Water, sanitation, and hygiene (WASH) factors and the incidence of communicable diseases in Urban Bangladesh: Evidence from municipal areas

Abstract

Background Safe drinking water, sanitation, and hygiene (WASH) are crucial for health and devel-opment, especially in low-and middle-income countries (LMICs) where WASH-related diseases are prevalent. Bangladesh, with high poverty rates and a large population, faces significant WASH challenges. This study examines the association between hygiene-related factors and communicable diseases in two Bangladeshi municipalities. Method A descriptive cross-sectional study was conducted from June 1 to July 30, 2021, in Savar and Satkhira municipalities, chosen for their diverse socioeconomic and geographic characteristics. A stratified random sampling method targeted poor, marginalised, and socially excluded populations. A total of 607 interviews were conducted using a structured questionnaire, collecting data on socio-demographics, hygiene practices, and disease history. Participants were included if they were adults (aged 18 or older), had resided in the municipality for at least one year, and provided informed consent to participate. Data were analysed using SPSS, employing chi-square tests and logistic regression to assess associations between variables. Results The study revealed that 24.1% of participants had a communicable disease, with diarrhoea being the most common. Significant predictors of communicable diseases included gender, with females being more likely affected (OR: 3.21, 95% CI: 1.19 to 8.66, p = 0.003), and the source of drinking water, with tube well users at higher risk (OR: 2.81, 95% CI: 1.13 to 7.02, p = 0.015). Poor hand hygiene significantly increased disease risk (OR: 12.31, 95% CI: 2.86 to 53.03, p < 0.001). Conclusions Communicable diseases are prevalent in Bangladeshi municipalities, primarily driven by poor WASH conditions. Enhancing access to safe drinking water and implement-ing community-based WASH interventions, such as hygiene education campaigns, improved sanitation infrastructure, and school-based awareness programs, are vital for reducing the disease burden. Further research should explore the effectiveness and scalability of these targeted strategies.