Semba Richard D, de Pee Saskia, Kraemer Klaus, Sun Kai, Thorne-Lyman Andrew, Moench-Pfanner Regina, Sari Mayang, Akhter Nasima, Bloem Martin W
Department of Ophthalmology, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 700, Baltimore, MD 21205, USA.
Int J Hyg Environ Health. 2009 Jul;212(4):387-97. doi: 10.1016/j.ijheh.2008.09.001. Epub 2008 Oct 30.
In developing countries, poor families in urban slums often do not receive municipal services including water. The objectives of our study were to characterize families who purchased drinking water and to examine the relation between purchasing drinking water and child morbidity and mortality in urban slums of Indonesia, using data collected between 1999 and 2003. Of 143,126 families, 46.8% purchased inexpensive drinking water from street vendors, 47.4% did not purchase water, i.e., had running or spring/well water within household, and 5.8% purchased more expensive water in the previous 7 days. Families that purchased inexpensive drinking water had less educated parents, a more crowded household, a father who smoked, and lower socioeconomic level compared with the other families. Among children of families that purchased inexpensive drinking water, did not purchase drinking water, or purchased more expensive water, the prevalence was, respectively, for diarrhea in last 7 days (11.2%, 8.1%, 7.7%), underweight (28.9%, 24.1%, 24.1%), stunting (35.6%, 30.5%, 30.5%), wasting (12.0%, 10.5%, 10.9%), family history of infant mortality (8.0%, 5.6%, 5.1%), and of under-five child mortality (10.4%, 7.1%, 6.4%) (all P<0.0001). Use of inexpensive drinking water was associated with under-five child mortality (Odds Ratio [O.R.] 1.32, 95% Confidence Interval [C.I.] 1.20-1.45, P<0.0001) and diarrhea (O.R. 1.43, 95% C.I. 1.29-1.60, P<0.0001) in multivariate logistic regression models, adjusting for potential confounders. Purchase of inexpensive drinking water was common and associated with greater child malnutrition, diarrhea, and infant and under-five child mortality in the family. Greater efforts must be made to ensure access to safe drinking water, a basic human right and target of the Millennium Development Goals, in urban slums.
在发展中国家，城市贫民窟中的贫困家庭往往无法获得包括水在内的市政服务。我们研究的目的是利用1999年至2003年期间收集的数据，描述购买饮用水的家庭特征，并研究在印度尼西亚城市贫民窟中购买饮用水与儿童发病率和死亡率之间的关系。在143,126个家庭中，46.8%的家庭从街头小贩处购买廉价饮用水，47.4%的家庭不购买水，即家庭内有自来水或泉水/井水，5.8%的家庭在过去7天内购买了更昂贵的水。与其他家庭相比，购买廉价饮用水的家庭父母受教育程度较低，家庭更为拥挤，父亲吸烟，社会经济水平较低。在购买廉价饮用水、不购买饮用水或购买更昂贵水的家庭的儿童中，过去7天内腹泻的患病率分别为（11.2%、8.1%、7.7%），体重不足的患病率分别为（28.9%、24.1%、24.1%），发育迟缓的患病率分别为（35.6%、30.5%、30.5%），消瘦的患病率分别为（12.0%、10.5%、10.9%），婴儿死亡率家族史的患病率分别为（8.0%、5.6%、5.1%），以及五岁以下儿童死亡率的患病率分别为（10.4%、7.1%、6.4%）（所有P<0.0001）。在多变量逻辑回归模型中，调整潜在混杂因素后，使用廉价饮用水与五岁以下儿童死亡率（优势比[O.R.]1.32，95%置信区间[C.I.]1.20 - 1.45，P<0.0001）和腹泻（O.R.1.43，95% C.I.1.29 - 1.6
