Knoblauch Astrid M, Hodges Mary H, Bah Mohamed S, Kamara Habib I, Kargbo Anita, Paye Jusufu, Turay Hamid, Nyorkor Emmanuel D, Divall Mark J, Zhang Yaobi, Utzinger Jürg, Winkler Mirko S
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
Helen Keller International Sierra Leone, P.O. Box, Freetown, Sierra Leone.
Int J Environ Res Public Health. 2014 Dec 12;11(12):12997-3016. doi: 10.3390/ijerph111212997. Print 2014 Dec.
Large private sector investments in low- and middle-income countries are often critically evaluated with regards to their environmental, social, human rights, and health impacts. A health impact assessment, including a baseline health survey, was commissioned by the Addax Bioenergy Sierra Leone project in 2010. As part of the monitoring, a follow-up survey was conducted three years later. A set of health indicators was assessed at six impacted and two control sites. Most of these indices improved, particularly at the impacted sites. The prevalences of stunting, wasting, and Plasmodium falciparum in children under five years of age decreased significantly at impacted sites (all p < 0.05) and non-significantly at control sites. Anemia in children and in women of reproductive age (15-49 years) decreased significantly at impacted and control sites (p < 0.05 and p < 0.001, respectively). Health facility-based deliveries increased significantly at the impacted sites (p < 0.05). The prevalences of helminth infections in children aged 10-15 years remained approximately at the same levels, although focal increases at the impacted sites were noted. Access to improved sanitation decreased significantly (p < 0.05) at control and non-significantly at impacted sites. Water quality remained poor without significant changes. The epidemiologic monitoring of a bioenergy project provides a useful contribution for evidence-based decision-making.
低收入和中等收入国家的大型私营部门投资往往会根据其对环境、社会、人权和健康的影响进行严格评估。2010年，Addax生物能源塞拉利昂项目委托进行了一次健康影响评估，包括一次基线健康调查。作为监测的一部分，三年后进行了一次随访调查。在六个受影响地点和两个对照地点评估了一组健康指标。这些指标大多有所改善，尤其是在受影响地点。五岁以下儿童的发育迟缓、消瘦和恶性疟原虫感染率在受影响地点显著下降（均p<0.05），在对照地点则无显著下降。儿童和育龄妇女（15-49岁）的贫血率在受影响地点和对照地点均显著下降（分别为p<0.05和p<0.001）。受影响地点基于医疗机构的分娩显著增加（p<0.05）。10-15岁儿童的蠕虫感染率大致保持在同一水平，不过注意到受影响地点有局部上升。对照地点改善卫生设施的普及率显著下降（p<0.05），受影响地点则无显著下降。水质仍然很差，没有显著变化。生物能源项目的流行病学监测为循证决策提供了有益贡献。
