Water for people.pdf - WHO Thailand Digital Repository

1 0 4 / C H A L L E N G E S T O L I F E A N D W E L L - B E I N GBasic Needs and the Right to HealthTable 5.1: Some water-associated diseases by cause and sex, estimates for 2001Deaths (in thousands)Burden of disease (in thousands)Both sexes Males Females Both sexes Males Femalesnumber % number % number % number % number % number %Total burden of 1,467,183 100 768,064 100 699,119 100disease (000s of DALYs)Total deaths (000s) 56,552 100 29,626 100 26,926 100Communicable 18,374 32.5 9,529 32.2 8,846 32.9 615,737 42.0 304,269 39.6 311.468 44.6diseases, maternaland perinatalconditions andnutritionaldeficiencies overallInfectious and 10,937 19.3 5,875 19.8 5,063 18.8 359,377 24.5 184,997 24.1 174,380 24.9parasitic diseasesaltogetherDiarrhoeal diseases 2,001 3.5 1,035 3.5 966 3.6 62,451 4.3 31,633 4.1 30,818 4.4Malaria 1,123 2.0 532 1.8 591 2.2 42,280 2.9 20,024 2.6 22,256 3.2Schistosomiasis 15 0.0 11 0.0 5 0.0 1,760 0.1 1,081 0.1 678 0.1Lymphatic filariasis 0 0.0 0 0.0 0 0.0 5,644 0.4 4,316 0.6 1,327 0.2Onchocerciasis 0 0.0 0 0.0 0 0.0 987 0.1 571 0.1 416 0.1Dengue 21 0.0 10 0.0 11 0.0 653 0.0 287 0.0 365 0.0Japanese encephalitis 15 0.0 8 0.0 8 0.0 767 0.1 367 0.0 400 0.1Trachoma 0 0.0 0 0.0 0 0.0 3,997 0.3 1,082 0.1 2,915 0.4Intestinal nematode 12 0.0 6 0.0 5 0.0 4,706 0.3 2,410 0.3 2,296 0.3infectionsAscariasis 4 0.0 2 0.0 2 0.0 1,181 0.1 604 0.1 577 0.1Trichuriasis 2 0.0 1 0.0 1 0.0 1,649 0.1 849 0.1 800 0.1Hookworm infection 4 0.0 2 0.0 2 0.0 1,825 0.1 932 0.1 893 0.1Unintentional injuries 3,508 6.2 2,251 7.6 1,256 4.7 129,853 8.9 82,378 10.7 47,475 6.8overallDrowning 402 0.7 276 1.0 126 0.5 11,778 0.8 8,150 1.1 3,628 0.5The burden of disease is calculated through an indicator of population health, the DALY: a DALY represents a lost year of healthy life and is the unit used to estimate the gap between the currenthealth of a population and an ideal situation in which everyone in that population would live into old age in full health. This table shows the total deaths and burden of disease caused bycommunicable diseases, maternal and perinatal conditions and nutritional deficiencies, non-communicable diseases and injuries related to water.Source: WHO, 2002e.systems carries specific risks of contamination, both with pathogenicorganisms (e.g. intestinal helminths) and chemicals (e.g. heavymetals) through concentration and amplification. More sophisticatedwater conveyance and treatment systems may become the source ofpathogens that are released into the environment as aerosols, as isthe case for Legionella ssp (Legionnaire’s disease) in associationwith air conditioning.A number of diseases caused by bacteria or parasites, forexample, trachoma and intestinal helminth infections, will proliferatebecause of lack of sufficient quantities of water for basic hygiene.These are traditionally referred to as the water-washed (as opposedto the water-borne) diseases. Behavioural changes, such as handwashingand regular bathing, will only be effective if the requiredminimum amounts of water are available, but evidence-basedstandards and norms are still lacking.A range of aquatic ecosystems supports the breeding of a greatnumber of species that play a role in the transmission of diseases;these species are known as vectors. Biological diversity is a mainfeature of vectors and the diseases they transmit, making itnecessary to consider epidemiological situations in the specific localcontext in which they occur. In different parts of the world theaccepted knowledge bases related to the diversity of all thesewater-related organisms vary a great deal. Frequently, our potentialto deal with these health problems in a sustainable way is limited bythe lack of sufficient knowledge of local pathogen and vectorecologies. New knowledge continues to be generated, however,