Association between childhood diarrhoeal incidence and climatic factors in urban and rural settings in the health district of Mbour, Senegal

We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011-2014). Climatic data (i.e., daily temperature, night temperature and rainfall) for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health-climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming

Prevalence of diarrhoea and risk factors among children under five years old in Mbour, Senegal: a cross-sectional study

Diarrhoeal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. In Senegal, diarrhoea is responsible for 15% of all deaths in children under the age of five and is the third leading cause of childhood deaths. For targeted planning and implementation of prevention strategies, a context-specific understanding of the determinants of diarrhoeal diseases is needed. The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour, Senegal.; Between February and March 2014, a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. The zones covered urban central, peri-central, north peripheral and south peripheral areas. Overall, 596 households were surveyed by a questionnaire, yielding information on sociodemographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.; The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18-2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00-3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20-3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11-2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11-2.56).; We found a high prevalence of diarrhoea in children under the age of five in Mbour, with the highest prevalence occurring in the central and peri-central areas. These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups. Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay

Qualité de l'eau et santé en contexte urbain sahélien et semi-aride : approche géopraphique à Nouakchot (Mauritanie)

International audienceAccess to drinking water with sufficient quantity is a major public health issue in a semi-arid sahelian city like Nouakchottwhere the low household connection rate to the supply network led to a multitude of remedies and practices with a risk of watercontamination and propagation of water-borne diseases (diarrhea, cholera, typhoid, parasitic infections, skin diseases, etc.). Thus,this paper proposes to analyze the impact of water quality on health risks inequalities in urban areas. To do this, the methodologicalapproach combines a socio-environmental, microbiological and epidemiological demarche based on the use of various datasources (national surveys, bacteriological studies of water and diarrheal morbidity provided by health facilities). Overall, the resultsshow that only 25.6% of households have improved water source when a majority of the population recourse on precarious modeswith a daily supply less than the recommended standard of 20 liters per person. Bacteriological analyzes show that 93% of waterpoints supplying about 74% of households are contaminated with values between 10 and 80 fecal coliforms per 100 ml of water.This degree of contamination corroborates with the level of diarrhea prevalence (12.8%) whose morbidity appears so unequal thatthe variability of supply modes and water microbiological quality according to the municipalities. Therefore, exposure to diarrhealdiseases through water prism is a real public health problem. It is essential to develop a strategy focalized in the people awareness,the water sources management and water treatment before consumption to improve water quality at all levels of supply chain.L’accès à une eau potable en quantité suffisante représente un enjeu majeur de santé publique dans une ville sahéliennesemi-aride à l’instar de Nouakchott en Mauritanie où le faible taux de raccordement des ménages au réseau d’adduction conduità une multitude de recours et pratiques avec un risque de contamination de l’eau et de propagation de maladies hydriques(diarrhée, choléra, typhoïde, parasitoses, dermatoses, etc.). Ainsi, ce papier cherche à analyser l’impact de la qualité de l’eausur les inégalités de risques sanitaires en milieu urbain. Pour ce faire, l’approche méthodologique combine une démarche socioenvironnementale,microbiologique et épidémiologique basée sur l’utilisation de sources de données diverses (enquêtes nationales,études bactériologiques de l’eau et morbidité diarrhéique diagnostiquée). Dans l’ensemble, les résultats montrent que seuls 25,6%des ménages disposent de sources d’approvisionnement améliorées en eau potable au moment où une majeure partie de lapopulation a recours à des modes d’alimentation précaires avec une dotation journalière inférieure à la norme recommandée de20 litres par personne. Les analyses bactériologiques montrent que 93% des points d’eau qui alimentent environ 74% des ménagessont contaminés avec des valeurs comprises entre 10 et 80 coliformes fécaux par 100 ml d’eau. Ce degré de contaminationcorrobore avec le niveau de prévalence de la diarrhée (12,8%) dont la morbidité se révèle aussi inégale que la variabilité desmodes d’approvisionnement et de la qualité microbiologique de l’eau selon les communes. Dès lors, l’exposition aux maladiesdiarrhéiques à travers le prisme de l’eau pose un véritable problème de santé publique. Il s’avère indispensable de développerune stratégie axée sur la sensibilisation, l’aménagement des points d’eau et le traitement avant la consommation pour améliorer laqualité de l’eau à tous les niveaux de la chaîne d’approvisionnement

Spatial epidemiology of urban health risks in select West African cities

West African cities face critical societal challenges that are linked to environmental and health changes. These challenges are further exacerbated by urbanization dynamics, climate change, socio-economic mutation and lack of capacity for sustainable urban development, governance and basic services delivery. The deficiency of environmental sanitation and ecosystem services have led to high complexity of urban health risks inequalities, resulting in the need for more research on efficient urban health policies. The purpose of this contribution is to present the main findings on the spatial epidemiology of diarrhaea and malaria, and their associated risks factors in the following select West African cities. Spatial variability of exposure to diarrhaea and malaria transmission is linked to several health risks such as lack of access to water and sanitation, solid wastes management, urban flooding

Evaluation of the Validity of Job Exposure Matrix for Psychosocial Factors at Work

ObjectiveTo study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP).Materials and methodsWe utilized two large population surveys (the Health 2000 Study and the Finnish Work and Health Surveys), one to construct the JEM and another to test matrix performance. In the first study, information on job demands, job control, monotonous work and social support at work was collected via face-to-face interviews. Job strain was operationalized based on job demands and job control using quadrant approach. In the second study, the sensitivity and specificity were estimated applying a Bayesian approach. The magnitude of misclassification error was examined by calculating the biased odds ratios as a function of the sensitivity and specificity of the JEM and fixed true prevalence and odds ratios. Finally, we adjusted for misclassification error the observed associations between JEM measures and selected health outcomes.ResultsThe matrix showed a good accuracy for job control and job strain, while its performance for other exposures was relatively low. Without correction for exposure misclassification, the JEM was able to detect the association between job strain and depression in men and between monotonous work and LBP in both genders.ConclusionsOur results suggest that JEM more accurately identifies occupations with low control and high strain than those with high demands or low social support. Overall, the present JEM is a useful source of job-level psychosocial exposures in epidemiological studies lacking individual-level exposure information. Furthermore, we showed the applicability of a Bayesian approach in the evaluation of the performance of the JEM in a situation where, in practice, no gold standard of exposure assessment exists