Influence of Latrine Proximity and Type on Tubewell Water Quality and Diarrheal Disease in Bangladesh

Diarrheal diseases are endemic in Bangladesh, where sanitation is poor, and untreated drinking water extracted from shallow (<43 m) tubewells could partially contribute to disease propagation. This study measures the effects of local population–environment context on tubewell water quality and diarrheal disease incidence. The study site includes six villages in Matlab, Bangladesh, with approximately 12,000 residents. Study data include monthly Escherichia coli concentrations for 100 wells, monthly diarrheal events for all children under five, and a detailed water and sanitation infrastructure database created through a submeter accuracy Global Positioning System survey. We developed sanitation metrics to measure the relationship between tubewell water fecal contamination and estimates of human fecal loadings at varying scales. The relationship between childhood diarrhea and E.…