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      Prevalence and correlates for diarrhoea in the mountainous informal settlements of Huye town, Rwanda

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          Abstract

          Dwellers of urban informal settlements in developing countries are consistently reported to be victims of high diarrhoea prevalence. Studies have frequently reported the association between high diarrhoea prevalence and other factors, such as poor living conditions, inadequate hygiene, and sanitation in these settings. However, little is known about the dynamics of diarrhoea prevalence in mountainous urban informal settlements similar to the Rwandan context. This study was conducted in the Matyazo cell of Huye town to review the prevalence and correlates of diarrhoea. A survey of 214 households and transect walks in the neighbourhoods were conducted during the rainy and dry seasons. Logistic regression was used to analyse the survey data while the thematic analysis technique was used to analyse qualitative data. Results indicated a substantial reduction of diarrhoea prevalence from the rainy to the dry season. It was also found that the prevalence was unequally distributed in the neighbourhoods according to household location. After controlling for other household characteristics and sanitation conditions of around homes, the study indicated that households established at 1800 metres or more above sea level were protected against diarrhoea during both rainy seasons (Adjusted Odds Ratio_ AOR: .42, 95% Confidence Interval_ CI: .13-.81) and dry seasons (AOR: .58, CI: .12-.90) while households found further from the road were likely to suffer from diarrhoea during rainy seasons (AOR: 3.32, CI: 1.47-7.48) as well as in dry seasons (AOR: 1.60, CI: 1.26-4.10). Poor sanitation within and around homes was also found to be associated with the increase of diarrhoea in either season. However, the evidence was not sufficient enough to confirm a significant association between diarrhoea prevalence and other household characteristics. We believe this is due to the strength of environmental factors in mountainous settings.

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          The online version of this article (doi:10.1186/2193-1801-3-745) contains supplementary material, which is available to authorized users.

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          The influence of climate variation and change on diarrheal disease in the Pacific Islands.

          Freshwater resources are a high-priority issue in the Pacific region. Water shortage is a serious problem in many small island states, and many depend heavily on rainwater as the source of their water. Lack of safe water supplies is an important factor in diarrheal illness. There have been no previous studies looking specifically at the relationship between climate variability and diarrhea in the Pacific region. We carried out two related studies to explore the potential relationship between climate variability and the incidence of diarrhea in the Pacific Islands. In the first study, we examined the average annual rates of diarrhea in adults, as well as temperature and water availability from 1986 to 1994 for 18 Pacific Island countries. There was a positive association between annual average temperature and the rate of diarrhea reports, and a negative association between water availability and diarrhea rates. In the second study, we examined diarrhea notifications in Fiji in relation to estimates of temperature and rainfall, using Poisson regression analysis of monthly data for 1978-1998. There were positive associations between diarrhea reports and temperature and between diarrhea reports and extremes of rainfall. These results are consistent with previous research and suggest that global climate change is likely to exacerbate diarrheal illness in many Pacific Island countries.
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            Cancer Epidemiology: Principles and Methods

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              Climate Change is Likely to Worsen the Public Health Threat of Diarrheal Disease in Botswana

              Diarrheal disease is an important health challenge, accounting for the majority of childhood deaths globally. Climate change is expected to increase the global burden of diarrheal disease but little is known regarding climate drivers, particularly in Africa. Using health data from Botswana spanning a 30-year period (1974–2003), we evaluated monthly reports of diarrheal disease among patients presenting to Botswana health facilities and compared this to climatic variables. Diarrheal case incidence presents with a bimodal cyclical pattern with peaks in March (ANOVA p < 0.001) and October (ANOVA p < 0.001) in the wet and dry season, respectively. There is a strong positive autocorrelation (p < 0.001) in the number of reported diarrhea cases at the one-month lag level. Climatic variables (rainfall, minimum temperature, and vapor pressure) predicted seasonal diarrheal with a one-month lag in variables (p < 0.001). Diarrheal case incidence was highest in the dry season after accounting for other variables, exhibiting on average a 20% increase over the yearly mean (p < 0.001). Our analysis suggests that forecasted climate change increases in temperature and decreases in precipitation may increase dry season diarrheal disease incidence with hot, dry conditions starting earlier and lasting longer. Diarrheal disease incidence in the wet season is likely to decline. Our results identify significant health-climate interactions, highlighting the need for an escalated public health focus on controlling diarrheal disease in Botswana. Study findings have application to other arid countries in Africa where diarrheal disease is a persistent public health problem.
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                Author and article information

                Contributors
                duwizeye@cartafrica.org
                csokoni@yahoo.com
                ckabiru@aphrc.org
                Journal
                Springerplus
                Springerplus
                SpringerPlus
                Springer International Publishing (Cham )
                2193-1801
                16 December 2014
                2014
                : 3
                : 745
                Affiliations
                [ ]Centre for Environment, Entrepreneurship and Sustainable Development, University of Rwanda, Kigali, Rwanda
                [ ]Centre for Population Studies and Research, University of Dar es Salaam, Dar es Salaam, Tanzania
                [ ]Urbanization and wellbeing research program, African Population and Health Research Center, Nairobi, Kenya
                Article
                1492
                10.1186/2193-1801-3-745
                4320130
                25674474
                471822d5-39bc-4b95-967c-01f751637d29
                © Uwizeye et al.; licensee Springer. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 15 July 2014
                : 11 December 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2014

                Uncategorized
                sanitation status,diarrhoea,urban informal settlements,mountainous environment,neighbourhoods,rwanda

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