Environmental change and infectious disease: Examining the impact of road construction on diarrheal disease

Abstract:

Environmental change plays a large role in the emergence of infectious disease. The construction of a new road in a previously roadless area of northern coastal Ecuador provides a valuable natural experiment to examine how changes in the social and natural environment, mediated by road construction, affect the epidemiology of diarrheal diseases. Twenty-one villages were randomly selected to capture the full distribution of village population size and level of remoteness. Estimates of enteric pathogen infection rates were obtained from case-control studies at the village-level. Higher rates of infection were found in non-remote vs. remote villages (pathogenic E. Coli: OR= 8.3 [1.7, 33.3]; rotavirus: OR= 3.8 [1.4, 11.1]; and Giardia: OR= 1.7 [1.1, 2.6]). The rates of all-cause diarrhea, however, show no such association (OR= 1.1 [0.47, 2.4]). These significant and consistent trends across viral, bacterial, and protozoan …

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