Impact of a city-wide sanitation intervention in a large urban centre on social, environmental and behavioural determinants of childhood diarrhoea: analysis of two cohort studies.

Background: Poor socioeconomic status (SES) increases diarrhoea risk, mostly mediated by lack of sanitation, poor infrastructure and living conditions. The effectiveness of a city-wide sanitation intervention on diarrhoea in a large urban centre in Northeast Brazil has recently been demonstrated. This article aims to explore how this intervention altered the magnitude of relative and attributable risks of diarrhoea determinants and the pathways by which those factors affect diarrhoea risk.

Effect of city-wide sanitation programme on reduction in rate of childhood diarrhoea in northeast Brazil: assessment by two cohort studies.

Background: A city-wide sanitation intervention was started in Salvador, Brazil, in 1997 to improve sewerage coverage from 26% of households to 80%. Our aim was to investigate the epidemiological effect of this city-wide sanitation programme on diarrhoea morbidity in children less than 3 years of age.

Methods: The investigation was composed of two longitudinal studies done in 1997-98 before the intervention (the sanitation programme) and in 2003-04 after the intervention had been completed.