Prevalence Of Women Health And It’s Association With Chlorinated Drinking Water Among The Reproductive Age-group Women In Chattogram.

Abstract

Background: Water quality remains a dominant problem in most urban areas, especially in developing countries like Bangladesh, where chlorinated drinking water and its attendant health implications, including pregnancy disorders, are poorly taken into consideration. Water quality is problematic in Chittagong, which is among the largest cities in Bangladesh and relies on chlorination for centralized water disinfection by WASA. Chlorinated drinking water may contain disinfection by-products (DBPs) such as trihalomethanes (THMs), which have been associated with different health adversities, including pregnancy complications. Despite the wide use of chlorine in water disinfection, not much is known through extensive research that explores the association between chlorinated drinking water and health and pregnancy complication in Chittagong. This study seeks to fill this gap by evaluating the knowledge, attitudes, and practices (KAP) regarding the use of water and purification methods, and the potential relationship between chlorinated drinking water and adverse pregnancy outcomes. Methodology This cross-sectional observational survey was conducted in Chittagong, Bangladesh, and was aimed at assessing the association between chlorinated drinking water and adverse health and pregnancy outcomes. The study households and the community were selected randomly. The research participants were reproductive-age women from the selected households. The sample was calculated based on a 50% expected prevalence, 95% confidence, and 5% margin for error, with an adjusted sample size of 424 respondents. Quantitative data were gathered using structured questionnaires on demographics, water use behavior, and self-reported health indicators. Water samples were also drawn from the households to perform laboratory analysis to measure chlorine levels. Data were analyzed using IBM SPSS Statistics (version 20) with univariate analysis to determine frequency distributions.

Result The sample consisted of 273 women with a mean age of 37.4 ± 7.8 years. The most common occupation of the study population was housewives (82.4%), and the highest income group had a household income of 50,000-79,999 BDT (31.1%). Complications in pregnancy were found to be frequent, as 25.3% of the women had a non-live birth pregnancy outcome. The KAP findings indicated that while 88.3% of the respondents did not drink tap water per se, many used it for household purposes like washing fruits (95.2%), cooking (84.6%), and personal hygiene (98.2%). The majority of participants (59.7%) were aware of disinfection methods, though fewer (31.5%) were aware of the application of chlorine in their water. Analysis of the water sample revealed that most of the drinking water had chlorine levels below 0.5 ppm, with a minimal percentage (approximately 10%) having chlorine levels above this level. The pregnancy complications reported were miscarriage (29.3%), reproductive complications (16.1%), and complications in children's health (15.4%). In terms of health outcomes, liver complications (72.2%), rashes on the skin (70.3%), and gastrointestinal complications (45.4%) were the most commonly reported. Conclusion This work postulates the major contribution of water drinking patterns and awareness in the health effects of the population in Chittagong. Although general satisfaction with water quality was moderate, it is surprising that awareness in the area of chlorine disinfection is weak, and this unawareness may influence water purification practice and general well-being. The results imply the potential existence of Ireland-like relationships between chlorinated drinking water and some of the health consequences, such as complications during pregnancy. But the relation between water chlorine concentration and complications during pregnancy needs to be researched more fully. The results highlight the necessity for a greater effort to raise public awareness of water purification and monitor water quality in urban areas to reduce the potential hazard of chlorinated water on health.