Word: bolivia
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Public-health experts now say the increase in hand-washing across the country may have had some collateral benefits, not only in helping to reduce H1N1 infections, but also the spread of other common diseases in Bolivia. "We see a steady 10% to 15% drop in the rate of incidence of acute diarrheal diseases in all age groups, compared with last year's numbers at this time," says Dr. René Lenis, Bolivia's director of epidemiology, referring to data collected on the number of weekly cases of diarrheal disease reported in medical centers nationwide...
Although the new statistics, and the apparent link between hand-washing practices and disease reduction, need further investigation, "this certainly raises our attention," says Lenis. Diarrheal diseases are the biggest killer of children under age 5 worldwide; in Bolivia, 30,000 children die each year from such illnesses. Swine flu, as H1N1 is still referred to there, has hit Bolivia hard as well, with more than 2,000 infections and 55 deaths in a country of 9 million, most having occurred during the southern hemisphere's winter (June through August). (Read "Child-Care Centers and Parents Brace for Flu Season...
When the virus first appeared, say government officials, the country reacted the only way it could. "You can combat these outbreaks in two ways - medically and nonmedically," says Lenis. "Bolivia doesn't have the medical resources that other countries do, so we rely on prevention and educational campaigns...
Often, though, the problem is not just about good habits or bad ones but about access to clean water or the ability to afford soap. In Bolivia, 25% of the country still doesn't have access to water in the home. Health officials recognize that every citizen must have a sink to wash their hands in before they can expect significant reduction in disease. But when more than half the population is already living with some sort of bacterial or parasitic stomach infection, it's crucial to encourage those who can wash their hands...
Lenis and Dooley are still wary of the short-term data on Bolivia's descending rates of diarrheal disease; it remains to be seen whether the trend will hold up. But the findings "make a lot of sense, because behavior change like increased hand-washing happens quicker when there is a perceived threat," says Dooley. She says she has not seen similar data regarding a drop in rates of diarrheal or other diseases on an H1N1 timeline from other countries (though at least one news report suggests that increased hand-washing due to H1N1 has led to a sharp reduction...