%0 Journal Article
%T Improvements to water purification and sanitation infrastructure may reduce the diarrheal burden in a marginalized and flood prone population in remote Nicaragua
%A Sheri A Denslow
%A Jess Edwards
%A Jennifer Horney
%A Rodolfo PeŁża
%A Daniel Wurzelmann
%A Douglas Morgan
%J BMC International Health and Human Rights
%D 2010
%I BioMed Central
%R 10.1186/1472-698x-10-30
%X A population-based, cross-sectional survey of women of reproductive age was conducted in the Sahsa region of northern Nicaragua in July, 2009. Households were selected by two stage cluster sampling methodology. A questionnaire was administered in Spanish and Miskito with assessment of household and socioeconomic conditions, sanitation practices, and health care access. Diarrhea prevalence differences at the household level over a two week reporting period were estimated with a standardized instrument which included assessment of water treatment and latrine use and maintenance.There were 189 women enrolled in the current study. The use of water purification methods, such as chlorine and filters, and latrine ownership were not associated with reduced prevalence of household diarrhea in the two week reporting period. Latrine overflow, however, was associated with an increased prevalence of diarrhea during the same two week period [adjusted prevalence difference and 95% CI: 0.19 (0.03, 0.36)].Simple, low cost interventions that improve water and latrine infrastructure may reduce the prevalence of diarrheal disease in the isolated regions of Nicaragua and Central America.Diarrhea remains a major health burden in resource limited nations, contributing substantially to morbidity and mortality. It is estimated that worldwide diarrheal disease leads to 1.87 million deaths each year in children under five, accounting for 19% of the total deaths in this age group[1]. Nearly 80% of these deaths occur in developing nations. Diarrheal illness is common in Nicaragua, particularly in the North Atlantic Autonomous Region (Regi¨®n Aut¨®noma del Atl¨˘ntico Norte, RAAN) province, where household sanitation measures are not in common use. The Nicaraguan Ministry of Health (MINSA) has found that the RAAN has one of the highest incidences of diarrheal disease in Nicaragua. Mortality due to diarrhea accounts for 7.3% of deaths per year in the RAAN, compared to 1 - 2% of deaths in other region
%U http://www.biomedcentral.com/1472-698X/10/30