Spatial Distribution and Trends of Waterborne Diseases in Tashkent Province

Outbreak of acute gastroenteritis associated with drinking water in rural Kazakhstan: A matched case-control study

We conducted an outbreak investigation from June 3 to 15th in a rural village in northern Kazakhstan, after surveillance showed an increase in gastroenteritis. Cases were residents who presented for medical treatment for diarrhea, fever (>37.5 °C), vomiting, or weakness from May 14 to June 15, 2021. Controls were residents matched by age ±2 years at a ratio of two controls for every case. Cases and controls were interviewed using structured questionnaires. We abstracted clinical data from medical records. We mapped cases and assessed risk for disease using conditional multivariable logistic regression. We identified 154 cases of acute gastroenteritis (attack rate of ~26 per 1,000 inhabitants). Symptoms were diarrhea, fever, vomiting, weakness, and decreased appetite. Among cases that participated (n = 107), 74% reported having drank unboiled tap water vs 18% of controls (n = 219). This was the only risk factor associated with disease (adjusted odds ratio: 18; 95% CI 9-35). Drinking water from a dispenser or carbonated drinks was protective. The city has two water supply networks; cases were clustered (107 cases in 79 households) in one. The investigation found that monitoring of quality and safety of water according to national regulations had not been conducted since 2018. No fatalities occurred, and no associated cases were reported after our investigation. Results suggest that untreated tap water was the probable source of the outbreak. The water supply had been cleaned and disinfected twice by the facility 2 days before our investigation began. Recommendations were made for regular monitoring of water supply facilities with rapid public notification when issues are detected to reduce likelihood of future drinking water associated outbreaks.

Trends of potential waterborne diseases at different health facilities in Bamboutos Division, West Region, Cameroon: a retrospective appraisal of routine data from 2013 to 2017

Many Cameroonian cities lack access to potable drinking water where populations rely on alternative water sources of doubtful quality. This study aimed at describing the trends and patterns of waterborne diseases (WBDs) reported in some health facilities in Bamboutos Division between 2013 and 2017 as baseline data towards understanding the profile of WBDs in this area. A retrospective review of clinical data kept on patients who visited the main health facilities in Bamboutos Division from January 2013 to December 2017 was conducted. Overall, 39.1% (n = 8,124) of total patients were positive for at least one WBD. Categories of WBDs were dysenteries (18.6%), gastroenteritis (4.2%), viral hepatitis (0.2%) and typhoid was the most preponderant (24.4%). The most affected age groups were those above 24 years but significant differences were observed only in 2013 and 2017. Distribution of potential WBDs was locality dependent. The highest prevalence of typhoid fever was recorded in Bameboro (35.4%), dysenteries in Bamedjinda (20.4%) and gastroenteritis (17.3%) in Bamekoumbou. The study shows very high overall prevalence of WBDs in some localities which could be considered as 'hotspots' of WBDs in Bamboutos. This suggests the urgent need for setting up measures to tackle the challenges of potable drinking water supply.

Health Risk in Urbanizing Regions: Examining the Nexus of Infrastructure, Hygiene and Health in Tashkent Province, Uzbekistan

Worldwide, development agencies have increased their investments in water supply and sanitation as a “powerful preventive medicine” to address infectious diseases. These interventions have focused on on-site technical interventions or social engineering approaches, emulating the result-based targets of the development goals. Against this backdrop, the study examines the following research question: What is the role of socio-cultural backgrounds, housing characteristics, and environmental hygiene practices in addressing water-transmitted diseases in the Tashkent province of Uzbekistan. In a country where public statistics and official maps are rarely accessible, and research is restrictive, the study carried out a household survey using open data kit (ODK) between July and October 2015 in Olmalik, an industrial district, and the Kibray urbanizing district in the province. The findings reveal that demographic factors, poor sanitation practices, housing characteristics, and social behaviors are key predictors of water-transmitted diseases in the two districts. In the industrial township, poor housing, larger household size, and poor excreta disposal habits increased the occurrence of diseases, while in urbanizing districts, higher household size, frequently eating out, and access to public taps significantly increased the occurrence of water-transmitted diseases. The study, which was carried out in a challenging institutional environment, highlights the need for Uzbekistan to focus their policies on environmental hygiene, demographic factors and social behavior as key interventions rather than merely on on-site drinking water and sanitation interventions.