Urban Sprawl, Water Insecurity, and Enteric Diseases in Children from Mexico City
An ecosystem approach was adopted to investigate the interactions among anthropogenic habitat alterations, overcrowding, water insecurity, and enteric diseases in young children in Mexico City. A geographic information system (GIS) was used to define eligible wells and surrounding homesteads. Water quality was obtained from previously published investigations, and bacterial indicators included fecal coliforms and fecal streptococci. A cross-sectional survey was conducted during the rainy season 2002. A total of 1250 eligible households were visited on a random sample basis, and only those with children younger than 5 years of age were interviewed. Data on diarrheal disease (with a recall period of the last 2 weeks) were obtained from 950 children, and their guardians also provided information on housing, water supply, sanitation, and socioeconomic variables. The study found that the risk of diarrheal diseases was higher in children from the households that received drinking water from contaminated wells than from clean wells (odds ratio [OR], 1.7, 95% confidence interval [CI], 1.00–2.86). The final analysis showed that the rate of diarrhea was higher in children from nonowned homes than in those living in owned dwellings (OR, 1.7, 95% CI, 1.04–2.77), the risk was also higher in children from houses with poor sanitation facilities (e.g., latrines or septic tank) than in those from houses connected to a sewage disposal system (OR, 1.7, 95% CI, 1.00–2.93). Children from households perceiving unpleasant characteristics of drinking water showed a higher risk than those without complaints (OR, 2.2, 95% CI, 1.28–3.76). This approach underlines the benefits of interdisciplinary research and may contribute to environmental health protection policy.