Disease burden associated with poor household environments

Disease burden associated with poor household environments
Estimated Burden of Disease from Poor Household Environments in Demographically Developing Countries, 1990, and Potential Reduction through Improved Household Services
Principal Diseases Related to Poor Household Environments *	Relevant Environmental Problem	Burden from these Diseases in Development Countries (millions of DALYS per year) [b]	Reduction Achievable Through Feasible Interventions (percent) [c]	Burden Averted by Feasible Interventions (millions of DALYs per year)	Burden Averted per 1,000 Population (DALYs per year)
Tuberculosis	Crowding	46	10	5	1.2
Diarrhea ^d	Sanitation, water supply, hygiene	99	40	40	9.7
Trachoma	Water supply, hygiene	3	30	1	0.3
Tropical cluster ^e	Sanitation, garbage disposal, vector breeding around the home	8	30	2	0.5
Intestinal worms	Sanitation, water supply, hygiene	18	40	7	1.7
Respiratory infections	Indoor air pollution, crowding	119	15	18	4.4
Chronic respiratory diseases	Indoor air pollution	41	15	6	1.5
Respiratory tract cancers	Indoor air pollution	4	10^f	*	0.1
All the above	�	338	–	79	19.4
Source: The World Bank, World Development Report 1993: Investing in Health, World Development Indicators (Oxford University Press, Oxford, U.K., 1993), p. 90. Notes: * Less than 1. �The demographically developing group consists of the demographic regions of Sub-Saharan Africa, India, China, Other Asia islands, Latin America and the Caribbean, and the Middle Eastern crescent. a. The diseases listed are those for which there is substantial evidence of a relationship with the household environment. Examples of excluded conditions are violence related to crowding (because of lack of evidence) and guinea worm infection related to poor water supply. b. DALYs are disability-adjusted life years. c. Estimates derived from the product of the efficacy of the interventions and the proportion of the burden of disease that occurs among the exposed. The efficacy estimates assume the implementation of improvements in sanitation, water supply, hygiene, drainage, garbage disposal, indoor air pollution, and crowding of the kind being made in poor communities in developing countries. d. Includes diarrhea, dysentery, cholera, and typhoid. e. Diseases within the tropical cluster most affected by the domestic environment are schistosomiasis, South American trypanosomiasis, and Bancroftian filariasis. f. Based on very inadequate data on efficacy.