Health Implications for Children in Wastewater-Irrigated Peri-Urban Aleppo, Syria

Despite widespread irrigation with diluted, untreated, or partially treated wastewater in developing countries, health implications of such irrigation on children living in wastewater-irrigated area have rarely been addressed. In a survey study, we investigated health implications of wastewater irrigation on children (8–12 years) in peri-urban Aleppo region, Syria. Six villages were selected within wastewater-irrigated area and six from freshwater-irrigated area. In consultation with the health officials and medical practitioners, two waterborne diseases (typhoid fever and gastroenteritis) and three non-waterborne diseases (flu, chickenpox, and strep throat) were selected along with eczema that may stem from watery or non-watery sources. Flu and strep throat had significantly higher prevalence rates in freshwater-irrigated area than those in wastewater-irrigated area while reverse was the case for gastroenteritis and eczema, i.e. significantly higher prevalence rates in wastewater-irrigated area. The prevalence rates of typhoid and chickenpox in both areas were low with non-significant differences between freshwater and wastewater areas. The annual health cost per child was 73 % higher in wastewater area than the health cost for the same age group in freshwater area. These findings suggest the need for hygiene education and an action plan that would help improving water quality and promoting the use of protective measures in handling wastewater and/or its products.