Impact of Water Quality Variability on Associations Between Water Quality and Water Sample Characteristics, Diarrhea Outcome, and Helminth Infection, in Northern Coastal Ecuador Öffentlichkeit
Alvarez, Alejandra (Spring 2020)
Published
Abstract
Background: Drinking water quality is vital for good health and affects health outcomes such as diarrhea and soil transmitted helminth infection. Spatiotemporal factors are known to affect water quality variability. Not as much research has been done on the variability effect of using categorical vs continuous water quality data in assessing health outcomes.
Methods: From the full dataset, randomly dropped, randomly kept and average datasets were created. Furthermore, a categorical variable for water quality was created in each dataset. Mixed effects linear and logistic regression were used to estimate associations to account for clustering by household for the households where there was more than one sample collected. Simple linear and logistic regression were used for the datasets that only had one sample per household.
Results: A total of 162 households were visited for this study Diarrhea occurred in 23% of households. Among urban households, the prevalence of diarrhea was 20.3% compared to 17.9% in rural areas. There was an association between continuous EC and diarrhea outcome in the average dataset. (OR = 1.07, 95% CI = 1.003 - 1.413). Alternatively, there was an association between categorical EC and diarrhea in the randomly kept dataset (OR = 4.659, 95% CI = 1.067 – 20.337). The prevalence of helminth infection in the entire dataset was 15.4% . Among rural households, the prevalence was 7.41% and among urban households, the prevalence was 24.4%. There was an association between continuous water quality and helminth infection in the randomly kept (OR = 1.512, 95% CI = 1.130 – 2.023) and average (OR = 1.869, 95% CI = 1.216 – 2.873) datasets. There was an association between categorical water quality and helminth in the average (OR = 5.921, 95% CI =1.144 – 30.652) and randomly kept (OR = 7.424, 95% CI = 1.859 – 29.652) datasets.
Conclusions: Datasets with one measurement for every household tend to result in statistically significant associations between water quality and health outcome. Furthermore, using categorical water quality variable may result in concluding that there is a stronger association than there actually is.
Table of Contents
Background ……………………………………………………………...……................1
Burden of disease ………………………………………………………...……...1
Association between water quality and diarrhea ……………………………...1
Association between water quality and helminth infection …………………...2
Water quality variability ………………………………………………………..3
Methods ……………………………..……………………………………………………7
Introduction ……………………………………………………………………...7
Population and sample ………………………………………………………….7
Research design ………………………………………………………………….8
Procedures ……………………………………………………………………….9
Data analysis …………………………………………………….……………...10
Ethical consideration …………………………………………………………..11
Results ……………………………………………………...…………………………...12
Descriptive statistics ……………………………………………………………15
Association between water quality and sample characteristics ……………..16
Association between water quality and health outcomes …..………………..20
Discussion ……………………………………………………..………………………..24
Limitations ….…………………………………………………………………..27
Future directions …………………………………………………………….…28
Tables and Figures ……………………………………………………………………..29
References ………………………………………………………………………………42
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Impact of Water Quality Variability on Associations Between Water Quality and Water Sample Characteristics, Diarrhea Outcome, and Helminth Infection, in Northern Coastal Ecuador () | 2020-04-29 19:11:44 -0400 |
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