Influence of Latrine Proximity and Type on Tubewell Water Quality and Diarrheal Disease in Bangladesh.

Diarrheal diseases are endemic in Bangladesh, where sanitation is poor, and untreated drinking water extracted from shallow (<43 m) tubewells could partially contribute to disease propagation. This study measures the effects of local population–environment context on tubewell water quality and diarrheal disease incidence. The study site includes six villages in Matlab, Bangladesh, with approximately 12,000 residents. Study data include monthlyEscherichia coliconcentrations for 100 wells, monthly diarrheal events for all children under five, and a detailed water and sanitation infrastructure database created through a submeter accuracy Global Positioning System survey. We developed sanitation metrics to measure the relationship between tubewell water fecal contamination and estimates of human fecal loadings at varying scales. The relationship between childhood diarrhea andE. coliin drinking water was measured for households that obtained drinking water from survey wells. Results show that tubewells surrounded by unsanitary latrines, latrine-polluted ponds, and higher population densities were more frequently contaminated with fecal coliforms. The analysis also showed that poor sanitation infrastructure might affect childhood diarrheal disease via tubewell contamination. Our findings shed light on the importance of integrating population and environment data to identify circumstances in which shallow well water quality is compromised and children are put at risk of contracting diarrheal diseases. Sanitation interventions should highlight the spatial separation of latrines and drinking water wells to limit contamination. [ABSTRACT FROM PUBLISHER]