Waterborne diseases as an indicator of health disparities: A nationwide study of WaSH related morbidity and mortality in Ecuador from 2011-2020

Abstract BackgroundDespite worldwide progress in terms of clean water supply, sanitation, and hygiene knowledge, some middle and most of low-income countries are still experiencing many diseases transmitted using unsafe water and the lack of sanitation.MethodsTo understand the impact of all waterborne diseases (WBD) registered in Ecuador, we performed an analysis of all cases and deaths related to WBD to compute incidence and mortality rates.ResultsWe found that in Ecuador, mestizo people had the greatest morbidity rate (141/100,000) patient followed by indigenous (63/100,000) and self-determined white patients (21/100,000). However, in terms of mortality, indigenous population have a 790% increase in mortality rate (2.6 /100,000) when compared to self-determined white populations (0.29/100,000) or 176% more when compared to mestizos (0.94/100,000). This trend remains the same among children and the elderly who have higher mortality rates when compared to other ethnic groups.ConclusionsIn Ecuador, water borne diseases (WBD) are still a major public health problem. We found that younger children and elderly are more likely to be get sick and die due to water borne diseases. In terms of morbidity, mestizos reported the highest rate, while in terms of mortality, indigenous populations are the most affected, having the highest mortality among different ethnic groups. We hypostatize that reduced health care access is linked to fewer reporting incidence rates among indigenous populations but higher mortality rates.