Incidence Of Diarrheal Disease Research Articles

Cow's milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT.

BackgroundNutrients such as docosahexaenoic acid (DHA), prebiotics and β-glucan have been associated with reduced incidence of respiratory illnesses and allergic manifestations (AM). Our objective was to assess if consumption of a cow’s milk-based beverage with these and other nutrients supports respiratory, gastrointestinal, and skin health in otherwise well-nourished, healthy children.MethodsIn this double-blind, randomized, controlled trial, healthy children (1–4 years of age) from two daycare centers in Brazil were fed three servings/day of a cow’s milk-based beverage (CMBB; n = 125) containing DHA, the prebiotics polydextrose (PDX) and galactooligosaccharides (GOS), β-glucan, and other key nutrients, or a control cow’s milk-based beverage (control; n = 131) for up to 28 weeks. Occurrence of respiratory infections, diarrheal disease and AM was assessed by study pediatricians and the number of episodes were analyzed with the Cochran-Mantel-Haenszel test and the Andersen-Gill model.ResultsThe CMBB group had fewer episodes of AM, which included allergic rhinitis or conjunctivitis, wheezing, allergic cough, eczema and urticaria, compared to the control group (p = 0.021). The hazard ratio for increased number of episodes of AM was lower in the CMBB group compared to control (HR, 0.64; 95 % CI 0.47–0.89; p = 0.007). There was no difference in the incidence of respiratory infections and diarrheal disease between groups.ConclusionA cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract.Trial registrationregistration number: NCT01431469

Virus Filtration in Porous Iron (III) Oxide Doped Ceramic Water Filters

The consumption of microbially - and virally - contaminated water is a pressing health issue in developing nations. The concentration of surface and underground water is often responsible for a high incidence of diarrheal diseases, especially among children under the age of five years [1]. Ceramic water filters (CWFs) have been proposed as a household water treatment solution. However, despite their high bacterial filtration efficiency [2], existing CWFs cannot yet effectively remove viruses from water. Using MS2 bacteriophage as a model for human enteric viruses, this work explores the effect of doping CWFs with goethite (FeOOH) on the removal of viruses from contaminated waters. Fe-CWFs were found to remove bacteriophage from challenged water at significantly higher efficiencies than the control CWF. Filters composed of 60:40 ceramic:sawdust volume ratios and doped with different amounts of FeOOH were studied. A Fe-CWF containing 24.9 wt% Fe2O3removed a mean of 1.93 log (98.83%) of MS2. The efficiency of viral filtration decreased significantly when the pH of the challenged water deviated from neutral (pH 5.9, 8.7 and 10.2). In addition, all Fe-CWFs tested removed more than 3 log (99.9%) of bacteria.

A systematic review and meta-analysis of ambient temperature and diarrhoeal diseases.

Global climate change is expected to increase the risk of diarrhoeal diseases, a leading cause of childhood mortality. However, there is considerable uncertainty about the magnitude of these effects and which populations bear the greatest risks. We conducted a systematic review using defined search terms across four major databases and, additionally, examined the references of 54 review articles captured by the search. We evaluated sources of heterogeneity by pathogen taxon, exposure measure, study quality, country income level and regional climate, and estimated pooled effect estimates for the subgroups identified in the heterogeneity analysis, using meta-analysis methods. We identified 26 studies with 49 estimates. Pathogen taxa were a source of heterogeneity. There was a positive association between ambient temperature and all-cause diarrhoea (incidence rate ratio (IRR) 1.07; 95% confidence interval (CI) 1.03, 1.10) and bacterial diarrhoea (IRR 1.07; 95% CI 1.04, 1.10), but not viral diarrhoea (IRR 0.96; 95% CI 0.82, 1.11). These associations were observed in low-, middle- and high-income countries. Only one study of protozoan diarrhoea was identified. Changes in temperature due to global climate change can and may already be affecting diarrhoeal disease incidence. The vulnerability of populations may depend, in part, on local pathogen distribution. However, evidence of publication bias and the uneven geographical distribution of studies limit the precision and generalizability of the pooled estimates.

Community-acquired diarrhoea in a world with rotavirus vaccine: a glimpse into the future.

Community-acquired diarrhoea in a world with rotavirus vaccine: a glimpse into the future.

Application of a QMRA Framework to Inform Selection of Drinking Water Interventions in the Developing Context.

The aim of this study was to develop a modified quantitative microbial risk assessment (QMRA) framework that could be applied as a decision support tool to choose between alternative drinking water interventions in the developing context. The impact of different household water treatment (HWT) interventions on the overall incidence of diarrheal disease and disability adjusted life years (DALYs) was estimated, without relying on source water pathogen concentration as the starting point for the analysis. A framework was developed and a software tool constructed and then implemented for an illustrative case study for Nepal based on published scientific data. Coagulation combined with free chlorine disinfection provided the greatest estimated health gains in the short term; however, when long-term compliance was incorporated into the calculations, the preferred intervention was porous ceramic filtration. The model demonstrates how the QMRA framework can be used to integrate evidence from different studies to inform management decisions, and in particular to prioritize the next best intervention with respect to estimated reduction in diarrheal incidence. This study only considered HWT interventions; it is recognized that a systematic consideration of sanitation, recreation, and drinking water pathways is important for effective management of waterborne transmission of pathogens, and the approach could be expanded to consider the broader water-related context.

Incidência de doença diarreica aguda em Caxias do Sul, Rio Grande do Sul, Brasil, em uma série histórica de 10 anos

Aims: To evaluate the incidence of acute diarrheal disease (ADD) recorded over a 10-year period in Caxias do Sul, southern Brazil, and its correlations with the vaccination against rotavirus, with rainfall, and with the number of hospitalizations.Methods: A descriptive study was conducted, analyzing the ADD records obtained from the Epidemiological Surveillance sector of the Local Health Department of Caxias do Sul.Results: A total of 61,246 cases of ADD were recorded between 2004 and 2013, most of which occurred in low-income neighborhoods. There were five outbreaks of ADD in the summer and winter months during the study period. No correlations were found between ADD and rainfall. The number of children aged between zero and four years hospitalized for ADD decreased from 2006 onwards, when vaccination against rotavirus was implemented in the public health network whereas the number of deaths across all age groups fluctuated during the study period.Conclusions: The assessment of the long-term incidence of ADD showed a fluctuation in the number of cases and deaths in Caxias do Sul. In addition, hospitalizations for ADD decreased after the implementation of rotavirus vaccination in the public health network.

The epidemiology and aetiology of diarrhoeal disease in infancy in southern Vietnam: a birth cohort study

Previous studies indicate a high burden of diarrhoeal disease in Vietnamese children, however longitudinal community-based data on burden and aetiology are limited. The findings from a large, prospective cohort study of diarrhoeal disease in infants in southern Vietnam are presented herein. Infants were enrolled at birth in urban Ho Chi Minh City and a semi-rural district in southern Vietnam, and followed for 12 months (n=6706). Diarrhoeal illness episodes were identified through clinic-based passive surveillance, hospital admissions, and self-reports. The minimum incidence of diarrhoeal illness in the first year of life was 271/1000 infant-years of observation for the whole cohort. Rotavirus was the most commonly detected pathogen (50% of positive samples), followed by norovirus (24%), Campylobacter (20%), Salmonella (18%), and Shigella (16%). Repeat infections were identified in 9% of infants infected with rotavirus, norovirus, Shigella, or Campylobacter, and 13% of those with Salmonella infections. The minimum incidence of diarrhoeal disease in infants in both urban and semi-rural settings in southern Vietnam was quantified prospectively. A large proportion of laboratory-diagnosed disease was caused by rotavirus and norovirus. These data highlight the unmet need for a rotavirus vaccine in Vietnam and provide evidence of the previously unrecognized burden of norovirus in infants.

Review on Slow Sand Filtration in Removing Microbial Contamination and Particles from Drinking Water

The improvement of water quality is closely associated with man-environment relationships. There should be a dialogue between all actors and the community when undertaking water and sanitation activities. For positive results and better sustainability, the community should be involved and participate at all stages of water development and environmental sanitation schemes. A combination of safe drinking water, adequate sanitation and hygiene practices like hand washing is a pre-requisite for morbidity and mortality rate reduction, especially among under five years old children in developing countries. To reduce the incidence and prevalence of diarrhoeal diseases, improvements in the availability, quantity, and quality of water, improved sanitation, and general personal and environmental hygiene are required. The majority of people in developing countries do not have access to piped drinking water and must carry; transport and store water within their homes and in the process the quality of water may deteriorate. Therefore, slow sand filtration has been recognized as an appropriate technology for drinking water treatment in rural areas, and is recognized as a suitable filtration technology for removing water borne pathogens and reducing turbidity. It is capable of improving the physical, chemical, and microbiological quality of water in a single treatment process without the addition of chemicals, and can produce an effluent low in turbidity and free of bacteria, parasites and viruses.

Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.

Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.

Breast Feeding versus Formula Feeding and Diarrheal Diseases in Infants and Children- A Review

The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) emphasize the value of breastfeeding for mothers as well as children. Both recommend exclusive breastfeeding for the first six months of life. Human breast milk is the healthiest form of milk for babies. Breastfeeding promotes health and helps to prevent diseases including diarrheal diseases. It contains all nutrients including antibodies (IgA),and lactoferrin, that potentially prevent infection and diarrhea in infants and children. Studies conducted in both developed and under developed nations have found that breast feeding is associated with significantly ( upto 64%) less diarrheal disease and the protective effect of breast feeding does not persist beyond two months after breast feeding is stopped. On the other hand, formula fed infants are found an upto 80% increased in the risk of developing diarrhea compared to breast fed infants and there is significantly more diarrheal disease in formula fed infants. Infection may be attributable to contamination of bottles, teats, milk, and food in infants who are not exclusively breastfed. Exclusive breastfeeding for the first six months of life and there after complementary feedings while breastfeeding continues for up to two years of age or beyond, enthusiastic support and involvement from clinicians, obstetricians and pediatricians, are essential in “breastfeeding vs formula feeding” issue and to reduce incidence of diarrheal diseases in infants and children. DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21033 J Bangladesh Coll Phys Surg 2014; 32: 26-30

Diarrhoeal Diseases Due to Unsafe Water Supply and Poor Sanitation Coverage in Nepal

Background: Diarrhoeal diseases contribute to significant mortality among children in low- and middle-income countries (LMICs), and unsafe water and poor sanitation are potential risk factors. The study aims to estimate the burden of diarrhoeal diseases among children aged <5 years in the context of water supply and sanitation status in Nepal. Methods:Data on diarrhoeal illnesses, and water supply and sanitation status during 2006/07-2011/12 were obtained from the Nepal Department of Health Services surveys and the WHO/UNICEF Joint Monitoring Programme. Water supply and sanitation status was categorized into urban, rural and national improved and unimproved, while diarrhoea was reported using incidence, death and case-fatality rates. Socio- demographics and economic factors were potential covariates. Results were reported as proportions and/or rates, along with correlation coefficients. Results: Incidence of diarrhoeal diseases among children <5years age significantly increased from 185 per 1000 in 2006/07 to 528 per 1000 in 2011/12, while the death and case-fatality rates significantly decreased (P<0.05). Similarly, water supply and sanitation facilities increased since 2006, with urban and rural disparities. In 2011, 90% of people obtained access to improved water supply, but not sanitation facilities. Only 35% obtained access to improved sanitation facilities and found to be inversely correlated with death and case-fatality rates of diarrhoeal illness (r=-0.7). Additionally, women with no education were highly correlated with increased incidence and prevalence of diarrhoeal illnesses (r=+0.84). Conclusion: Findings support ongoing efforts to understand the impact of sanitation in reducing the burden of diarrhoeal illnesses in LMICs, along with consideration of other socio-demographic and economic factors.

The MAL-ED study: a multinational and multidisciplinary approach to understand the relationship between enteric pathogens, malnutrition, gut physiology, physical growth, cognitive development, and immune responses in infants and children up to 2 years of age in resource-poor environments.

Highly prevalent conditions with multiple and complex underlying etiologies are a challenge to public health. Undernutrition, for example, affects 20% of children in the developing world. The cause and consequence of poor nutrition are multifaceted. Undernutrition has been associated with half of all deaths worldwide in children aged <5 years; in addition, its pernicious long-term effects in early childhood have been associated with cognitive and physical growth deficits across multiple generations and have been thought to suppress immunity to further infections and to reduce the efficacy of childhood vaccines. The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED) Study, led by the Fogarty International Center of the National Institutes of Health and the Foundation for the National Institutes of Health, has been established at sites in 8 countries with historically high incidence of diarrheal disease and undernutrition. Central to the study is the hypothesis that enteropathogen infection contributes to undernutrition by causing intestinal inflammation and/or by altering intestinal barrier and absorptive function. It is further postulated that this leads to growth faltering and deficits in cognitive development. The effects of repeated enteric infection and undernutrition on the immune response to childhood vaccines is also being examined in the study. MAL-ED uses a prospective longitudinal design that offers a unique opportunity to directly address a complex system of exposures and health outcomes in the community-rather than the relatively rarer circumstances that lead to hospitalization-during the critical period of development of the first 2 years of life. Among the factors being evaluated are enteric infections (with or without diarrhea) and other illness indicators, micronutrient levels, diet, socioeconomic status, gut function, and the environment. MAL-ED aims to describe these factors, their interrelationships, and their overall impact on health outcomes in unprecedented detail, and to make individual, site-specific, and generalized recommendations regarding the nature and timing of possible interventions aimed at improving child health and development in these resource-poor settings.

Follow-up formula consumption in 3- to 4-year-olds and respiratory infections: an RCT.

Children are vulnerable to diet inadequacies, which may affect immune function. Our objective was to determine if a follow-up formula (FUF) containing DHA, the prebiotics PDX and GOS, and yeast β-glucan affects incidence of respiratory infections and diarrheal disease in healthy children. In a double-blind, randomized, controlled, prospective trial, 3-4 year old children were fed 3 servings per day of either a FUF with 25 mg DHA, 1.2 g PDX/GOS, and 8.7 mg yeast β-glucan per serving or an unfortified, cow's milk-based beverage (control) for 28 weeks. Fecal and blood samples were collected to assess immune markers and iron/zinc status. Incidence of acute respiratory infections (ARI), diarrheal disease, and antibiotic treatment were obtained from medical records. The FUF group had fewer episodes and shorter duration of ARI (mean days [SE]; control = 4.3 [0.2]; FUF = 3.5 [0.2]; P = .007), less antibiotic use (n [%]; control = 21 [14%]; FUF = 8 [5%]; P = .01), and fewer missed days of day care due to illness. No diarrheal disease was diagnosed in either group. The FUF group had higher interleukin-10 and white blood cell count at the end of the study. There were no differences in hemoglobin, serum ferritin and zinc, or fecal secretory immunoglobulin A. Daily consumption of a FUF was associated with fewer episodes and shorter duration of ARI, as well as less antibiotic use. The children who consumed the FUF had increased interleukin-10 and white blood cells, suggesting an antiinflammatory mechanism and/or an increase of effector immune cells.

Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing, China.

BackgroundTo date, a large proportion of people still suffer from diarrhea diseases. In addition to the burden of diarrhea, there are substantial social and economic costs caused by the high incidence of diarrheal diseases. Therefore, the purpose of this study was to explore the self-reported prevalence of diarrhea and associated risk factors of diarrhea among adults in Beijing, China.MethodsA multistage, stratified study based on cross-sectional data was performed using randomized and systematic sampling, recruiting 12,936 adults over 18 years of age in Beijing. All adults were requested to complete a questionnaire, including information such as demographic characteristics, incidence of diarrhea, and behaviors related to the diarrhea.ResultsThe self-reported prevalence of diarrhea was 17.5% during the last year prior to the survey. Six behavioral factors were significantly associated with diarrhea in our study including: (1) washing hands before meals and after defecation (Adjusted Odds Ratio (AOR) 0.707, 95% CI 0.597 ~ 0.837), (2) washing hands with soap and running water (AOR 0.872, 95% CI 0.786 ~ 0.967), (3) consuming raw seafood (AOR 1.285, 95% CI 1.138 ~ 1.450), (4) using the same chopping block and knife when processing raw and cooked food (AOR 1.375, 95% CI 1.225 ~ 1.542), (5) using the same chopsticks to handle raw and cooked food (AOR1.149, 95% CI 1.041 ~ 1.268), and (6) regularly participating in physical exercise (AOR 0.719, 95% CI 0.651 ~ 0.793).ConclusionGood health habits, good eating habits, and regular exercise can prevent the episodes of diarrhea, and thus decrease the potential for disease occurrence.

An investigation of the effects of a hand washing intervention on health outcomes and school absence using a randomised trial in Indian urban communities

To evaluate how an intervention, which combined hand washing promotion aimed at 5-year-olds with provision of free soap, affected illnesses among the children and their families and children's school absenteeism. We monitored illnesses, including diarrhoea and acute respiratory infections (ARIs), school absences and soap consumption for 41 weeks in 70 low-income communities in Mumbai, India (35 communities per arm). Outcomes from 847 intervention households (containing 847 5-year-olds and 4863 subjects in total) and 833 control households (containing 833 5-year-olds and 4812 subjects) were modelled using negative binomial regression. Intervention group 5-year-olds had fewer episodes of diarrhoea (-25%, 95% confidence intervals [CI] = -37%, -2%), ARIs (-15%, 95% CI = -30%, -8%), school absences due to illnesses (-27%, 95% CI = -41%, -18%) and eye infections (-46%, 95% CI = -58%, -31%). Further, there were fewer episodes of diarrhoea and ARIs in the intervention group for 'whole families' (-31%, 95% CI = -37%, -5%; and -14%, 95% CI = -23%, -6%, respectively), 6- to 15-year-olds (-30%, 95% CI = -39%, -7%; and -15%, 95% CI = -24%, -6%) and under 5 s (-32%, 95% CI = -41%, -4%; and -20%, 95% CI = -29%, -8%). Direct-contact hand washing interventions aimed at younger school-aged children can affect the health of the whole family. These may be scalable through public-private partnerships and classroom-based campaigns. Further work is required to understand the conditions under which health benefits are transferred and the mechanisms for transference.

Patterns of diseases and preventive measures among domestic hajjis from Central, Saudi Arabia [complete republication

To identify the occurrence of upper respiratory tract infections (URTI), diarrheal diseases and trauma during the Haji season, and the practice of some preventive measures by pilgrims. A cohort study during November and December 2009 among hajjis registered while visiting Primary Health Care Centers of Riyadh, Kingdom of Saudi Arabia to get mandatory meningococcal meningitis vaccination. On return from hajj, hajjis were contacted on telephone to collect information on occurrence of URTI and diarrhea along with other associated activities in Hajj. Out of 1507 hajjis, 54.7% developed symptoms; 97% reported upper respiratory tract symptoms, and 9.3% reported diarrheal symptoms. Those < 40 years of age were more likely to develop an URTI. The incidence of diarrheal diseases or trauma was not statistically associated with age. No statistical difference for educational level was found for U RTI or trauma, but there was a statistically significant difference for diarrheal diseases. There was no statistical difference for nationality in relation to diarrheal diseases and trauma, but there was a statistically significant difference for URTI. There was a statistically significant difference of URTI between those pilgrims who used the face mask most of the time and those who used it sometimes. Upper respiratory tract infections is a common health problem among studied domestic hajjis. Generally, there is room for improvement in the adoption of preventive measures by hajjis; and there is still limited information on the use of facemasks in spite of the fact that using it significantly decreases the risk for URTI.

Potential impact of influenza A/H1N1 pandemic and hand-gels on acute diarrhea epidemic in France.

BackgroundThe 2009 A/H1N1 influenza pandemic has received a great deal of attention from public health authorities. Our study examines whether this pandemic and the resulting public health measures could have impacted acute diarrhea, a prevalent, highly transmissible and historically monitored disease.MethodsUsing augmentation procedures of national data for the previous five years (2004–2009), we estimated the expected timing and incidence of acute diarrhea in France in 2009–2010 and evaluated differences with the observed. We also reviewed national hand gels for the same period.FindingsNumber of episodes of acute diarrhea in France in 2009–2010 was significantly lower than expected until the third week of December (−24%, 95% CI [−36%; −9%]), then significantly higher (+40%, 95% CI [22%; 62%]), leading to a surplus of 574,440 episodes. The epidemic was delayed by 5 weeks with a peak 1.3 times higher than expected. Hand-gels sales inversely correlated with incidence of both influenza-like illness and acute diarrheal disease. Among individuals >65 yo, no excess cases of influenza and no excess rebound in acute diarrhea were observed, despite similar delay in the onset of the seasonal diarrheal epidemic.InterpretationOur results suggest that at least one endemic disease had an unexpected behavior in 2009–2010. Acute diarrhea seems to have been controlled during the beginning of the pandemic in all age groups, but later peaked higher than expected in the younger population. The all-age delay in seasonal onset seems partly attributable to hand-gels use, while the differential magnitude of the seasonal epidemic between young and old, concurrent for both influenza and acute diarrhea, is compatible with disease interaction.

The burden of diarrhoeal disease in malnourished children

Diarrhoeal disease is the second leading cause of death in children, killing 1.5 million children every year. Malnourished children suffer most. Rotavirus, Escherichia coli, Shigella, Campylobacter, Salmonella, Vibrio cholerae and Cryptosporidium are the major pathogens that cause diarrhoeal disease in children. The tremendous incidence of diarrhoeal diseases in malnourished children underscores the urgent need for interventions, such as food-based oral rehydration salt (ORS) treatment. This review gives a summary of major pathogens that cause diarrhoeal diseases in poor nations and discusses the use of food-based ORS solutions in the treatment of dehydration in malnourished children.

Risk factor analysis of diarrhoeal disease incidence in faecal sludge-applying farmers’ households in Tamale, Ghana

This study assesses the effect of risk factors and their inter-related mediation on diarrhoeal disease incidence in households applying faecal sludge in agricultural fields in Tamale, Ghana. Risk factors were assigned to three inter-related blocks: distal socio-economic, proximal public and domestic domains. The study involved 1,431 individuals living in 165 faecal sludge-applying households followed bi-weekly for 12 months. The incidence rate of diarrhoeal disease in the sludge-applying households was 1.09 (95% CI: 0.78–1.23) diarrhoeal episodes per person year at risk. Risk factors for diarrhoeal disease transmission in the public domain included sludge drying time (population attributable fraction (PAF) of 6%) and distance covered to collect water (PAF = 18%). The main distal socio-economic risk factor was wealth status (PAF = 15%). In the domestic domain, the risk factor significantly associated with diarrhoeal disease transmission was, not washing hands with soap after defecation (PAF = 18%). About 17% of the effect of sludge drying time (including distance to water facilities) was mediated by the domestic domain risk factors. The study recommends risk management strategies in sludge-applying households that address public and domestic domain risk factors in addition to specific farm level interventions.

Water sanitation, access, use and self-reported diarrheal disease in rural Honduras

Only 79% of individuals living in rural Honduras use improved water sources. Inadequate drinking water quality is related to diarrheal illness, which in Honduras contributes to 18.6 episodes of diarrhea per child year in children under five years of age. The purpose of this study was to examine and compare access to drinking water and sanitation, as well as self-reported diarrheal disease incidence among three proximal communities in the Department of Yoro area of Honduras. An 11-item language-specific, interviewer-administered, anonymous questionnaire was administered to 263 randomly selected adults attending a June 2011 medical brigade held in the communities of Coyoles, La Hicaca, and Lomitas. Chi-square with Fisher exact tests were utilized to compare water access, sanitation, and self-reported diarrheal incidence among these communities. Coyoles and La Hicaca used private faucets as their primary water sources. Coyoles had the greatest use of bottled water. Lomitas used rivers as their primary water source, and did not use bottled water. Mostly, females were responsible for acquiring water. Usage of multiple water sanitation methods was most common in Coyoles, while no sanitation method was most common in Lomitas. In Lomitas and La Hicaca, water filters were mostly provided via donation by non-governmental organizations. Lomitas had the highest reported incidence of diarrhea among self and other household members. Critical differences in water access, sanitation, and self-reported diarrheal incidence among three geographically distinct, yet proximal, communities highlights the need for targeted interventions even in geographically proximal rural areas.