Finding Safe Drinking Water to Mitigate Arsenic Contamination: Tube Wells, Storage, and Diarrhea

Keywords: Medical Geography, infectious disease, spatial epidemiology, disease ecology, water quality
Abstract Type: Paper Abstract

Abstract

This study provides an assessment of whether deep tube wells installed through arsenic mitigation programs are a safe drinking water source in areas where there is a groundwater arsenic problem. A household survey was administered to determine water source, use, storage, hygiene, and sanitation practices. The microbial water quality of tube wells and household water storage containers was measured for the presence and concentrations of E. coli as fecal indicator bacteria. We implemented a community diarrheal disease surveillance across 142 villages in Matlab, Bangladesh. We found that microbial quality of drinking water at point of use is significantly worse for deep tubewell users than for shallow tubewell users. We also found that there is a distance decay effect, that households that had to walk further to obtain their water had worse water quality because they store their water longer. Deep tubewell use was associated with lower childhood diarrhea. Children in households using tubewells in neighborhoods where more than 60% of households used deep tubewells had significantly lower odds of diarrhea compared to those in neighborhoods with lower deep tubewell use. These results suggest that although deep tubewell use may have additional positive health benefits, those benefits are not equally distributed, and increasing density of deep tubewells can further reduce childhood diarrheal disease burden in rural Bangladesh and beyond. This study highlights the importance of incorporating spatial context in research on population health interventions.