Sy I, Handschumacher P, Wyss K, Cisse G, Lo B, Piermay J L, Tanner M
Centre suisse de recherche scientifique en Côte d'Ivoire et l'Institut national de recherches en santé publique, Nouakchott, Mauritanie.
Med Trop (Mars). 2010 Feb;70(1):57-61.
Rapid urbanization has created numerous health risks in developing countries, but the exact impact on many diseases in function of living conditions is unclear. For insight into this complex relationship, a study on diarrheal diseases was carried out to obtain knowledge about the distribution of health risks in an urban setting. An epidemiological survey with a combined longitudinal and transverse design was conducted in Rufisque, Senegal, from April 2002 to March 2003 in a sample including households with children less than 5-years-old living in four areas presenting different levels of hygiene. Results showed a high overall incidence of diarrhea (6.5 episodes/child/year) but there were major discrepancies between the four study areas in direct relation with level of hygiene. The annual incidence per child was lower in the low-cost housing project (fair hygiene, 3.4 episodes) than in the Castors area (poor hygiene, 6.8 episodes), Diokoul Wague area (very poor hygiene, 7.3 episodes) and Goufe Aldiana area (no hygiene, 8.4 episodes). The study showed only a slight seasonal effect on diarrheal disease in the different areas. However, the differences observed between areas during the cold and hot dry seasons were considerably attenuated in the rainy season. This variability in the incidence rate that underlines the diversity of urban living conditions depends on a variety of risk factors (such as age and number of children) that may interact, although hygiene level remains critical. For issues usually given priority at the national level, multiplying studies aimed at fine analysis of factors underlying disease transmission is useful since this approach can improve understanding of public health policy in city environments characterized by the complex conditions (density and diversity) created by urbanization.
快速城市化在发展中国家带来了诸多健康风险，但生活条件对多种疾病的确切影响尚不清楚。为深入了解这种复杂关系，开展了一项关于腹泻疾病的研究，以获取城市环境中健康风险分布的相关知识。2002年4月至2003年3月在塞内加尔的鲁菲斯克进行了一项采用纵向和横向相结合设计的流行病学调查，样本包括居住在四个卫生水平不同地区的有5岁以下儿童的家庭。结果显示腹泻总体发病率较高（6.5次/儿童/年），但四个研究区域之间存在重大差异，且与卫生水平直接相关。低成本住房项目（卫生条件一般，3.4次）中每个儿童的年发病率低于卡斯特斯地区（卫生条件差，6.8次）、迪奥库尔瓦盖地区（卫生条件很差，7.3次）和古费阿尔迪亚纳地区（无卫生设施，8.4次）。该研究表明不同地区腹泻疾病仅存在轻微的季节性影响。然而，在雨季，寒冷和炎热干燥季节各地区之间观察到的差异大幅减弱。发病率的这种变化突出了城市生活条件的多样性，它取决于多种可能相互作用的风险因素（如年龄和儿童数量），尽管卫生水平仍然至关重要。对于通常在国家层面优先考虑的问题，开展更多旨在精细分析疾病传播潜在因素的研究是有益的，因为这种方法有助于更好地理解在城市化所造成的复杂条件（密度和多样性）下的城市环境中的公共卫生政策。
