Objective To assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreón, Mexico. Design Cross-sectional household survey conducted in two waves (rainy and dry seasons). Participants 500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale. Primary outcome measures The HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale. Results Water system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (β=0.28, SE=0.07, t =4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress. Conclusion Short-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities.

中文翻译：

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横断面研究，以衡量墨西哥市区的家庭用水不安全状况及其健康结果

目的评估墨西哥水上不安全的结构性因素和家庭决定因素之间的联系，并测试三种水不安全性措施，以应对墨西哥托伦市中等收入和低收入城市地区自我报告的腹泻，登革热和感知压力。设计在两次浪潮（雨季和旱季）中进行的横断面住户调查。参与者通过选定社区中的多阶段聚类样本选择了500户家庭。社会经济地位决定了参与社区的选择；在社会经济地位低的社区确定了五个，在社会经济地位低的社区确定了五个。我们研究了城市供水的背景如何与新的跨文化有效的家庭用水不安全经验量表（HWISE）相关。主要结局指标HWISE量表，自我报告的腹泻，登革热和感知压力量表。结果水系统的间歇性（调整后的OR（AOR）3.96，95％CI 2.40至6.54，p <0.001），不可预测性（AOR 2.24，95％CI 1.34至3.74，p = 0.002）和旱季（AOR 3.47，95％ CI 2.18至5.52，p <0.001）是HWISE量表的结构相关性。这项研究还发现，HWISE量表与两项健康结局相关，自我报告的腹泻（AOR 1.09，95％CI 1.03至1.15，p = 0.002）和感知的压力（β= 0.28，SE = 0.07，t = 4.30， p <0.001），但非自我报告的登革热（AOR 1.02，95％CI 0.98至1.06）。3项卫生评分和3项水忧虑评分也与自我报告的腹泻和感觉到的压力呈正相关。