Article Category:
Research Article

Changing Water-Sanitation Determinants of Cholera over Two Decades in Bangladesh

Mohammad Habibur Rahman Sarker International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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Sumon Kumar Das Menzies School of Health Research, Charles Darwin University, Darwin, Australia;

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Hasnat Sujon International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;
Infectious Disease and One Health Program, Hannover Medical School, Hannover, Germany;

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Michiko Moriyama Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;

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Md Moshiur Rahman Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;

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Md. Nazim Uzzaman International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;
Usher Institute, University of Edinburgh, Edinburgh, United Kingdom;

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Shakila Banu International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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Abu SMSB Shahid International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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Jui Das Institute for Social Science Research, The University of Queensland, Brisbane, Australia

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Soroar Hossain Khan International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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Mohammod Jobayer Chisti International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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ASG Faruque International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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Tahmeed Ahmed International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;

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DOI:
https://doi.org/10.4269/ajtmh.22-0575
Volume/Issue:
Volume 109: Issue 2
Page(s):
368–375
Restricted access
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ABSTRACT.

Cholera is a leading global public health threat, especially in developing countries. This study aimed to determine the changing determinants of cholera related to water-sanitation practices between 1994–1998 and 2014–2018 in Dhaka, Bangladesh. Data of all cause diarrhea cases were extracted from the Diarrheal Disease Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, and analysis was performed among three groups: Vibrio cholerae detected as sole pathogen, V. cholerae detected as mixed infection, and detection of no common enteropathogen in stool specimens (reference). Using sanitary toilet, drinking tap water, drinking boiled water, family size greater than five, and slum dwelling were the main exposures. Overall, 3,380 (20.30%) and 1,290 (9.69%) patients were positive for V. cholerae during 1994–1998 and 2014–2018, respectively. In 1994–1998, use of sanitary toilet (adjusted odds ratio [aOR]: 0.86, 95% CI: 0.76–0.97) and drinking tap water (aOR: 0.81, 95% CI: 0.72–0.92) were found to be negatively associated and in 2014–2018, drinking tap water (aOR: 1.47, 95% CI: 1.21–1.78) and slum dwelling (aOR: 1.43, 95% CI: 1.10–1.86) were found to be positively associated with V. cholerae infection after adjusting for age, sex, monthly income, and seasonality. Because the determinants of cholera such as drinking tap water can change over time in developing cities, ameliorating the water, sanitation, and hygiene (WASH) situation is of paramount importance. In addition, in settings such as urban slums, where long-term WASH monitoring might be difficult to achieve, mass vaccination with oral cholera vaccine should be introduced to control cholera.

Author Notes

Address correspondence to Mohammod Jobayer Chisti, Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh. E-mail: chisti@icddrb.org

Financial support: The authors did not receive specific funding for this study. Hospital surveillance, however, is funded by International Centre for Diarrhoeal Disease Research, Bangladesh and the Government of the People’s Republic of Bangladesh through IHP-HNPRP. International Centre for Diarrhoeal Disease Research, Bangladesh is also grateful to the Governments of Bangladesh, Canada, Sweden, and the United Kingdom for providing core/unrestricted support. The funding agency had no role in collecting, analyzing, or interpreting the results.

Disclosure: The Diarrheal Disease Surveillance System of International Center for Diarrheal Disease Research, Bangladesh (icddr,b) is a routine ongoing activity of the Dhaka Hospital that has been approved by the Research Review Committee and Ethical Review Committee of icddr,b.

Authors’ addresses: Mohammad Habibur Rahman Sarker, Shakila Banu, Abu SMSB Shahid, Soroar Hossain Khan, Mohammod Jobayer Chisti, ASG Faruque, and Tahmeed Ahmed, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh, E-mails: habibur.rahman@icddrb.org, shakila@icddrb.org, sayeem@icddrb.org, soroar@icddrb.org, chisti@icddrb.org, gfaruque@icddrb.org, and tahmeed@icddrb.org. Sumon Kumar Das, Menzies School of Health Research, Charles Darwin University, Darwin, Australia, E-mail: dassumonkumar1@gmail.com. Hasnat Sujon, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh, and Infectious Disease and One Health Program, Hannover Medical School, Hannover, Germany, E-mail: hasnatsujon@gmail.com. Michiko Moriyama and Md. Moshiur Rahman, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan, E-mails: morimich@hiroshima-u.ac.jp and moshiur@hiroshima-u.ac.jp. Md. Nazim Uzzaman, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh, and Usher Institute, University of Edinburgh, Edinburgh, United Kingdom, E-mail: m.n.uzzaman@sms.ed.ac.uk. Jui Das, Institute for Social Science Research, The University of Queensland, Brisbane, Australia, E-mail: jui.das@uq.net.au.

Copyright:
© American Society of Tropical Medicine and Hygiene 2023
Received:
04 Sep 2022
|
Accepted:
10 Mar 2023
|
Published Online:
05 Jun 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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