title: Population Density, Poor Sanitation, and Enteric Infections in Nueva Santa Rosa, Guatemala.
abstract: Poor sanitation could pose greater risk for enteric pathogen transmission at higher human population densities because of greater potential for pathogens to infect new hosts through environmentally mediated and person-to-person transmission. We hypothesized that incidence and prevalence of diarrhea, enteric protozoans, and soil-transmitted helminth infections would be higher in high-population-density areas compared with low-population-density areas, and that poor sanitation would pose greater risk for these enteric infections at high density compared with low density. We tested our hypotheses using 6 years of clinic-based diarrhea surveillance (2007-2013) including 4,360 geolocated diarrhea cases tested for 13 pathogens and a 2010 cross-sectional survey that measured environmental exposures from 204 households (920 people) and tested 701 stool specimens for enteric parasites. We found that population density was not a key determinant of enteric infection nor a strong effect modifier of risk posed by poor household sanitation in this setting.
authors: Claudia
authors: C
authors: Jarquin
authors: Benjamin F
authors: BF
authors: Arnold
authors: Fredy
authors: F
authors: Muñoz
authors: Beatriz
authors: B
authors: Lopez
authors: Victoria M
authors: VM
authors: Cuéllar
authors: Andrew
authors: A
authors: Thornton
authors: Jaymin
authors: J
authors: Patel
authors: Lisette
authors: L
authors: Reyes
authors: Sharon L
authors: SL
authors: Roy
authors: Joe P
authors: JP
authors: Bryan
authors: John P
authors: JP
authors: McCracken
authors: John M
authors: JM
authors: Colford
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D005191:Family Characteristics; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006373:Helminthiasis / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D006801:Humans; D015994:Incidence; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D008297:Male; D011156:Population Density; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012499:Sanitation / Q000706:statistics & numerical data*; D055815:Young Adult