Spatial Distribution and Trends of Waterborne Diseases in Tashkent Province

Main Article Content

Veluswami Saravanan Subramanian
Min Jung Cho
Siwei Zoe Tan
Dilorom Fayzieva
Christian Sebaly


Introduction: The cumulative effect of limited investment in public water systems, inadequate public health infrastructure, and gaps in infectious disease prevention increased the incidence of waterborne diseases in Uzbekistan. The objectives of this study were: (1) to spatially analyze the distribution of the diseases in Tashkent Province, (2) to identify the intensity of spatial trends in the province, (3) to identify urban-rural characteristics of the disease distribution, and (4) to identify the differences in disease incidence between pediatric and adult populations of the province.

Methods: Data on four major waterborne diseases and socio-demographics factors were collected in Tashkent Province from 2011 to 2014. Descriptive epidemiological methods and spatial-temporal methods were used to investigate the distribution and trends, and to identify waterborne diseases hotspots and vulnerable population groups in the province.

Results: Hepatitis A and enterobiasis had a high incidence in most of Tashkent Province, with higher incidences in the eastern and western districts. Residents of rural areas, including children, were found to be more vulnerable to the waterborne diseases compared to other populations living in the province.

Conclusions: This pilot study calls for more scientific investigations of waterborne diseases and their effect on public health in the region, which could facilitate targeted public health interventions in vulnerable regions of Uzbekistan. 


Article Details

How to Cite
Subramanian, V. S., Cho, M. J., Tan, S. Z., Fayzieva, D., & Sebaly, C. (2017). Spatial Distribution and Trends of Waterborne Diseases in Tashkent Province. Central Asian Journal of Global Health, 6(1).


UNFCC. Climate Change: Impacts, Vulnerabilities and Adaptation in Developing Countries. Bonn: United Nations Framework for Climate Convention (1), 2007. Accessed 4 July 2017.

GWP. Central Asia and Caucasus- Regional Review, Water Supply and Sanitation in the Countries of Central Asia and Southern Caucasus. Global Water Partnership, 2009. Accessed 4 July 2017.

Mermin J, Villar R, Carpenter J, Roberts L, Samaridden A, Gasanova L, et al. A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water. The Journal of Infectious Diseases. 1999;179(6):1416-22.

Matthys B, Bobieva M, Karimova G, Mengliboeva Z, Jean-Richard V, Hoimnazarova M, et al. Prevalence and risk factors of helminths and intestinal protozoa infections among children from primary schools in western Tajikistan. Parasites Vectors. 2011;4(195):13.

Steinmann P, Usubalieva J, Imanalieva C, Minbaeva G, Stefiuk K, Jeandron A, et al. Rapid appraisal of human intestinal helminth infections among schoolchildren in Osh Oblast, Kyrgyzstan. Acta Tropica. 2010;116(3):178-84.

Small I, Falzon D, LBW vdM, Ford N. Safe water for the Aral Sea area. Could it get any worse? European Journal of Public Health. 2003;13(1): 87-89.

FAO. Irrigation in Central Asia in Figures. Geneva: FAO Land and Water Division, 2013. Accessed 4 July 2017.

Bekturganov Z, Tussupova K, Berndstsson R, Sharapatova N, Aryngazin K, Zhanasova M. Water-related health problems in Central Asia – A review. Water. 2016;8(6-219):13.

Crighton E, Barwin L, Small I, Upshur R. What have we learned? A review of the literature on children's health and the environment in the Aral Sea area. International Journal of Public Health. 2011;56:126-38.

Latipov R, Utegenova E, Kuatbayeva A, Kasymbekova K, Anbdykarimov S, Juraev R, et al. Epidemiology and burden of rotavirus disease in Central Asia. International Journal of Infectious Diseases. 2011;15:e464-e9.

Herbst S, Fayzieva D, Kistemann T. Risk factor analysis of diarrhoeal diseases in the Aral Sea area (Khorzem, Uzbekistan). International Journal of Environmental Health Research. 2008;18(5).

Semenza J, Roberts L, Henderson A, Bogan J, Rubin C. Water distribution system and diarrheal disease transmission: A case study in Uzbekistan. The American Journal of Tropical Medicine and Hygiene. 1998;59(6):941-6.

Global Health Observatory, Kazakhstan. 2015 . Accessed 4 July 2017.

Global Health Observatory Kyrgyzstan. 2015. Accessed 4 July 2017.

Global Health Observatory Tajikistan 2015. Accessed 4 July 2017.

Global Health Observatory Turkmenistan 2015. Accessed 4 July 2017.

Global Health Observatory Uzbekistan 2015. Accessed 4 July 2017.

UNECE. Environmental Performance Reviews: Uzbekistan - Second Review. 2010 Environmental Performance Reviews Series No. 29. Accessed 4 July 2017.

Mirshina O. Water and hygiene in Uzbekistan: An overview. Global Environmental Change and Water-related Diseases: Improving Risk Assessment Strategies for Public Health Care in Uzbekistan; 2-6 May 2011; Tashkent, Uzbekistan 2011.

WHO. Public health risk assessment and interventions: Kyrgystan and Uzbekistan. Bonn: World Health Organization (WHO) Regional Office for Europe, 2010.

WHO/UNICEF. Joint Monitoring Program for Water Supply and Sanitation - Estimates on the use of water sources and sanitation facilities. World Health Organization, UNICEF, 2015.[type]=country_files. Accessed 4 July 2017.

World Bank. Social Impact Analysis of Water Supply and Sanitation Services in Central Asia: The Case of Uzbekistan. World Bank, 2015. Accessed 4 July 2017.

UNDP. Water: Crtical Resource for Uzbekistan's Future. Tashkent, Uzbekistan: United Nations Development Program, 2007. Accessed 4 July 2017.

Alimova F, Fayzieva D. Spatial pattens of water-borne diseases in relation with climatic conditions in Tashkent Province, Uzbekistan. Conference paper presented at the ‘Water and Health’ Conference; University of North Carolina: Water Institute; 2013.

Republic of Uzbekistan. Uzbekistan Health Examination Survey 2002. Tashkent: Analytical and Information Center, Ministry of Health, Republic of Uzbekistan, ORC macro Calverton, Maryland USA, 2002. . Accessed 4 July 2017.

Ahmedov M, Azimov R, Mutalov Z, Huseynov S, Tsoyi E, Rechel B. Uzbekistan: Health System Review. 2014. Health Syst Transit. 2014;16(5):1-137, xiii.

Sharapov M, Favorov M, Yashina T, Brown M, Onischenko G, Margolis H, et al. Acute viral hepatitis morbidity and mortality associated with hepatitis E virus infection: Uzbekistan surveillance data. BMC Infectious Diseases. 2009;9:35.

Niyazmatov B, Shefer A, Grabowsky M, Vitek C. Diphtheria epidemic in the Republic of Uzbekistan-1993-196. Journal of Infectious Diseases. 2000;181(Supplement 1):S104-9.

Open Street Map. Available from: Accessed 4 July 2017.

DeLorme World Basemap. Accessed 4 July 2017.

Hota T. Trend Surface Analysis of Spatial Data. Gondwana Geological Magazine. 2014;29:39-44.

Ibadov G, Akhmedova M, Kasymbekova K, Khodjaev N, Shirinova N, Baltabaeva M. Environment and Infectious Diseases. In: Fayzieva D, editor. Environmental Health in Central Asia: The Present and the Future. Southhampton, Boston: WIT Press; 2004. p. 129-55.

Fayzieva D. Environmental Health in Central Asia: The Past and Future. Southampton, Boston: WIT Press; 2004. 257 p.

Corcoran E, Nellemann C, Baker E, Bos R, Osborn D, Savelli H, editors. Sick Water? The Central Role of Wastewater Management in Sustainable Development. A Rapid Response Asessment: United Nations Environment Pro- gramme, UN-HABITAT, GRID-Arendal. 2010. Accessed 4 July 2017.

Raschid-Sally L, Jayakodi P. Drivers and characteristics of wastewater agriculture in developing countries: Results from a global assessment. Colombo, Sri Lanka: International Water Management Institute, 2008. Research Report 127. Accessed 4 July 2017.

Maier C, Martin-Moreno J. Quo Vadis SANEPID? A Cross country analysis of public health reforms in 10 post-soviet states. Health Policy. 2011;102(1):18-25.

Usmanov I, Favorov MO, Chorba T. Universal immunization: The Diphtheria Control Strategy of Choice in the Republic of Tajikistan-1993-1997. Journal of Infectious Diseases. 2000;181 (Supplement -1):S86-S93.

Gungoren B, Latipov R, Regallet G, Musabaev E. Effect of hygiene promotion on the risk of reinfection rate of intestinal parasites in children in rural Uzbekistan. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007;101(6):564-9.

Hay J, Yeh K, Dasgupta D, Shapieva Z, Omasheva G, Deryabin P, et al. Biosurveillance in Central Asia: Successes and challenges of tick-borne disease research in Kazakhstan and Kyrgyzstan. Frontiers in Public Health. 2016; 4(4).