outcomes. This is especially true in areas affected by severe natural disasters, such as flooding or extreme rainfall. Previous studies have examined the association between catastrophic natural disasters and negative health outcomes. However, studies on disaster-prone areas are limited. This study focused on the impact of flood risks and examined whether the improvement of sanitation facilities would be sufficient to suppress the prevalence of diarrhea in flood-prone areas. Two secondary datasets including geodata on flood-prone areas were used for the analysis: one each was obtained from the Bangladesh Demographic and Health Survey and Bangladesh Agricultural Research Council. Two models with categorizations of sanitation facilities based on containment type and excreta flow were applied for analysis. Results showed that the severe flood-prone areas and “diffused” type of sanitation, where the feces are diffused without any containment, had significant positive associations with diarrhea prevalence; however, the interaction between them was negative. Moderate flood-prone areas had a significant positive association with diarrhea prevalence; however, the interaction with unimproved sanitation, which includes containment without clear partition from feces, was significantly negative. These findings indicate that improved sanitation or containment type of sanitation may not positively contribute to the prevention of diarrhea in these severe- and moderate-flood prone areas. The urgent need for alternative sanitation technologies should be addressed in flood-prone regions. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-023-29373-0.

CITATION EXPORT

Michiko Kikuchi. Influence of sanitation facilities on diarrhea prevalence among children aged below 5 years in flood-prone areas of Bangladesh: a multilevel analysis. Environmental Science and Pollution Research International. (2023). https://doi.org/10.1007/s11356-023-29373-0

AUTHORS

1 · 1 CENTRES

Michiko Kikuchi

grid.26999.3d0000 0001 2151 536XGraduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa City, Chiba Prefecture 277-8561 Japan