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Cholera as a 'sanitary test' of British cities, 1831-1866.

ABSTRACT: The malign contribution of northern industrial cities to the stagnation of national life expectancy over the period 1820-1870 forms part of one of the most long-running debates in English economic history, regarding the impact of early industrialisation on living standards. The deteriorating quality of urban water supplies often features in these arguments as the key driver of worsening mortality in this period. Here we use mortality reported from cholera in the epidemic years 1831-1832 and 1848-1849 as an indicator of the extent of sewage contamination of water in English and Welsh towns in this period. Surprisingly, the geography of reported mortality did not indicate that northern manufacturing and industrial towns were especially deficient in this respect. However, logistic regression analyses identified a number of risk factors for high cholera mortality, including location on coal-bearing strata, which was a feature of many industrial towns. Notably, however, textile-manufacturing towns, although often located in coal-rich districts, were associated with low levels of cholera mortality, and high population growth rates did not influence the risk of cholera. Reductions in cholera mortality after 1849 raise the possibility of widespread improvements in water quality after mid-century, rather earlier than is often assumed. However, in contrast to cholera, infant and diarrhoeal mortality remained high especially in northern towns until at least 1900. Several lines of evidence suggest that infants were relatively protected from waterborne diseases such as cholera and typhoid, and therefore did not benefit greatly from improvements in water quality. We conclude (1) that any worsening of water quality in urban areas c.1800-1850 was not confined to new? or rapidly growing industrial or manufacturing towns; and (2) infants probably rarely drank untreated water, so high infant or diarrhoeal mortality rates should not be read as indicators of poor water quality, in the English context.

SUBMITTER: Davenport RJ

PROVIDER: S-EPMC6582458 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Cholera as a 'sanitary test' of British cities, 1831-1866.

Davenport Romola Jane RJ Satchell Max M Shaw-Taylor Leigh Matthew William LMW

The history of the family : an international quarterly 20181103 2

The malign contribution of northern industrial cities to the stagnation of national life expectancy over the period 1820-1870 forms part of one of the most long-running debates in English economic history, regarding the impact of early industrialisation on living standards. The deteriorating quality of urban water supplies often features in these arguments as the key driver of worsening mortality in this period. Here we use mortality reported from cholera in the epidemic years 1831-1832 and 1848 ...[more]

PMID: 31274973

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Project description:BackgroundEcological and environmental protection is essential to achieving sustainable and high-quality development, which highlights the important role of environmental governance. In terms of the practical actions of environmental governance, the central government in China has carried out continuous rating and praise campaigns, and local governments have actively promoted this effort. However, the related performance consequences have not been empirically investigated. We aimed to verify whether this incentive policy can improve the efficiency of environmental governance and whether this governance method has long-term effects. In addition, we sought to identify mechanisms through which the policy can improve environmental governance.MethodWe take the rating and praise campaign of the Establishment of National Sanitary Cities (EONSCs) as a quasi-natural experiment and use the panel data for 174 cities from 2004 to 2016 and the propensity score matching-difference in differences (PSM-DID) method to test the impact of rating and praise campaigns on environmental governance efficiency.ResultsEONSCs campaign can improve the efficiency of environmental governance by 0.7595 (p<0.01), which is significant at the 1% level; the effects are clearly significant during the evaluation process and the year in which cities are named National Sanitary Cities (NSCs) but decrease annually thereafter. The EONSCs campaign has a significant promoting effect on public services provision, such as public infrastructure investment, public transportation and education.Conclusions(1) The rating and praise campaigns can effectively improve the efficiency of environmental governance; (2) the incentive effect is distorted and is not a long-term effect; (3) the impact of the rating and praise campaign of EONSCs on the efficiency of environmental governance is mainly realized through the provision of corresponding public services that are closely related to environmental protection. The findings of this paper provide empirical support for the effectiveness of the central government's rating and praise campaigns and could motivate local governments to actively participate in environmental governance. Moreover, the findings provide an important reference for further improving the rating and praise campaigns and the level of environmental governance.

Project description:BackgroundCholera remains a substantial health burden in Asia and Africa particularly in resource poor settings. The standard procedures to identify the etiological organism V. cholerae are isolation from microbiological culture from stool as well as Polymerase Chain Reaction (PCR). Both the processes are highly lab oriented, labor extensive, time consuming, and expensive. In an effort to control for outbreaks and epidemics; an effective, convenient, quick and relatively less expensive detection method is imperative, without compromising the sensitivity and specificity that exists at present. The objective of this component of the study was to evaluate the effectiveness of a locally produced rapid diagnostic test (RDT) for cholera diagnosis.MethodsIn Bangladesh, nationwide cholera surveillance is ongoing in 22 hospitals covering all 8 divisions of the country since June, 2016. In the surveillance, stool samples have been collected from patients presenting to hospitals with acute watery diarrhea. Crystal VCTM (Span diagnostics, India) and Cholkit (locally produced RDT) have been used to detect V. cholerae from stool samples. Samples have also been sent to the main laboratory at icddr,b where the culture based isolation is routinely performed. All the tests were carried out for both direct and enriched stool samples. RDT sensitivity and specificity were calculated using stool culture as the gold standard.ResultsA total of 7720 samples were tested. Among these, 5865 samples were solely tested with Crystal VC and 1355 samples with Cholkit whereas 381 samples were tested with both the RDTs. In comparison with culture, direct testing with Crystal VC showed a sensitivity of 72% (95% CI: 50.6% to 87.9%) and specificity of 86.8% (95% CI: 82.8% to 90.1%). After enrichment the sensitivity and specificity was 68% (95% CI: 46.5% to 85.1%) and 97.5% (95% CI: 95.3% to 98.8%) respectively. The direct Cholkit test showed sensitivity of 76% (95% CI: 54.9% to 90.6%) and specificity of 90.2% (95% CI: 86.6% to 93.1%).ConclusionThis evaluation has demonstrated that the sensitivity and specificity of Cholkit is similar to the commercially available test, Crystal VC when used in field settings for detecting V. cholerae from stool specimens. The findings from this study suggest that the Cholkit could be a possible alternative for cholera endemic regions where V. cholerae O1 is the major causative organism causing cholera.

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Cholera as a 'sanitary test' of British cities, 1831-1866.

Publications

Cholera as a 'sanitary test' of British cities, 1831-1866.

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