Int J Health Geogr - Diarrheal disease risk in rural Bangladesh decreases as tubewell density increases: a zero-inflated and geographically weighted analysis.

Tópicos

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Resumo

CKGROUND: This study investigates the impact of tubewell user density on cholera and shigellosis events in Matlab, Bangladesh between 2002 and 2004. Household-level demographic, health, and water infrastructure data were incorporated into a local geographic information systems (GIS) database. Geographically-weighted regression (GWR) models were constructed to identify spatial variation of relationships across the study area. Zero-inflated negative binomial regression models were run to simultaneously measure the likelihood of increased magnitude of disease events and the likelihood of zero cholera or shigellosis events. The aim of this study was to examine the effect of tubewell density on both the occurrence of diarrheal disease and the magnitude of diarrheal disease incidence.RESULTS: In Matlab, households with greater tubewell density were more likely to report zero cholera or shigellosis events. Results for both cholera and shigellosis GWR models suggest that tubewell density effects are spatially stationary and the use of non-spatial statistical methods is appropriate.CONCLUSIONS: Increasing the amount of drinking water available to households through increased density of tubewells contributed to lower reports of cholera and shigellosis events in rural Bangladesh. Our findings demonstrate the importance of tubewell installation and access to groundwater in reducing diarrheal disease events in the developing world.

Resumo Limpo

ckground studi investig impact tubewel user densiti cholera shigellosi event matlab bangladesh householdlevel demograph health water infrastructur data incorpor local geograph inform system gis databas geographicallyweight regress gwr model construct identifi spatial variat relationship across studi area zeroinfl negat binomi regress model run simultan measur likelihood increas magnitud diseas event likelihood zero cholera shigellosi event aim studi examin effect tubewel densiti occurr diarrheal diseas magnitud diarrheal diseas incidenceresult matlab household greater tubewel densiti like report zero cholera shigellosi event result cholera shigellosi gwr model suggest tubewel densiti effect spatial stationari use nonspati statist method appropriateconclus increas amount drink water avail household increas densiti tubewel contribut lower report cholera shigellosi event rural bangladesh find demonstr import tubewel instal access groundwat reduc diarrheal diseas event develop world

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