Peruvian children with inadequate water supplies and
sanitation were found to be shorter and had more episodes
of diarrhea, according to research from the Johns Hopkins
Bloomberg School of Public
Health and other institutions. Past studies have shown
that improvements to water supply and sanitation benefit
health and improve life expectancy in industrialized
countries, but the effect on long-term growth is less
clear. The study is published in the Jan. 10 issue of
The Lancet.
Lead author William Checkley, an associate in the
school's Department of
International Health, said, "The public health
challenges of unsafe water and inadequate sanitation have
plagued humanity for centuries and will continue to do so
unless governments make water and sanitation infrastructure
improvements one of their first priorities. The poor in
most of the developing world either pay more for their
access to water or have to travel farther distances to
obtain water."
Between April 1995 and December 1998, researchers
recruited 230 children at birth from Pampas de San Juan, a
community in Lima, Peru, to assess the effects of water and
sanitation on linear growth, diarrheal disease and
prevalence of parasites. Follow-up with the children was
done once a day for diarrhea and once a month for height
measurements. Household water and sanitation levels were
obtained at the initial recruitment of the children.
Children at 2 years of age with the worst conditions
for water source, water storage and sanitation were found
to be 1 centimeter shorter and had 54 percent more
diarrheal incidents than those children with the best
conditions. A height deficit of 0.9 centimeter was also
associated with a lack of adequate sewage disposal. The
researchers found that a better water source alone did not
provide full health benefits. Those children with a water
connection but without adequate sewage disposal were 1.8
centimeter shorter than children in households with sewage.
These results suggest that more reliable water sources
would discourage water storage, which puts the water at
risk of being contaminated, and consequently decrease
diarrheal occurrences and improve growth in children.
"Better water supply alone does not guarantee full
health benefits; our findings underscore the importance of
adequate sanitation facilities in developing countries to
reduce childhood malnutrition and diarrhea," Checkley said.
"We must not fail to recognize that access to safe water
and adequate sanitation is not a privilege but a basic
human right."
The study was funded by the National Research Service
Award of the National Institutes of Child Health and
Development, an ICTDR grant of the National Institute of
Allergy and Infectious Diseases and the charitable RG-ER
fund.
Co-authors of the study from Johns Hopkins were Robert
H. Gilman, Robert E. Black and Lawrence H. Moulton.