Multiscalar Evaluation of the Water Distribution System and Diarrheal Disease Risk in Addis Ababa, Ethiopia

Leon M. Espira, Brook Gessese, Bayable A. Kassa, Chia Chen Wu, Joshua Riley, Seifedin Bedru, Geremew Sahilu, Adey Desta, Kaleab Baye, Andrew D. Jones, Nancy G. Love*, Joseph N.S. Eisenberg*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Despite growing urbanization, our understanding of the impacts of water and sanitation on human health has largely come from studies in rural sectors. To this end, we collected data at both regional (water quality measures from water treatment systems) and community (cross-sectional surveys) scales to examine determinants of enteric pathogen infection and diarrheal disease among infants in Addis Ababa, Ethiopia. Regionally, the Legedadi water treatment plant had significantly lower heterotrophic plate counts, total coliform counts, and fecal coliform counts compared with the Gefersa water treatment plant. The number of pathogen types in infant stool also differed by plant. Decreases in chlorine levels and increases in the relative abundance of Gammaproteobacteria with distance from treatment plants suggest a compromised water distribution system. In communities, infants in households that obtained water from yard pipes or public taps had significantly lower odds of diarrhea compared to households that had water piped into their dwellings (OR = 0.35, 95% CI 0.16, 0.76, and OR = 0.39, 95% CI 0.15, 1.00, respectively). Similarly, infants in households that boiled or filtered water had significantly lower odds of diarrhea compared to households that did not treat water (OR = 0.40, 95% CI 0.19, 0.86 and OR = 0.23, 95% CI 0.06, 0.84, respectively). Integrating multiscalar data better informs the health impacts of water in urban settings.

Original languageEnglish
Pages (from-to)13313-13324
Number of pages12
JournalEnvironmental Science and Technology
Volume57
Issue number36
DOIs
StatePublished - 12 Sep 2023

Keywords

  • diarrhea
  • indicator organisms
  • microbiome
  • stool pathogen diversity
  • water distribution system

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