Association of water quality with soil-transmitted helminthiasis and diarrhea in Nueva Santa Rosa, Guatemala, 2010

• Published in: Journal of water and health 2018-10, Vol.16 (5), p.724-736
• Main Authors: Matanock, Almea, Lu, Xin, Derado, Gordana, Cuéllar, Victoria M, Juliao, Patricia, Alvarez, Maricruz, López, Beatriz, Muñoz, Fredy, Thornton, Andrew, Patel, Jaymin C, Lopez, Gerard, Reyes, Lissette, Arvelo, Wences, Blackstock, Anna J, Lindblade, Kim A, Roy, Sharon L
• Format: Article
• Language: English
• Subjects: Animals; Ascaris; Censuses; Chemotherapy; Concentrators; Confidence intervals; Control programs; Cross-Sectional Studies; Diarrhea; Diarrhea - epidemiology; Disease; Drinking water; E coli; Environmental Exposure; Escherichia coli; Estimates; Guatemala - epidemiology; Health surveillance; Helminthiasis; Helminthiasis - epidemiology; Households; Humans; Hygiene; Infections; Mortality; Parasites; Population; Prevalence; Prevention; Public health; Quality assessment; Regression analysis; Regression models; Sanitation; Soil; Soil water; Statistical analysis; Surveying; Systematic review; Water purification; Water Quality; Water quality assessments; Water treatment
• ISSN: 1477-8920; 1996-7829
• DOI: 10.2166/wh.2018.207

Improved water quality reduces diarrhea, but the impact of improved water quality on Ascaris and Trichuris, soil-transmitted helminths (STH) conveyed by the fecal-oral route, is less well described. To assess water quality associations with diarrhea and STH, we conducted a cross-sectional survey in households of south-eastern Guatemala. Diarrhea was self-reported in the past week and month. STH was diagnosed by stool testing using a fecal parasite concentrator method. We explored associations between Escherichia coli-positive source water (water quality) and disease outcomes using survey logistic regression models. Overall, 732 persons lived in 167 households where water was tested. Of these, 79.4% (581/732) had E. coli-positive water, 7.9% (58/732) had diarrhea within the week, 14.1% (103/732) had diarrhea within the month, and 6.6% (36/545) tested positive for Ascaris or Trichuris, including 1% (6/536) who also reported diarrhea. Univariable analysis found a statistically significant association between water quality and STH (odds ratio [OR] = 5.1, 95% confidence interval [CI] = 1.1-24.5) but no association between water quality and diarrhea. Waterborne transmission and effects of water treatment on STH prevalence should be investigated further. If a causal relationship is found, practices such as household water treatment including filtration might be useful adjuncts to sanitation, hygiene, and deworming in STH control programs.