Relationship of sanitation, water boiling, and mosquito nets to health biomarkers in a rural subsistence population

Abstract

Objectives: Throughout human evolutionary history, parasites and pathogens were a major cause of mortality-modern urban life with public health infrastructure has changed disease exposure. We examine associations between boiling water, using latrines, mosquito net usage, and biomarkers among the Tsimane, a nonindustrial subsistence population with little public health infrastructure. Methods:We conducted cross sectional surveys on water, latrines, and bed nets among 507 heads of households (aged 18-92 years, median age 41 years). Regression models estimated associations between behaviors and health biomarkers (ie, white blood cell count [WBC], hemoglobin, eosinophil count, and erythrocyte sedimentation rate) adjusting for age, sex, body mass index, wealth, schooling, and distance to the nearby market town. Results: Latrine use is associated with 6.5% lower WBC count (β = −679.6, P = .031, SE = 314.1), 17.4% lower eosinophil counts (β = −244.7, P = .023, SE = 107.2), and reduced odds of eosinophilia (adjusted OR = 0.40, P < .019, 95% CI = 0.18-0.86). Boiling water and mosquito net use are not significantly associated with any biomarkers measured. Conclusions: In a subsistence population currently undergoing epidemiological transition, we find that latrine use was associated with several objective measures of health. This suggests that relatively low cost and low maintenance public health interventions may wish to focus on latrine use, as there is unmet need and potential health benefits for those who use latrines. Additionally, while the cost is higher, public health organizations aimed at improving sanitation may be able to use minimally invasive field-collected biomarkers as a diagnostic to objectively test the efficacy of interventions with greater specificity than anthropometric measurements.

Transmission‐dynamicsmodels for theSARSCoronavirus‐2

“…It is therefore surprising that there has been relatively little formal work on infectious disease dynamics and their consequences for populations and individuals embedded within populations within the fields of Human Biology and Biological Anthropology. Human biology remains concerned with the consequences of infectious disease (eg, Dinkel et al, 2020; Gurven, Kaplan, & Supa, 2007; Houldcroft, Ramond, Rifkin, & Underdown, 2017; Houldcroft & Underdown, 2016; McDade et al, 2012), but with precious few exceptions (Hazel & Jones, 2018; Hazel, Marino, & Simon, 2015; Hazel, Ponnaluri‐Wears, Davis, Low, & Foxman, 2014; McGrath, 1988; Nakazawa, Ohmae, Ishii, & Leafasia, 1998; O'Neil & Sattenspiel, 2010; Sattenspiel, Koopman, Simon, & Jacquez, 1990; Upham, 1986) generally does not integrate the rich body of theory and methodology derived from mathematical models of transmission dynamics.…”

Voluntary collective isolation as a best response to COVID-19 for indigenous populations? A case study and protocol from the Bolivian Amazon

“…They have high infectious burden from diverse pathogens. [23][24][25] Much morbidity and mortality is due to infections, particularly respiratory infections. Pulmonary tuberculosis remains widespread and bronchi ectasis is very common.…”

Water & Human Biology and New Developments for the American Journal of Human Biology

“…Papers by Piperata et al (), Thompson et al (), Brewis et al () and Schuster et al () explore the influence of water insecurity on diverse aspects of nutritional health, ranging from the gut microbiome in children to infant feeding strategies, and the dual nutritional burden. In turn, the contributions by Houck et al () and Dinkel et al () examine the impact water quality and availability on infectious disease risks.…”