Sy Ibrahima, Traoré Doulo, Niang Diène Aminata, Koné Brama, Lô Baidy, Faye Ousmane, Utzinger Jürg, Cissé Guéladio, Tanner Marcel
Sante Publique. 2017 Dec 5;29(5):741-750. doi: 10.3917/spub.175.0741.
Drinking water and sanitation are two factors of inter-linked inextricably public health especially in the city of Nouakchott where the low availability of these services leads to a multitude of use and hygiene practices involving a complex socio-ecological system with an increased risk of waterborne diseases transmission (diarrhea, cholera, etc.).
Thus, this contribution analyzes the impact of socio-ecological system on the development of diarrheal diseases by using socio-environmental and epidemiological data from various sources (national surveys and registries consultation).
Overall, the results show that only 25.6% of households have access to drinking water sources while 69.8% of the populations dispose improved latrines. Hence, the weakness in environmental sanitation conditions explains the level of diarrheal morbidity averring 12.8% at the urban level, with an unequal spatial distribution showing less affected communes such as Tevragh Zeina (9.1%) and municipalities more affected like Sebkha (19.1%). The distribution according to the age categories shows that children under 5 years are the most affected with 51.7% followed by people aged over 14 with 34.2%. The correlation analysis between socio-economic, environmental and epidemiological variables reveals a number of significant associations: untreated water consumption and diarrhea (R = 0.429); collection of wastewater and occurrence of diarrhea ; existence of improved latrine and reduction of diarrheal risk (R = 0.402).
Therefore, exposure to diarrheal diseases through the prism of water and sanitation is a real public health problem that requires a systemic and integrated approach to improving environmental health.
饮用水和卫生设施是紧密相连的两个公共卫生因素，在努瓦克肖特市尤其如此，这些服务的供应不足导致了大量涉及复杂社会生态系统的用水和卫生习惯，增加了水传播疾病（腹泻、霍乱等）传播的风险。
因此，本研究通过使用来自各种来源（国家调查和登记处咨询）的社会环境和流行病学数据，分析了社会生态系统对腹泻疾病发展的影响。
总体而言，结果表明只有25.6%的家庭能够获得饮用水源，而69.8%的人口拥有改良厕所。因此，环境卫生条件的薄弱解释了腹泻发病率的水平，城市层面平均为12.8%，空间分布不均，受影响较小的社区如特夫拉格·泽纳（9.1%），受影响较大的市镇如塞卜哈（19.1%）。按年龄类别分布显示,5岁以下儿童受影响最大，为51.7%，其次是14岁以上人群，为34.2%。社会经济、环境和流行病学变量之间的相关性分析揭示了一些显著关联：饮用未处理水与腹泻（R = 0.429）；污水收集与腹泻发生；改良厕所的存在与腹泻风险降低（R = 0.402）。
因此，通过水和卫生设施的视角来看，腹泻疾病的暴露是一个切实的公共卫生问题，需要采取系统和综合的方法来改善环境卫生。
