The effect of the waste disposal crisis on the rates of hospitalization due to acute diarrheal illness in a middle-income country: Retrospective chart review

Abstract

Background: A waste disposal crisis occurred in Lebanon leading to the accumulation of garbage in the streets of Beirut. It is not clear whether such a limited crisis of improper waste disposal will lead to more diarrhea illnesses. The purpose of this study is to compare the rates of admissions due to diarrhea and characterize the illness among adults and children before, during and after the garbage crisis. Materials and methods: This study is an observational retrospective in-patient chart review extending over four time intervals: pre-crisis, major crisis, minor crisis, and post-crisis periods. Hospital admissions due to diarrhea or gastroenteritis were included. Descriptive analysis of the following was done: characteristics of the present illness at the time of admission, stool and lab tests ordered and management of the diarrhea illness. Results: There was an increase in admission rates due to diarrhea in the months of the crisis as compared to pre and post-crisis months. The severity of diarrheal illness and the management of admitted patients were almost the same across the four periods. Rota virus diarrheal outbreak was noted during the major crisis among children less than 2 years old, and adults above 18 years old. Conclusions: Despite an increase in the rates of admissions due to diarrhea during the garbage crisis, the severity of the diarrhea illness did not differ. This may indicate that physicians and patients were more worried and utilized more health services. However, Rota outbreaks may be more prominent with improper garbage disposal. Keywords: Diarrhea, Waste disposal, Rota virus, Garbage crisis, Middle East