Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000

Lewin, Simon, Norman, Rosana, Nannan, Nadine, Thomas, Elizabeth, & Bradshaw, Debbie (2007) Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000. South African Medical Journal, 97(8), pp. 755-762.

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Abstract

Objectives

To estimate the burden of disease attributable to unsafe water, sanitation and hygiene (WSH) by age group for South Africa in 2000.

Design

World Health Organization comparative risk assessment methodology was used to estimate the disease burden attributable to an exposure by comparing the observed risk factor distribution with a theoretical lowest possible population distribution. A scenario-based approach was applied for estimating diarrhoeal disease burden from unsafe WSH. Six exposure scenarios were defined based on the type of water and sanitation infrastructure and environmental faecal-oral pathogen load. For ‘intestinal parasites’ and schistosomiasis, the burden was assumed to be 100% attributable to exposure to unsafe WSH.

Setting

South Africa.

Outcome measures

Disease burden from diarrhoeal diseases, intestinal parasites and schistosomiasis, measured by deaths and disability-adjusted life years (DALYs).

Results

13 434 deaths were attributable to unsafe WSH accounting for 2.6% (95% uncertainty interval 2.4 - 2.7%) of all deaths in South Africa in 2000. The burden was especially high in children under 5 years, accounting for 9.3% of total deaths in this age group and 7.4% of burden of disease. Overall, the burden due to unsafe WSH was equivalent to 2.6% (95% uncertainty interval 2.5 - 2.7%) of the total disease burden for South Africa, ranking this risk factor seventh for the country.

Conclusions

Unsafe WSH remains an important risk factor for disease in South Africa, especially in children under 5. High priority needs to be given to the provision of safe and sustainable sanitation and water facilities and to promoting safe hygiene behaviours, particularly among children.

Impact and interest:

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18 citations in Web of Science®

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ID Code: 80235
Item Type: Journal Article
Refereed: Yes
Additional Information: Research with the South African Comparative Risk
Assessment Collaborating Group
Keywords: Unsafe water, Sanitation, Hygiene, South Africa, Burden of disease
ISSN: 2078-5135
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Environmental and Occupational Health and Safety (111705)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Epidemiology (111706)
Australian and New Zealand Standard Research Classification
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2007 Health & Medical Publishing Group
Deposited On: 27 Jan 2015 02:05
Last Modified: 30 Jan 2015 01:02

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