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Open AccessArticle

Micro-Space Complexity and Context in the Space-Time Variation in Enteric Disease Risk for Three Informal Settlements of Port au Prince, Haiti

1
GIS Health & Hazards Lab, Kent State University, Kent, OH 44242, USA
2
Les Centres Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
3
Emerging Pathogens Institute and Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32601, USA
4
Emerging Pathogens Institute and Department of Environmental & Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32601, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(5), 807; https://doi.org/10.3390/ijerph16050807
Received: 21 December 2018 / Revised: 26 February 2019 / Accepted: 26 February 2019 / Published: 5 March 2019
Diffusion of cholera and other diarrheal diseases in an informal settlement is a product of multiple behavioral, environmental and spatial risk factors. One of the most important components is the spatial interconnections among water points, drainage ditches, toilets and the intervening environment. This risk is also longitudinal and variable as water points fluctuate in relation to bacterial contamination. In this paper we consider part of this micro space complexity for three informal settlements in Port au Prince, Haiti. We expand on more typical epidemiological analysis of fecal coliforms at water points, drainage ditches and ocean sites by considering the importance of single point location fluctuation coupled with recording micro-space environmental conditions around each sample site. Results show that spatial variation in enteric disease risk occurs within neighborhoods, and that while certain trends are evident, the degree of individual site fluctuation should question the utility of both cross-sectional and more aggregate analysis. Various factors increase the counts of fecal coliform present, including the type of water point, how water was stored at that water point, and the proximity of the water point to local drainage. Some locations fluctuated considerably between being safe and unsafe on a monthly basis. Next steps to form a more comprehensive contextualized understanding of enteric disease risk in these environments should include the addition of behavioral factors and local insight. View Full-Text
Keywords: cholera; informal settlements; GIS; spatial video; Haiti cholera; informal settlements; GIS; spatial video; Haiti
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Curtis, A.; Squires, R.; Rouzier, V.; Pape, J.W.; Ajayakumar, J.; Bempah, S.; Taifur Alam, M.; Alam, M.M.; Rashid, M.H.; Ali, A.; Morris, Jr, J.G. Micro-Space Complexity and Context in the Space-Time Variation in Enteric Disease Risk for Three Informal Settlements of Port au Prince, Haiti. Int. J. Environ. Res. Public Health 2019, 16, 807.

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