Daily Archives: November 16, 2011

American Water wants people to drink tap water, of course

Environmental activism takes many forms. Here, an investor owned company makes a pitch for people to ditch  bottles and drinking tap water (which I generally agree with)….but their primary reason is because bottled water containers causes waste….use energy, and with the underlying implication that it causes global warming, etc…..Of course, they sell drinking water too, and would be glad to sell you some……I do indeed drink tap water and  bottled water does indeed cost more…..but attacking bottled water product in this way does not make a good case for the benefits of tap water….and just like not all bottled water is alike….not all tap water is alike…..When there is tap water contamination, guess what people drink?….bottled water!

Kone-Coulibaly et al 2010: Risk factors associated with cholera in Harare City, Zimbabwe, 2008.

A Kone-Coulibaly, M Tshimanga, G Shambira, NT Gombe, A Chadambuka, P Chonzi, S Mungofa. Risk factors associated with cholera in Harare City, Zimbabwe, 2008. East African Journal of Public Health. Vol. 4, No. 4 (2010)

Objective: Two suspected cholera cases at Beatrice Road Infectious Diseases Hospital were reported to Harare City Health on 14 October 2008 setting in motion investigation and control measures. We determined the extent of the epidemic and risk factors for contracting cholera.

Methods: An unmatched 1:1 case-control study was conducted. Case: Any resident of Harare City, 2years and above, with acute watery diarrhoea, with or without vomiting from 30 October 2008 to 01 December 2008. Control: Any resident of Harare City, 2years and above, neighbour to a case, who did not contract cholera during the same period.

Results: From 14 October 2008 to 21 January 2009, 11203 cases and case fatality rate (CFR)= 3.98%. We interviewed 140 cases and 140 controls. Median age was 28years (Q1= 20; Q3= 37.5) and 28.5years (Q1= 23; Q3= 38) for cases and controls respectively. Having a diarrhoea contact at home [AOR= 12.02; 95% CI (5.46 – 26.44)], having attained less than secondary education [AOR= 4.40; 95% CI (2.28 – 8.48)]; eating cold food [AOR= 4.24; 95% CI (1.53 – 11.70)] were independent risk factors while drinking tap water [AOR= 0.05; 95% CI (0.03 – 0.11)], washing hands after using toilet [AOR= 0.19; 95% CI (0.09 – 0.39)]; eating hot food always [AOR= 0.29; 95% CI (0.17 – 0.49)] were independently protective.

Discussion: The high CFR may be due to poor case management and staff shortage in treatment camps. The cholera outbreak in Harare resulted from poor personal and hygiene practices that occur when water supplies are cut. Lack of water, low knowledge on cholera prevention measures and delays in community health education campaigns contributed to the protracted outbreak. Having a diarrhoea contact at home increases chances of household members acquiring infection. Provision of safe drinking water, community health education, recruitment of staff and training of health workers on cholera case management must be prioritized.