An Examination of the Relationship between Levels of Drinking Water Quality and the Occurrence of Self-Reported Diarrheal Disease: A Prospective Cohort Study in the Dominican Republic, 2005-2006.

Abstract

Background: 884 million people do not have access to clean water, which is a potential contributor to diarrhea (JMP, 2010). The purpose of this study was to examine the potential associations between the occurrence of diarrhea and the levels of turbidity, total coliforms, and Escherichia coli (E. coli), in 185 households in Bonao, Dominican Republic in 2005-2006. Methods: A biweekly water quality dataset and a weekly diarrhea occurrence dataset were merged using three different methods. T-tests and odds ratios were calculated for all three different datasets. Multivariate logistic regression was also conducted. Results: There were 430 cases of diarrhea out of 14,245 observations. In the age-adjusted multivariate logistic regression, turbidity (OR = 1.36; p-value = .012) and total coliforms (OR = .842; p-value = .006) were found to be significant for an association with the occurrence of diarrhea. E. coli was not found to be significant for an association. Conclusions: This study strengthens the evidence supporting a positive association between turbidity and the occurrence of diarrhea. This study also showed a negative association between total coliforms and diarrhea. Future studies are needed to clarify these associations