Diarrheal disease risk in Matlab, Bangladesh.

The objective of this research project is to assess risk for diarrheal disease in rural Bangladesh by analyzing the complex and dynamic interaction of biological, socioeconomic, cultural/behavioral and environmental factors over time and space. Risk factors of cholera and non-cholera water diarrheal disease are calculated to compare the relative importance of risk for several independent variables. Diarrheal disease data were collected for people who were hospitalized at the International Centre for Diarrhoeal Disease Research (ICDDR) hospital from January 1, 1992 to December 31, 1994. Using laboratory and hospital records, cases were assigned to one of two diarrhea disease categories (cholera or non-cholera watery diarrhea) that were used as dependent variables in the analysis stage of the research. Age-matched individuals were randomly chosen from the community to be controls. Information was collected for independent variables that were hypothesized to be related to watery diarrhea. This information was collected by administering questionnaires, obtaining secondary data from the ICDDR's demographic surveillance system records and community health worker record books and calculating variables using a geographic information system database. Sanitation and water availability and use are extremely important in the effort to reduce secondary cholera and non-cholera, watery diarrhea transmission. Water use and availability variables were more important for non-cholera watery diarrheal risk than for cholera but nevertheless they were important for both. Socioeconomic status is an important indirect cause of both of these diseases because poverty is the root cause of many of the other variables, such as lack of sanitation and clean water. Flood-control was related to both types of diarrhea but it is not understood why. Since the Bangladesh Flood Action Plan will continue to build and maintains flood-control embankments, it is important to investigate whether there is a pattern to this relationship throughout the country and to investigate why the relationship exists.