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Sep 19, 2007Article Details
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Main Article Content
Estimating the burden of disease attributable to unsafe water and lack of sanitation and hygiene in South Africa in 2000
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.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 755-762
