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Geospatial Analysis of Water-Associated Infectious Diseases: Case of Myanmar

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A thesis submitted to the Department of Environmental Sciences and Policy of Central European University in part fulfilment of the Degree of Master of Science Geospatial Analysis of Water-associated Infectious Diseases: Case of Myanmar Slobodan Tofiloski CEU eTD Collection July, 2018 Budapest i Notes on copyright and the ownership of intellectual property rights: (1) Copyright in text of this thesis rests with the Author. Copies (by any process) either in full, or of extracts, may be made only in accordance with instructions given by the Author and lodged in the Central European University Library. Details may be obtained from the Librarian. This page must form part of any such copies made. Further copies (by any process) of copies made in accordance with such instructions may not be made without the permission (in writing) of the Author. (2) The ownership of any intellectual property rights which may be described in this thesis is vested in the Central European University, subject to any prior agreement to the contrary, and may not be made available for use by third parties without the written permission of the University, which will prescribe the terms and conditions of any such agreement. (3) For bibliographic and reference purposes this thesis should be referred to as: Tofiloski, S. 2018. Geospatial analysis of water-associated infectious diseases: Case of Myanmar. Master of Science thesis, Central European University, Budapest. Further information on the conditions under which disclosures and exploitation may take place is available from the Head of the Department of Environmental Sciences and Policy, Central European University. CEU eTD Collection ii Author’s declaration No portion of the work referred to in this thesis has been submitted in support of an application for another degree or qualification of this or any other university or other institute of learning. Slobodan Tofiloski CEU eTD Collection iii Acknowledgements I want to thank God for keeping me strong to sustain during the whole process of creation of this thesis. I want to thank my parents and my girlfriend Ana for giving me their material, technical and emotional support, for their sincere advices and for their unlimited and unselfish patience and love during the writing process. I am grateful for having Prof. Dr. Viktor Lagutov as mentor, for his unselfish friendly advices and professional insights. I am also grateful for having such a wonderful circle of friends and colleagues around me during the working process. Rual, Ladu, Danica, Aydana, Chris, I will miss that sleepless nights in Syslab. CEU eTD Collection iv CENTRAL EUROPEAN UNIVERSITY ABSTRACT OF THESIS Submitted by: Slobodan Tofiloski For the degree of Master of Science and entitled: Geospatial analysis of water-associated infectious diseases: Case of Myanmar Month and Year of submission: July, 2018. Water can serve as a medium for pathogenic organisms, posing substantial health treats to humans through the variety of pathways. Water-associated infectious diseases are a major cause of morbidity and mortality in Myanmar. The recent environmental and social changes in Myanmar have significant influence over water-associated infectious diseases and it is expected for that trend to continue in future. Alterations in climate factors, human migration caused by several ongoing armed conflicts, low levels of sanitation, difficult access to clean drinking water, increased agricultural practices and industrialization; all of them can change the patterns of distribution, emergence, and re-emergence of the water-associated infectious diseases in Myanmar. This research utilizes the social and environmental determinants mentioned above and water-associated prevalence data in conjunction with a GIS analysis method, to present the distribution and risk of the water-associated diseases in Myanmar and their relation with diverse factors. The results show that Yangon has the highest number of waterborne diseases outbreaks and second highest number of water-related diseases outbreaks. Results also show that there is CEU eTD Collection specific interconnected influence of different factors, with some of them dominating in certain states or regions. KEYWORDS: GIS analysis, Myanmar, water, water-associated diseases, social and environmental factors. v Table of Contents Acknowledgements ....................................................................................................................................... iv Table of figures ............................................................................................................................................. vii Table of tables ............................................................................................................................................. viii List of Abbreviations ...................................................................................................................................... ix 1. Introduction ........................................................................................................................................... 1 1.1. Background of the problem ........................................................................................................... 1 1.2. Aim and objectives of the thesis .................................................................................................... 2 1.3. Thesis outline ................................................................................................................................ 3 2. Literature review ................................................................................................................................... 4 2.1. Water and water-associated diseases ........................................................................................... 4 2.1.1. Water-associated diseases: question of history or visible presence? ................................... 5 2.2. Myanmar geographical and socio-economic background ............................................................. 6 2.2.1. Geography and climate .......................................................................................................... 6 2.2.2. Socio-historical status ............................................................................................................ 9 2.3. Major water-associated diseases present in Myanmar ................................................................ 10 2.3.1. Waterborne diseases ............................................................................................................ 10 2.3.1.8. Situation in Myanmar ...................................................................................................... 14 2.3.2. Water-associated diseases .................................................................................................. 15 2.4. Major factors influencing water-associated diseases................................................................... 23 2.4.1. Social factors ....................................................................................................................... 23 2.4.2. Environmental factors ......................................................................................................... 28 1.1.2. Natural disasters .................................................................................................................. 35 1.2. GIS for health and epidemiological studies ................................................................................. 36 1.2.1. Geospatial epidemiological and health studies in the South-East Asian region .................. 40 2. Methodology ....................................................................................................................................... 41 2.1. Data collection and organization ................................................................................................. 41 CEU eTD Collection 2.1.1. Water-associated diseases outbreaks database ................................................................. 41 2.1.2. Social and environmental GIS data ..................................................................................... 42 2.2. ArcGIS mapping and geospatial data analysis ............................................................................ 44 2.3. Research limitations .................................................................................................................... 45 vi 3. Results and discussion ......................................................................................................................... 46 3.1. Number of water-associated outbreaks and cases by regions ................................................... 47 Number of waterborne outbreaks ...................................................................................................... 47 Number of water-related outbreaks ................................................................................................... 49 3.2. Geospatial correlation between the diseases distribution and the possible factors .................. 52 3.2.1. Social factors ....................................................................................................................... 52 3.2.2. Environmental factors ......................................................................................................... 55 3.3. Situation in the most affected regions .......................................................................................
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