Aguiar Prieto P, Cepero Martín J A, Coutin Marie G
Unidad Nacional de Salud Ambiental, Ministerio de Salud Pública, La Habana, Cuba.
Rev Panam Salud Publica. 2000 May;7(5):313-8. doi: 10.1590/s1020-49892000000500004.
A study was conducted in 1996 and 1997 in 31 Cuban cities having a population greater than 35,000, in order to determine if there was a relationship between drinking water quality and the frequency of acute diarrheal diseases (ADD). We used the level of disinfection (based on chlorine concentration) as well as the level of bacterial contamination (based on the presence of coliform bacteria) as water quality indicators, and the frequency of ADD was calculated on the basis of the number of visits (per 100,000 inhabitants) to individual family physicians and to physicians on call in hospitals and polyclinics that were prompted by ADD. Weekly determinations of chlorine concentrations and monthly measurements of bacterial contamination were performed by taking daily water samples at 2,045 key sites along the water distribution channels in the cities included in the study. In 1996 and 1997, the percentages of samples with good chlorination (residual chlorine > or = 0.3 mg/L) for the entire country were 72.4% and 74.8%, respectively, whereas the percentages of samples with little bacterial contamination (most probable number [MPN] of fecal coliform bacteria < or = 9.2/100 mL) were 87.0% and 76.5%, respectively. Logistic regression revealed, at the local level, an inverse correlation between each of these percentages and the number of medical consultations for ADD (per 100,000 inhabitants), although it was not statistically significant. These results allowed the authors to stratify the cities included in the study according to their different levels of risk for ADD: high risk (23 cities), moderate risk (8 cities), and low risk (0 cities).
1996年和1997年，在古巴31个人口超过35000的城市开展了一项研究，以确定饮用水质量与急性腹泻病（ADD）发病频率之间是否存在关联。我们将消毒水平（基于氯浓度）以及细菌污染水平（基于大肠菌的存在情况）用作水质指标，并根据因ADD而去看个体家庭医生以及前往医院和综合诊所找值班医生的就诊次数（每10万居民）来计算ADD的发病频率。通过在研究涵盖城市的配水渠道沿线2045个关键地点每日采集水样，每周测定氯浓度，每月测量细菌污染情况。1996年和1997年，全国氯化良好（余氯≥0.3mg/L）的样本百分比分别为72.4%和74.8%，而细菌污染轻微（粪大肠菌最可能数≤9.2/100mL）的样本百分比分别为87.0%和76.5%。逻辑回归显示，在地方层面，这些百分比中的每一个与ADD的医疗咨询次数（每10万居民）之间均呈负相关，尽管未达到统计学显著性。这些结果使作者能够根据研究中各城市不同的ADD风险水平进行分层：高风险（23个城市）、中度风险（8个城市）和低风险（0个城市）。
