Lonergan S, Vansickle T
Department of Geography, University of Victoria, British Columbia, Canada.
Soc Sci Med. 1991;33(8):937-46. doi: 10.1016/0277-9536(91)90264-d.
Due to the increasingly documented prevalence of diarrhoeal diseases in Malaysia, a number of water-related programmes have been implemented in an attempt to improve health status through the reduction of incidence of waterborne communicable diseases associated with poor public water supplies. The implicit assumption underlying these projects is that the enhancement of the physical infrastructure, and subsequent improvements in the quality of the water supply, will substantially reduce water-related disease. The present study questions this hypothesis and uses a socio-ecological model as a framework to assess risk factors associated with the increased probability of waterborne disease. Research is centred on Port Dickson, a district which typifies existing water and sanitation conditions in much of semi-rural Malaysia. Health services utilization data and a 268-household diarrhoeal morbidity survey were used to measure the burden of illness of waterborne disease within the district and to identify predictors of morbidity. It was concluded that although treatment facilities will reduce the health burden in the region, a number of behavioural and sanitation factors may be more important and could act to minimize the potential impacts of improved water quality.
由于马来西亚腹泻疾病的患病率越来越多地被记录在案，一些与水相关的项目已经实施，试图通过降低与公共供水不佳相关的水源性传染病发病率来改善健康状况。这些项目背后隐含的假设是，加强基础设施建设以及随后改善供水质量，将大幅减少与水相关的疾病。本研究对这一假设提出质疑，并使用社会生态模型作为框架来评估与水源性疾病发生概率增加相关的风险因素。研究集中在波德申，该地区代表了马来西亚半农村地区大部分地方现有的水和卫生条件。利用卫生服务利用数据和一项对268户家庭的腹泻发病率调查来衡量该地区水源性疾病的疾病负担，并确定发病率的预测因素。得出的结论是，尽管治疗设施将减轻该地区的健康负担，但一些行为和卫生因素可能更为重要，并且可以起到将改善水质的潜在影响降至最低的作用。
