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Center for American Indian Health
415 N. Washington Street
4th Floor
Baltimore, MD 21231
phone: (410) 955-6931
toll free: 1-800-509-8456
fax: (410) 955-2010

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Research and Programs

Pilot Study of the Association between Acute Gastroenteritis and Water Quality, Availability, and Handling Practices on the Navajo Nation

This is a case-control study of water contamination as a risk for diarrheal disease among Navajo Nation residents. This study is a collaboration between the Johns Hopkins Center for American Indian Health and the Centers for Disease Control and Prevention, who will be conducting the laboratory testing.  


  1. To evaluate potential associations between the incidence of acute gastroenteritis among Navajo Nation residents presenting for medical care and household drinking water quality, availability, and handling practices.
  2. To determine the specific etiologic causes of acute gastroenteritis among Navajo Nation residents presenting for medical care and determine if enteric pathogens and microbial indicators of fecal contamination are present in the primary household drinking water source of the patients.

The study took place in the Chinle and Fort Defiance Service Units.  32 cases and 29 controls were enrolled in the study.  American Indians seeking care for diarrheal illness were enrolled as cases.  American Indians of a similar age who are seeking medical care for something other than diarrhea at the same facilities were enrolled as controls.  A questionnaire was administered about participants’ health, their water source, and the illness they are experiencing and a stool sample is collected. Finally, the participant’s home was visited for the purpose of sampling the source of drinking water and to find out more about where the water comes from.

The stool and water samples were tested for presence of bacteria, viruses and parasites that can cause diarrhea. Results of stool and water tests were provided back to the participants in the study so that they will know if their illness was associated with contaminated water and whether or not the water source they are using has viral or bacterial pathogens in the water.  Analysis for this study is ongoing.

Project PI: Dr. Katherine O’Brien
JHU Co-Investigators: Dr. James Campbell, Dr. Raymond Reid, Robert Weatherholtz
CDC Co-Investigators: Aron Hall, Douglas Esposito,Vincent Hill

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