Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.

<h4>Background</h4>As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenu...

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Autores principales:	Katherine Penrose, Marcia Caldas de Castro, Japhet Werema, Edward T Ryan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/3ec058a3c1bd4906b8aa059c7dcbf0e4
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spelling	oai:doaj.org-article:3ec058a3c1bd4906b8aa059c7dcbf0e42021-11-25T06:33:39ZInformal urban settlements and cholera risk in Dar es Salaam, Tanzania.1935-27271935-273510.1371/journal.pntd.0000631https://doaj.org/article/3ec058a3c1bd4906b8aa059c7dcbf0e42010-03-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20300569/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania.<h4>Methodology/principal findings</h4>Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km(2) in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest.<h4>Conclusions/significance</h4>Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand.Katherine PenroseMarcia Caldas de CastroJaphet WeremaEdward T RyanPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 4, Iss 3, p e631 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Katherine Penrose Marcia Caldas de Castro Japhet Werema Edward T Ryan Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
description	<h4>Background</h4>As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania.<h4>Methodology/principal findings</h4>Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km(2) in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest.<h4>Conclusions/significance</h4>Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand.
format	article
author	Katherine Penrose Marcia Caldas de Castro Japhet Werema Edward T Ryan
author_facet	Katherine Penrose Marcia Caldas de Castro Japhet Werema Edward T Ryan
author_sort	Katherine Penrose
title	Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
title_short	Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
title_full	Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
title_fullStr	Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
title_full_unstemmed	Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
title_sort	informal urban settlements and cholera risk in dar es salaam, tanzania.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/3ec058a3c1bd4906b8aa059c7dcbf0e4
work_keys_str_mv	AT katherinepenrose informalurbansettlementsandcholerariskindaressalaamtanzania AT marciacaldasdecastro informalurbansettlementsandcholerariskindaressalaamtanzania AT japhetwerema informalurbansettlementsandcholerariskindaressalaamtanzania AT edwardtryan informalurbansettlementsandcholerariskindaressalaamtanzania
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Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.

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