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Environmental interventions in developing countries: interactions and their implications

J VanDerslice1, J Briscoe

  • 1University of Texas Health Science Center at Houston, School of Public Health.

American Journal of Epidemiology
|January 15, 1995
PubMed
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Improving drinking water quality and sanitation significantly reduces diarrheal disease in infants. Environmental factors are key, with combined improvements offering the greatest health benefits in developing nations.

Area of Science:

  • Environmental Health
  • Infectious Disease Epidemiology
  • Public Health Interventions

Background:

  • Diarrheal diseases remain a major cause of infant mortality globally.
  • Environmental factors, including water quality and sanitation, are critical determinants of diarrheal disease incidence.
  • Understanding the interplay between water quality and sanitation is essential for effective public health strategies.

Purpose of the Study:

  • To assess the impact of drinking water quality on diarrheal disease among Filipino infants.
  • To evaluate the influence of varying sanitary conditions (household and community) on this relationship.
  • To determine the effectiveness of specific water and sanitation interventions in reducing infant diarrhea.

Main Methods:

  • A random sample of 2,355 Filipino infants was studied over their first year of life.
Keywords:
Age FactorsBiologyDemographic FactorsDeveloping CountriesDiarrheaDiarrhea, InfantileDiseasesHealthInfantNatural ResourcesPopulationPopulation CharacteristicsPublic HealthRisk FactorsSanitationWater SupplyYouth

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  • Data collected included drinking water quality parameters and sanitation indicators at household and community levels.
  • Statistical analyses were employed to determine the significance and magnitude of effects.

    • Main Results:

    • Both water quality and sanitation (household and community) showed strong, consistent, and statistically significant effects on diarrheal disease.
    • Improved water quality had a greater positive impact under good sanitary conditions, particularly when sanitation was measured at the community level.
    • Reducing fecal coliforms by two orders of magnitude in areas with better community sanitation could decrease diarrhea by 40%; improved excreta disposal could reduce it by 30-42%.

    Conclusions:

    • Improvements in both drinking water supply and sanitation are crucial for enhancing infant health in developing countries.
    • The effectiveness of water quality interventions is significantly moderated by the level of existing sanitation.
    • Behavioral, institutional, and economic factors should guide the prioritization of public health interventions.