Myint Su Latt Tun, Myint Thuzar, Aung Wah Wah, Wai Khin Thet
Department of Medical Research, Yangon, Myanmar.
WHO South East Asia J Public Health. 2015 Jan-Jun;4(1):62-68. doi: 10.4103/2224-3151.206623.
A major health consequence of rapid population growth in urban areas is the increased pressure on existing overstretched water and sanitation services. This study of an expanding periurban neighbourhood of Yangon Region, Myanmar, aimed to ascertain the prevalence of acute diarrhoea in children under 5 years; to identify household sources of drinking-water; to describe purification and storage practices; and to assess drinking-water contamination at point-of-use.
A survey of the prevalence of acute diarrhoea in children under 5 years was done in 211 households in February 2013; demographic data were also collected, along with data and details of sources of drinking water, water purification, storage practices and waste disposal. During March-August, a subset of 112 households was revisited to collect drinking water samples. The samples were analysed by the multiple tube fermentation method to count thermotolerant (faecal) coliforms and there was a qualitative determination of the presence of Escherichia coli.
Acute diarrhoea in children under 5 years was reported in 4.74% (10/211, 95% CI: 3.0-9.0) of households within the past two weeks. More than half of the households used insanitary pit latrines and 36% disposed of their waste into nearby streams and ponds. Improved sources of drinking water were used, mainly the unchlorinated ward reservoir, a chlorinated tube well or purified bottled water. Nearly a quarter of households never used any method for drinking-water purification. Ninety-four per cent (105/112) of water samples were contaminated with thermotolerant (faecal) coliforms, ranging from 2.2 colony-forming units (CFU)/100 mL (21.4%) to more than 1000 CFU/100 mL (60.7%). Of faecal (thermotolerant)-coliform-positive water samples, 70% (47/68) grew E. coli.
The prevalence of acute diarrhoea reported for children under 5 years was high and a high level of drinking-water contamination was detected, though it was unclear whether this was due to contamination at source or at point-of-use. Maintenance of drinking-water quality in study households is complex. Further research is crucial to prove the cost effectiveness in quality improvement of drinking water at point-of-use in resource-limited settings. In addition, empowerment of householders to use measures of treating water by boiling, filtration or chlorination, and safe storage with proper handling is essential.
城市地区人口快速增长带来的一个主要健康问题是，现有的不堪重负的供水和卫生服务面临的压力增大。本研究针对缅甸仰光地区一个不断扩张的城郊社区，旨在确定5岁以下儿童急性腹泻的患病率；查明家庭饮用水来源；描述水的净化和储存做法；并评估使用点的饮用水污染情况。
2013年2月，对211户家庭中5岁以下儿童的急性腹泻患病率进行了调查；还收集了人口数据，以及饮用水来源、水净化、储存做法和废物处理的数据及详细信息。在3月至8月期间，再次走访了112户家庭的一个子集以采集饮用水样本。通过多管发酵法对样本进行分析，以计数耐热（粪便）大肠菌群，并对大肠杆菌的存在进行定性测定。
在过去两周内，4.74%（10/211，95%置信区间：3.0 - 9.0）的家庭报告其5岁以下儿童患有急性腹泻。超过一半的家庭使用不卫生的坑式厕所，36%的家庭将废物排放到附近的溪流和池塘中。使用了改善后的饮用水源，主要是未加氯的病房蓄水池、加氯的管井或净化瓶装水。近四分之一的家庭从未使用任何饮用水净化方法。94%（105/112）的水样被耐热（粪便）大肠菌群污染，范围从2.2菌落形成单位（CFU）/100毫升（21.4%）到超过1000 CFU/100毫升（60.7%）。在粪便（耐热）大肠菌群呈阳性的水样中，70%（47/68）培养出了大肠杆菌。
报告的5岁以下儿童急性腹泻患病率较高，且检测到饮用水污染程度较高，不过尚不清楚这是由于水源污染还是使用点污染所致。研究家庭中饮用水质量的维持情况较为复杂。进一步的研究对于证明在资源有限的环境中改善使用点饮用水质量的成本效益至关重要。此外，使住户有能力采用煮沸、过滤或氯化等水处理措施，并通过妥善处理进行安全储存至关重要。
