Influence of Seasonal Hazards on Water, Sanitation, and Hygiene–Related Behavior and Implications for Cholera Transmission in Bangladesh
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Influence of Seasonal Hazards on Water, Sanitation, and Hygiene–Related Behavior and Implications for Cholera Transmission in Bangladesh. / Grant, Stephen Lawrence; Lange, Sina; Almeida, Sara; Hoque, Bilqis; Jensen, Peter Kjær Mackie.
In: American Journal of Tropical Medicine and Hygiene, Vol. 108, No. 3, 2023, p. 518-523.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Influence of Seasonal Hazards on Water, Sanitation, and Hygiene–Related Behavior and Implications for Cholera Transmission in Bangladesh
AU - Grant, Stephen Lawrence
AU - Lange, Sina
AU - Almeida, Sara
AU - Hoque, Bilqis
AU - Jensen, Peter Kjær Mackie
N1 - Publisher Copyright: Copyright © 2023 The American Society of Tropical Medicine and Hygiene.
PY - 2023
Y1 - 2023
N2 - Most cholera outbreaks in Bangladesh are seasonal, peaking in the dry and post-monsoon periods. Therefore, we investigated whether changes in water, sanitation, and hygiene (WASH) behavior in three populations in Bangladesh during the year could help explain why these two periods are particular to cholera transmission. The study used a mixed-method design, including a repeated cross-sectional study, focus group discussions, and key informant interviews. Through a repeated cross-sectional study, WASH-related variables were assessed during the dry, monsoon, and control seasons in 600 households from coastal Satkhira, inland Sirajganj, and the Dhaka slums. Seasonal behavioral changes were observed in all study areas. Dhaka and Satkhira had an increased mean distance to water sources during the dry and monsoon seasons (Dhaka: control season, 12 m [95% CI, 11–13]; dry season, 36 m [95% CI, 18–55]; and monsoon season, 180 m [95% CI, 118–243]; Satkhira: control season, 334 m [95% CI, 258–411]; dry season, 669 m [95% CI, 515–822]; and monsoon season, 2,437 m [95% CI, 1,665–3,209]). The participants attributed this to pollution of the usual water source. Perceived water quantity was lowest during the dry season in Dhaka and Sirajganj, and during the monsoon season in Satkhira. Handwashing with soap declined in all areas during the dry and monsoon seasons. Open defecation was frequent among children younger than 5 years, increasing during seasonal climate hazards. Results show that WASH-related behavior changed seasonally, increasing the risk of cholera transmission through multiple hygiene-related transmission pathways. Future research would benefit by ensuring that the length of studies covers all seasons throughout the year and also by looking in more detail at people’s behavior and hygiene practices.
AB - Most cholera outbreaks in Bangladesh are seasonal, peaking in the dry and post-monsoon periods. Therefore, we investigated whether changes in water, sanitation, and hygiene (WASH) behavior in three populations in Bangladesh during the year could help explain why these two periods are particular to cholera transmission. The study used a mixed-method design, including a repeated cross-sectional study, focus group discussions, and key informant interviews. Through a repeated cross-sectional study, WASH-related variables were assessed during the dry, monsoon, and control seasons in 600 households from coastal Satkhira, inland Sirajganj, and the Dhaka slums. Seasonal behavioral changes were observed in all study areas. Dhaka and Satkhira had an increased mean distance to water sources during the dry and monsoon seasons (Dhaka: control season, 12 m [95% CI, 11–13]; dry season, 36 m [95% CI, 18–55]; and monsoon season, 180 m [95% CI, 118–243]; Satkhira: control season, 334 m [95% CI, 258–411]; dry season, 669 m [95% CI, 515–822]; and monsoon season, 2,437 m [95% CI, 1,665–3,209]). The participants attributed this to pollution of the usual water source. Perceived water quantity was lowest during the dry season in Dhaka and Sirajganj, and during the monsoon season in Satkhira. Handwashing with soap declined in all areas during the dry and monsoon seasons. Open defecation was frequent among children younger than 5 years, increasing during seasonal climate hazards. Results show that WASH-related behavior changed seasonally, increasing the risk of cholera transmission through multiple hygiene-related transmission pathways. Future research would benefit by ensuring that the length of studies covers all seasons throughout the year and also by looking in more detail at people’s behavior and hygiene practices.
U2 - 10.4269/ajtmh.21-0708
DO - 10.4269/ajtmh.21-0708
M3 - Journal article
C2 - 36689946
AN - SCOPUS:85149171046
VL - 108
SP - 518
EP - 523
JO - Journal. National Malaria Society
JF - Journal. National Malaria Society
SN - 0002-9637
IS - 3
ER -
ID: 342055566