Increase in Diarrheal Disease Associated with Arsenic Mitigation in Bangladesh

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Citation

Wu, Jianyong; van Geen, Alexander; Ahmed, Kazi Matin; Akita, Yasuyuki; Alam, Md. Jahangir; Culligan, Patricia J.; Escamilla, Veronica; Feighery, John; Ferguson, Andrew S.; & Knappett, Peter S. K., et al. (2011). Increase in Diarrheal Disease Associated with Arsenic Mitigation in Bangladesh. PLOS ONE, 6(12), e29593. PMCID: PMC3247276

Abstract

BACKGROUND: Millions of households throughout Bangladesh have been exposed to high levels of arsenic (As) causing various deadly diseases by drinking groundwater from shallow tubewells for the past 30 years. Well testing has been the most effective form of mitigation because it has induced massive switching from tubewells that are high (>50 microg/L) in As to neighboring wells that are low in As. A recent study has shown, however, that shallow low-As wells are more likely to be contaminated with the fecal indicator E. coli than shallow high-As wells, suggesting that well switching might lead to an increase in diarrheal disease.
METHODS: Approximately 60,000 episodes of childhood diarrhea were collected monthly by community health workers between 2000 and 2006 in 142 villages of Matlab, Bangladesh. In this cross-sectional study, associations between childhood diarrhea and As levels in tubewell water were evaluated using logistic regression models.
RESULTS: Adjusting for wealth, population density, and flood control by multivariate logistic regression, the model indicates an 11% (95% confidence intervals (CIs) of 4-19%) increase in the likelihood of diarrhea in children drinking from shallow wells with 10-50 microg/L As compared to shallow wells with >50 microg/L As. The same model indicates a 26% (95%CI: 9-42%) increase in diarrhea for children drinking from shallow wells with 50 microg/L As.
CONCLUSION: Children drinking water from shallow low As wells had a higher prevalence of diarrhea than children drinking water from high As wells. This suggests that the health benefits of reducing As exposure may to some extent be countered by an increase in childhood diarrhea.

URL

http://dx.doi.org/10.1371/journal.pone.0029593

Reference Type

Journal Article

Year Published

2011

Journal Title

PLOS ONE

Author(s)

Wu, Jianyong
van Geen, Alexander
Ahmed, Kazi Matin
Akita, Yasuyuki
Alam, Md. Jahangir
Culligan, Patricia J.
Escamilla, Veronica
Feighery, John
Ferguson, Andrew S.
Knappett, Peter S. K.
Mailloux, Brian J.
McKay, Larry D.
Serre, Marc L.
Streatfield, Peter Kim
Yunus, Mohammad
Emch, Michael E.

PMCID

PMC3247276

ORCiD

Emch - 0000-0003-2642-965X