Implantação de cisternas para armazenamento de água de chuva eseus impactos na saúde infantil: um estudo de coorte em Berilo e Chapada do Norte, Minas Gerais

Abstract

The Brazilian Federal Government One Million Cisterns Program (P1MC) has benefited more than 400,000 Brazilian families with the construction of cement tanks that can store 16,000 liters of rainwater collected on the roof. Despite the benefits reported by their users, few studies have been developed to elucidate the consequences of this Program on populations health. Thus, the aim of this study was to evaluate the impact of cement tanks on childrens health, from rural families living into two municipalities of Jequitinhonha Valley, Minas Gerais. An epidemiological cohort study was developed with 664 children, under five years old, selected and monitored for one year (between 2009 and 2010). By this time, 332 children had access to rainwater tanks (Group 1) and 332 needed alternative sources (Group 2). Fecal indicators were analyzed in water samples from 100 households (50 in each group), monitored three times. In addtion two health indicators were examined: diarrhea occurrence (monitored daily by filling calendars) and intestinal parasites (investigated in the feces, three times). For 256 water samples, total coliforms and Escherichia coli were detected, respectively, 94 and 66% of the time. By comparing the two groups, statistical tests indicated that the presence of rainwater cisterns did not improve the quality of water consumed by the beneficiaries, which was consistent with the observed risk behaviors for participants from both groups. About intestinal parasites, higher rates of commensal and pathogenic protozoa were detected instead of helminthes. Multivariate analysis confirmed the protective effect of cement tanks related to pathogenic protozoa occurrence (OR = 1.42 for Group 2, p = 0.02) and specifically for Giardia (OR = 1.63 for Group 2, p = 0.02). However, other risk factors independently associated with these outcomes were also detected. The average number of diarrhea days were 2.29 and 3.41 for children into Groups 1 and 2, respectively. Once again the protective effect offered by the rainwater tanks was showed for diarrhea occurrence (Exp () = 1.45 for Group 2, p = 0.04). In conclusion, this study confirmed health benefits related to cement tanks, but also identified that others sanitation investments are needed. In addition, among the families, it is necessary encourage the practice of healthier lifestyles and the use of sanitary barriers to be possible further minimize health risks of rural people that have difficulty in accessing water.