Dissertation/Thesis Abstract

The Socioecology of Diarrheal Disease Exposure in Peri-Urban Communities of Kisumu, Kenya
by Anderson, John David, IV, Ph.D., University of Florida, 2016, 171; 10679072
Abstract (Summary)

Currently, high migration from rural areas to cities is outpacing construction of safe, municipal sanitation infrastructure. Migrants take up residence in unplanned, informal settlements in peri-urban communities, where the urban poor reside in substandard housing with poor access to safe water and sanitation. This research implements a socio-ecological systems approach in a cross-sectional study of 1) how urbanization and poverty contribute to high diarrheal disease exposure and 2) how collective action could mediate exposure in peri-urban Kisumu, Kenya.

A history of migration and city planning in Kisumu provides context for qualitative and quantitative data analyses of tenant and landlord Focus Group Discussions (FGDs), household surveys (N = 800) and observations of household compound water, sanitation, and hygiene (WASH) conditions and filth flies. Text analysis of FGDs were used to identify key domains necessary for successful collective action. Generalized Linear Mixed Models (GLMM) are used to test hypothesized effects of social and WASH conditions on filth fly density estimates and predictors of self-reported collective action around improving sanitation.

In response to plague epidemics in the 1900s, colonial administrators implemented a racially-biased zoning schema to prevent spread of disease, leading to today’s informal settlements. Models of effects of sanitation conditions on fly counts showed negative associations between compound latrines with intact slabs and blowfly (Chrysomya putoria) counts, while absence of foul latrine smell was negatively associated with housefly (Musca domestica) counts. Housefly counts were positively associated with trapping near refuse piles than latrines, while blowfly counts were positively associated with residing in Nyalenda A. Only 13% of respondents said that they participated in collective action to improve sanitation in the year leading up to the survey. Models of effects of household demographics showed that households who lived in their dwelling for more than 1 year was positively associated with participation in collective action. Improving sanitation facilities and solid waste collection are crucial to reducing exposure from filth fly-transmitted diarrheal disease in historically neglected peri-urban communities. Collective action offers promise to overcome land tenure issues by involving community members in government initiatives, improving low neighborhood sanitation coverage.

Indexing (document details)
Advisor: Rheingans, Richard
Commitee: Liang, Song, Young, Alyson
School: University of Florida
Department: Interdisiciplinary Ecology
School Location: United States -- Florida
Source: DAI-B 79/04(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Ecology, Environmental Health, Urban planning
Keywords: community health, diarrheal diseases, enteric pathogens, filth fly, peri-urban, socioecology
Publication Number: 10679072
ISBN: 9780355400922
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