Khan Jahidur Rahman, Hossain Md Belal, Chakraborty Promit Ananyo, Mistry Sabuj Kanti
Health Research Institute, University of Canberra, Canberra, ACT 2617, Australia.
Department of Climate and Environmental Health, Biomedical Research Foundation, Dhaka, Bangladesh.
Environ Sci Pollut Res Int. 2022 May;29(21):32180-32189. doi: 10.1007/s11356-021-18460-9. Epub 2022 Jan 11.
Faecal contamination (by Escherichia coli [E. coli]) of household drinking water can have adverse effects on child health, particularly increasing the episodes of childhood diarrhea; however, the evidence is scanty in Bangladesh. This study utilised data from the most recent nationally representative 2019 Multiple Indicator Cluster Survey to investigate the relationship between E. coli concentration in household drinking water and diarrheal episodes among children aged under-5 years in Bangladesh. Childhood diarrhea was identified by asking the children's mothers or caregivers if they had a diarrheal episode in the 2 weeks preceding the survey. E. coli colonies were counted as colony-forming units (CFUs) per 100 ml of water and classified into three risk groups (low: < 1 CFU/100 ml; moderate: 1-10 CFU/100 ml; and high: > 10 CFU/100 ml). The design-adjusted logistic regression was used to estimate the association between drinking water E. coli risk groups and childhood diarrhea, adjusting for potential confounders. We observed a significant association between household drinking water E. coli contamination and diarrheal episodes among under-5 children. Compared to the children from households with a low risk of E. coli contamination in drinking water, children from households with a moderate risk of E. coli contamination were 1.68 times more likely to have diarrhea, which was 2.28 times among children from households with a high risk of E. coli contamination. Findings of the study have significant policy implications and urge to ensure safe water supplies, improve water management practices and modify hygiene behaviours to reduce episodes of childhood diarrhea.
家庭饮用水的粪便污染（由大肠杆菌引起）会对儿童健康产生不利影响，尤其是会增加儿童腹泻的发作次数；然而，在孟加拉国，这方面的证据很少。本研究利用了来自最近具有全国代表性的2019年多指标类集调查的数据，以调查孟加拉国5岁以下儿童家庭饮用水中大肠杆菌浓度与腹泻发作之间的关系。通过询问儿童的母亲或照顾者在调查前两周内孩子是否有腹泻发作来确定儿童腹泻情况。大肠杆菌菌落按每100毫升水中的菌落形成单位（CFU）计数，并分为三个风险组（低：<1 CFU/100毫升；中：1-10 CFU/100毫升；高：>10 CFU/100毫升）。采用设计调整后的逻辑回归来估计饮用水大肠杆菌风险组与儿童腹泻之间的关联，并对潜在的混杂因素进行调整。我们观察到5岁以下儿童家庭饮用水中的大肠杆菌污染与腹泻发作之间存在显著关联。与饮用水中大肠杆菌污染风险低的家庭的儿童相比，大肠杆菌污染风险中等的家庭中的儿童腹泻的可能性高1.68倍，而大肠杆菌污染风险高的家庭中的儿童腹泻的可能性高2.28倍。该研究结果具有重大政策意义，并敦促确保安全供水、改善水管理做法和改变卫生行为，以减少儿童腹泻发作次数。
