Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.
JMIR Res Protoc. 2024 Nov 29;13:e63415. doi: 10.2196/63415.
The water supply in the Gaza Strip, Palestine, has been unstable and under strain for decades, resulting in major issues with drinking water quality, reliability, and acceptability. In 2018, between 25% and 30% of Gazans did not have regular access to running water. The progressive deterioration of water infrastructure and concerns over the quality of piped water have resulted in a complex mix of drinking water sources used in the Gaza Strip. The challenges of safe water provision in the Gaza Strip could potentially have severe adverse effects on the population's health and well-being.
The main objectives of this survey are to determine the quality of drinking water at the household level and to investigate the association of various health outcomes with water quality at the household level in the Gaza Strip.
We conducted a cross-sectional household survey in the North Gaza, Gaza, and Rafah governorates between January and March 2023. We selected a subsample of households from a representative cross-sectional survey conducted in the Gaza Strip in 2020 with persons aged 40 years and older. From each household in the 2023 survey, we invited 3 individuals (2 older than 40 years and 1 between 18 and 30 years) to participate. The face-to-face interview included questions on drinking water, mental health and well-being, self-reported diagnoses for selected diseases, use of antibiotics, and knowledge about antimicrobial resistance. Additionally, we measured each participant's blood pressure. We sampled drinking water from each household and analyzed the samples for microbial contamination, nitrate, sodium, and mineral content.
In total, we visited 905 households and interviewed 2291 participants. In both age groups, more female participants were interviewed. A total of 56.60% (914/1615) were aged ≥40 years, and 58.9% (398/676) were aged between 18 and 30 years. We obtained water samples from nearly all households (902/905, 99.8%). The results are expected to be published in several papers in 2025.
The extensive survey components, coupled with drinking water testing and building on an existing survey, allowed us to identify a broad set of potential impacts on health and well-being and to track changes over time. This study intends to identify humanitarian and development interventions that could impact the population served most. However, we completed data collection before the escalation of violence in October 2023. Given the impact of the still ongoing conflict, the initial intent of this work is no longer valid. However, the results emerging from the survey may still serve as a valuable baseline to assess the impacts of the current escalations on physical and mental health and on drinking water quality. In addition, our findings could provide important information for rebuilding the Gaza Strip in a more health-promoting way.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63415.
巴勒斯坦加沙地带的供水系统几十年来一直不稳定且紧张，这导致饮用水质量、可靠性和可接受性方面存在重大问题。2018 年，有 25%至 30%的加沙人无法定期获得自来水。水基础设施的逐渐恶化以及对管道水质量的担忧，导致加沙地带出现了复杂的饮用水源组合。加沙地带安全供水面临的挑战可能会对民众的健康和福祉产生严重的不利影响。
本调查的主要目的是确定家庭层面饮用水的质量，并研究各种健康结果与加沙地带家庭层面水质之间的关联。
我们于 2023 年 1 月至 3 月在北加沙、加沙和拉法省进行了一项横断面家庭调查。我们从 2020 年在加沙地带进行的具有代表性的横断面调查中选择了一部分家庭作为抽样，其中包括 40 岁及以上的人。我们邀请每个家庭的 3 个人（2 名年龄在 40 岁及以上，1 名年龄在 18 至 30 岁之间）参加。面对面访谈包括关于饮用水、心理健康和幸福感、选定疾病的自我报告诊断、抗生素使用以及对抗菌药物耐药性的了解等问题。此外，我们还测量了每位参与者的血压。我们从每个家庭采集饮用水样本，并分析样本中的微生物污染、硝酸盐、钠和矿物质含量。
我们共访问了 905 户家庭，采访了 2291 名参与者。在两个年龄组中，接受采访的女性比例都较高。共有 56.60%（914/1615）的人年龄≥40 岁，58.9%（398/676）的人年龄在 18 至 30 岁之间。我们几乎从所有家庭（902/905，99.8%）都获得了水样。预计这些结果将在 2025 年发表在几篇论文中。
广泛的调查内容，加上饮用水测试和在现有调查的基础上，使我们能够确定对健康和福祉的广泛潜在影响，并跟踪随时间的变化。本研究旨在确定可能对所服务人群产生影响的人道主义和发展干预措施。然而，我们在 2023 年 10 月暴力升级之前完成了数据收集。鉴于当前冲突的影响，这项工作的最初意图不再有效。然而，调查中出现的结果仍可作为评估当前升级对身心健康和饮用水质量影响的宝贵基线。此外，我们的研究结果可为以更促进健康的方式重建加沙地带提供重要信息。
国际注册报告标识符（IRRID）：DERR1-10.2196/63415。
