Professional Documents
Culture Documents
The Spectrum of
Water-Related Disease
Transmission Processes
David Bradley
London School of Hygiene & Tropical Medicine and
Department of Zoology, University of Oxford
3.
A Waters-Eye View
2.
3.
4.
WATER-BORNE
-Classical
-Other
WATER-WASHED -Diarrhoea
-Skin & Eyes
WATER-BASED
-Percutaneous
-Oral
WATER-RELATED -Breeding
INSECT VECTORS -Biting
5. WATER-AEROSOL
The Legionella pattern of transmission does
not fit well into any of the four existing
categories, which are defined by how the
diseases are contracted. None of the others
relates to intake via the respiratory tract
l WATER-WASHED
l WATER-BASED
l WATER-RELATED
INSECT VECTORS
-Classical
-Other
-Diarrhoea
-Skin & Eyes
-Percutaneous
-Oral
-Breeding
-Biting
DOW I
DOW II
Piped Urban
128
66.0
Down, Halved
Unpiped Urban
15.4
23.7
Up, By Half
Unpiped Rural
9.7
18.3
Up, Doubled
Diarrhoea
Skin
Eyes: Trachoma
? Waterwashed Respiratory
Infections
-Classical
-Other
l WATER-WASHED -Diarrhoea
-Skin & Eyes
l WATER-BASED
-Percutaneous
-Oral
l WATER-RELATED -Breeding
INSECT VECTORS -Biting
CLASSIFICATION OF DISEASES
RELATED TO SANITATION
Excreted Load
LATENCY
PERSISTENCE
MULTIPLICATION
Infective Dose
Biology Focus
V,Pr,He Pers,Dom
II
III
IV
V
VI
No
Short
No
Examples
Rotavirus
Enterobius
No Longer Yes
Bact
P,D,W
Typhoid
Cholera
Yes Long
No
Helm Field,C
Ascaris
Hookworm
Yes [Long] Cow/Pig Helm Field
Taenia saginata
Taenia solium
Yes [Long] Aquatic Helm Water
Paragonimus
Schistosoma
Spread by excreta-related insects Some mosq.
Wuchereria
Flies. Cockroaches: several above
l
l
Where to next?
l
Limitations of Strengths
Speak to engineers; but they cannot provide the whole
solution
Show needs for behaviour change
Greater complexity of Rural and Periurban Sites
AGENDA ITEM:
l
Spatial Processes
In Control and in Service Provision
Periurban complications for interventions.
l Private Space & Public Space (Cairncross)
e.g. Who constructs & who maintains?
l Successive circles of Space (Kolsky)
l
Spatial Processes
In Disease Persistence and Emergence
l
l
l
l
l
l
l
Spatial Processes
In Disease Persistence and Emergence
l
l
l
l
l
l
l
Rwetamo
##
#
#
##
$
Z
##
#
###
#
$
##
Z
##
##
$
Z
#
#
#
#
##
###
[$
%
#
# Kaitanturegye
#
#
$
###
#
Z
#
##
##
[$
%
Z
####
#
$
##
Z
Z
##%
#
#
Z
#$#
#
###
$
#
Z####
[#
#
##
$
[##
%
#
##Z
##
##
#
Z
##
#
#
$
#
$
#
#
Z
#
#
#
Z
[###
$
[##
###
#
[##
%
Z
#
#
$
[#####
%
[
#$
Z
[#
%
#
$##
$
#%
Z
Z
Z
#
#%
##
#$
##
$
##
Z
#
#%
$
#
Z
Kasaana
bu
Mugore
Macuncu
Rugongi
R w
e n ju
Nyakasharara
Byanamira
Mooya
Mooya
Ifura
Z
####$
##$
##$
#
$
#Z
Z
#
#
Z$
Z
#
#
###$
Z
##$
#Z
#
#Z###$Z##$Z####$Z#$#Z#####$Z#$Z####$Z#
#
##$
##
#
#$
Z
#
Rugaaga
##
##
## ##
$
#
Z
##
###
$
Z
#
#$
#
$
Z##
Z
#
##
##
###
#
##
$
#
Z
#
Z
#
#
##
#
##
##
$
$
#
##
#$
$
Z###
#$
#
Z
#
Z
$
#
##
###
Z
Z
###
#$
#Z
$
$
Z
Z
# #
#
$
#$
#$
Z
##
#
##
##
##
[##
%
##
$
#
##
##
$
###
$
Z
##
#
Z
Z
#Z
#
#$
##
##
#$
$
##
#Z
Z
Z
$
ore#
$
##
#$
Z
#
Z
#
Z
#$
#
#
#
###
#
##
$
Akatong
Z
Z
#$
#
#
#
Z
##
###
#
$
#$Z$Z####
###
Z
Z
#
#
#
Z
##$
##$
#
##
##
[#####
%
$
##
#$
#Z
##
$
[##
%
#
##
Z
$
Z
$
##
Z
##
Z
##
#
$
#
$
#$
Z
Z
$
#Z
Z
##
Z
#$
$
###
#
Z
Z#
#
#
$
[##
%
###
[####
Z
[##
[#$
%
##
##%
#
##
#$Z#%
Z
$
$
Z
#
Z
#
##
Katooma
Embal e
#$
$
##$
Z
#####
###
##
###
#$
#
#
###
$
Z###$
##
#
#
Z
Z
#$
##
##
#
##
#Z
Z
$
Z
#
#
Z
##
Z
#
##
#
#$
#
Z
#
$
#$
#
#$
$
Z
###$
#
#Z
##
Z
$
###
##
Z
##
###
#
##
#
Z
Z
#
#
#
Z
####$
#
#
##
#
$$
#$
Z
#$
Z
#$
#
#
Z
#
#$
#
#$Z#Z###$Z####
Z
####
Ntuura
Kayonza
###
#
#
#
###
#
##
##
#
$
Z
#$
#
[###
%
#$
#
$
Z
##$
$
#
#### #
Z
Z####
Z
##
#
#
#
#
$
Z##
Z
$
##
Z
##
##
##
##
##
#
$##
#
$
Z
$
#
Z
Z
##$Z#$Z##### ##$Z##$Z$Z#######
S ch
#Z
#$
##$
##
Z
##
#
#
##
##
$
$
#$
Z
#
Z
Z
$
#
#
#
$
[$
#
Z
$
#
Z
#%
##
#
Z
[Z
%
#Z
$
[###
%
$
Z
Z
Kir
ibw
a
ky
ee
ra
es
uR
er
ry
ya
K an
land use
20
boarder Kakyeera
#
#
#
#
#
$
Z
[
%
#
#
#
20
40 Miles
LCI
brick burning
centre
charcoal burning
homestead (P)
homestead (S)
homestead (T)
kakyeera centre
kraal
lake
plantation
# pond
# swamp
# village
#
Nyakahita
#
Rwabarata
em
##
##
#
$
Z
$
#$
#$
#
Z
###
#$
#
Z
Z
#$
Z
Z
##
###
$
Z
#
$
Z
[###$##
%
#$
##$
##
#$
###
Z
Z
##
#
Z
Z
$
#
#
#$
Z
$
###
Z
[#
%
$
#
##
## #
Z
#
Ka
Rwemamba
N
W
E
S
Acknowledgements
Ross Institute, LSHTM
Sandy Cairncross
Richard Feachem
Pete Kolsky
Tom Clasen
Valerie Curtis
Sylvia Struck
Sanga Project, Uganda
Joseph Okello- Onen
Charles Muchunguzi
and many others