{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:58:54Z","timestamp":1792810734644,"version":"4.5.0"},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Most cholera outbreaks in Bangladesh are seasonal, peaking in the dry and post-monsoon periods. Therefore, we investigated whether changes in water, sanitation, and hygiene (WASH) behavior in three populations in Bangladesh during the year could help explain why these two periods are particular to cholera transmission. The study used a mixed-method design, including a repeated cross-sectional study, focus group discussions, and key informant interviews. Through a repeated cross-sectional study, WASH-related variables were assessed during the dry, monsoon, and control seasons in 600 households from coastal Satkhira, inland Sirajganj, and the Dhaka slums. Seasonal behavioral changes were observed in all study areas. Dhaka and Satkhira had an increased mean distance to water sources during the dry and monsoon seasons (Dhaka: control season, 12 m [95% CI, 11\u201313]; dry season, 36 m [95% CI, 18\u201355]; and monsoon season, 180 m [95% CI, 118\u2013243]; Satkhira: control season, 334 m [95% CI, 258\u2013411]; dry season, 669 m [95% CI, 515\u2013822]; and monsoon season, 2,437 m [95% CI, 1,665\u20133,209]). The participants attributed this to pollution of the usual water source. Perceived water quantity was lowest during the dry season in Dhaka and Sirajganj, and during the monsoon season in Satkhira. Handwashing with soap declined in all areas during the dry and monsoon seasons. Open defecation was frequent among children younger than 5 years, increasing during seasonal climate hazards. Results show that WASH-related behavior changed seasonally, increasing the risk of cholera transmission through multiple hygiene-related transmission pathways. Future research would benefit by ensuring that the length of studies covers all seasons throughout the year and also by looking in more detail at people\u2019s behavior and hygiene practices.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0708","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T13:57:56Z","timestamp":1674482276000},"page":"518-523","source":"Crossref","is-referenced-by-count":4,"title":["Influence of Seasonal Hazards on Water, Sanitation, and Hygiene\u2013Related Behavior and Implications for Cholera Transmission in Bangladesh"],"prefix":"10.4269","volume":"108","author":[{"given":"Stephen","family":"Lawrence Grant","sequence":"first","affiliation":[{"name":"Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Lange","sequence":"additional","affiliation":[{"name":"Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Almeida","sequence":"additional","affiliation":[{"name":"Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilqis","family":"Hoque","sequence":"additional","affiliation":[{"name":"Environment and Population Research Centre, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kj\u00e6r Mackie Jensen","sequence":"additional","affiliation":[{"name":"Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Infect Dis","first-page":"96","article-title":"A 4-year study of the epidemiology of Vibrio cholerae in four rural areas of Bangladesh","volume":"187","author":"Sack","year":"2003"},{"key":"b2","series-title":"Geophys Res Lett","first-page":"96","article-title":"Dual peak cholera transmission in Bengal Delta: a hydro climatological explanation","volume":"36","author":"Akanda","year":"2009"},{"key":"b3","series-title":"Trop Med Int Health","first-page":"928","article-title":"Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression","volume":"19","author":"Wolf","year":"2014"},{"key":"b4","series-title":"Appl Environ Microbiol","first-page":"2370","article-title":"Detection of Vibrio cholerae O1 in the aquatic environment by fluorescent-monoclonal antibody and culture methods","volume":"56","author":"Huq","year":"1990"},{"key":"b5","series-title":"Hydrobiologia","first-page":"141","article-title":"Marine ecosystems and cholera","volume":"460","author":"Colwell","year":"2001"},{"key":"b6","series-title":"Lett Appl Microbiol","first-page":"241","article-title":"Toxigenic Vibrio cholerae from environmental sources associated with the cholera outbreak after \u201cAILA\u201d cyclone in West Bengal, India","volume":"51","author":"Palit","year":"2010"},{"key":"b7","series-title":"J Infect Dev Ctries","first-page":"720","article-title":"Cholera outbreaks in Malawi in 1998\u20132012: social and cultural challenges in prevention and control","volume":"8","author":"Msyamboza","year":"2014"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e0004153","article-title":"Cholera transmission in Ouest Department of Haiti: dynamic modeling and the future of the epidemic","volume":"9","author":"Kirpich","year":"2015"},{"key":"b9","series-title":"Int J Infect Dis","first-page":"28","article-title":"Can cholera \u201chotspots\u201d be converted to cholera \u201ccoldspots\u201d in cholera endemic countries? The Matlab, Bangladesh experience","volume":"95","author":"Zaman","year":"2020"},{"key":"b10","author":"Wagner","year":"1958"},{"key":"b11","series-title":"Front Microbiol","first-page":"489","article-title":"A comparative analysis of Vibrio cholerae contamination in point-of-drinking and source water in a low-income urban community, Bangladesh","volume":"9","author":"Ferdous","year":"2018"},{"key":"b12","series-title":"Emerg Infect Dis","first-page":"2143","article-title":"Epidemic cholera in a crowded urban environment, Port-au-Prince, Haiti","volume":"17","author":"Dunkle","year":"2011"},{"key":"b13","series-title":"J Infect Dev Ctries","first-page":"234","article-title":"Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap","volume":"6","author":"Mahamud","year":"2012"},{"key":"b14","series-title":"Arch Dis Child","first-page":"629","article-title":"Water, sanitation, hygiene and enteric infections in children","volume":"98","author":"Brown","year":"2013"},{"key":"b15","series-title":"Pan Afr Med J","first-page":"5","article-title":"Cholera outbreak in a na\u00efve rural community in northern Nigeria: the importance of hand washing with soap, September 2010","volume":"30","author":"Gidado","year":"2018"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"1314","article-title":"Observed handwashing with soap practices among cholera patients and accompanying household members in a hospital setting (CHoBI7 Trial)","volume":"95","author":"Zohura","year":"2016"},{"key":"b17","series-title":"Int J Epidemiol","first-page":"2056","article-title":"Impact of adding handwashing and water disinfection promotion to oral cholera vaccination on diarrhoea-associated hospitalization in Dhaka, Bangladesh: evidence from a cluster randomized control trial","volume":"46","author":"Najnin","year":"2017"},{"key":"b18","series-title":"J Appl Microbiol","first-page":"1002","article-title":"Tubewell water quality and predictors of contamination in three flood-prone areas in Bangladesh","volume":"105","author":"Luby","year":"2008"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"1067","article-title":"Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004","volume":"74","author":"Schwartz","year":"2006"},{"key":"b20","series-title":"Trop Geogr Med","first-page":"377","article-title":"Cholera epidemic and natural disasters: where is the link?","volume":"41","author":"Siddique","year":"1989"},{"key":"b21","series-title":"Trop Med Int Health","first-page":"455","article-title":"Drinking cholera: salinity levels and palatability of drinking water in coastal Bangladesh","volume":"20","author":"Grant","year":"2015"},{"key":"b22","series-title":"Trop Med Int Health","first-page":"46","article-title":"Irrigation water as a source of drinking water: is safe use possible?","volume":"6","author":"van der Hoek","year":"2001"},{"key":"b23","series-title":"Int J Infect Dis","first-page":"55","article-title":"Fecal contamination hotspots in low-income households in Bangladesh","volume":"73","author":"Hossain","year":"2018"},{"key":"b24","series-title":"J Water Health","first-page":"714","article-title":"A rapid assessment of drinking water quality in informal settlements after a cholera outbreak in Nairobi, Kenya","volume":"13","author":"Blanton","year":"2015"},{"key":"b25","series-title":"Am J Trop Med Hyg","first-page":"1299","article-title":"Chlorination of household drinking water among cholera patients\u2019 households to prevent transmission of toxigenic Vibrio cholerae in Dhaka, Bangladesh: CHoBI7 trial","volume":"95","author":"Rashid","year":"2016"},{"key":"b26","series-title":"Exploring the Influence of Seasonal Hazards on Cholera Transmission Routes in the Light of Climate Change and the Climate Change Narrative in Bangladesh","author":"Grant","year":"2019"},{"key":"b27","series-title":"World J Microbiol Biotechnol","first-page":"146","article-title":"Survival of Vibrio cholerae O1 on fomites","volume":"32","author":"Farhana","year":"2016"},{"key":"b28","series-title":"Trop Med Int Health","first-page":"2","article-title":"Can Escherichia coli fly? The role of flies as transmitters of E. coli to food in an urban slum in Bangladesh","volume":"23","author":"Lindeberg","year":"2018"},{"key":"b29","series-title":"Acta Pathol Microbiol Immunol Scand","first-page":"421","article-title":"Historical and contemporary views on cholera transmission: are we repeating past discussions? Can lessons learned from cholera be applied to COVID-19?","volume":"129","author":"Jensen","year":"2020"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/108\/3\/article-p518.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/108\/3\/article-p518.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/108\/3\/article-p518.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T13:30:38Z","timestamp":1677677438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/108\/3\/article-p518.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,1]]},"references-count":29,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0708","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,1]]}}}