Traoré Doulo, Sy Ibrahima, Utzinger Jürg, Epprecht Michael, Kengne Ives M, Lô Baidy, Odermatt Peter, Faye Ousmane, Cissé Guéladio, Tanner Marcel
Geospat Health. 2013 Nov;8(1):53-63. doi: 10.4081/gh.2013.54.
Access to sufficient quantities of safe drinking water is a human right. Moreover, access to clean water is of public health relevance, particularly in semi-arid and Sahelian cities due to the risks of water contamination and transmission of water-borne diseases. We conducted a study in Nouakchott, the capital of Mauritania, to deepen the understanding of diarrhoeal incidence in space and time. We used an integrated geographical approach, combining socio-environmental, microbiological and epidemiological data from various sources, including spatially explicit surveys, laboratory analysis of water samples and reported diarrhoeal episodes. A geospatial technique was applied to determine the environmental and microbiological risk factors that govern diarrhoeal transmission. Statistical and cartographic analyses revealed concentration of unimproved sources of drinking water in the most densely populated areas of the city, coupled with a daily water allocation below the recommended standard of 20 l per person. Bacteriological analysis indicated that 93% of the non-piped water sources supplied at water points were contaminated with 10-80 coliform bacteria per 100 ml. Diarrhoea was the second most important disease reported at health centres, accounting for 12.8% of health care service consultations on average. Diarrhoeal episodes were concentrated in municipalities with the largest number of contaminated water sources. Environmental factors (e.g. lack of improved water sources) and bacteriological aspects (e.g. water contamination with coliform bacteria) are the main drivers explaining the spatio-temporal distribution of diarrhoea. We conclude that integrating environmental, microbiological and epidemiological variables with statistical regression models facilitates risk profiling of diarrhoeal diseases. Modes of water supply and water contamination were the main drivers of diarrhoea in this semi-arid urban context of Nouakchott, and hence require a strategy to improve water quality at the various levels of the supply chain.
获得充足的安全饮用水是一项人权。此外，获得清洁水与公共卫生相关，特别是在半干旱和萨赫勒地区的城市，因为存在水污染和水传播疾病传播的风险。我们在毛里塔尼亚首都努瓦克肖特进行了一项研究，以加深对腹泻发病率在空间和时间上的了解。我们采用了一种综合地理方法，结合了来自各种来源的社会环境、微生物和流行病学数据，包括空间明确的调查、水样的实验室分析以及报告的腹泻病例。应用地理空间技术来确定控制腹泻传播的环境和微生物风险因素。统计和制图分析表明，该市人口最密集地区的未改善饮用水源集中，同时每日人均用水量低于建议的每人20升标准。细菌学分析表明，在取水点供应的非管道水源中，93%每100毫升被10至80个大肠菌群污染。腹泻是在卫生中心报告的第二大重要疾病，平均占医疗服务咨询的12.8%。腹泻病例集中在受污染水源数量最多的市。环境因素（如缺乏改善的水源）和细菌学方面（如大肠菌群水污染）是解释腹泻时空分布的主要驱动因素。我们得出结论，将环境、微生物和流行病学变量与统计回归模型相结合有助于对腹泻疾病进行风险评估。在努瓦克肖特这种半干旱城市环境中，供水方式和水污染是腹泻的主要驱动因素，因此需要制定一项战略来改善供应链各层面的水质。
