1
|
Birdida RT, Malka ES, Negash Kush E, Tolesa Alemu F. Hygienic practice during complementary feeding and associated factors among mothers of children aged 6-24 months in Borecha Woreda, southwestern Ethiopia: a community-based cross-sectional study. Front Pediatr 2024; 12:1321558. [PMID: 39435388 PMCID: PMC11491354 DOI: 10.3389/fped.2024.1321558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 09/06/2024] [Indexed: 10/23/2024] Open
Abstract
Introduction Complementary feeding is a critical transitional phase in the life of an infant, and complementary foods should be prepared, stored, and fed hygienically, with clean hands, dishes, and utensils to prevent diseases. However, the prevalence and risk factors associated with hygienic complementary feeding practice have not been well addressed in Ethiopia, especially in the study area. Objective This study aimed to assess hygienic practices and associated factors during complementary feeding among mothers with children aged 6-24 months in Borecha Woreda, Buno Bedele Zone, southwestern Ethiopia, in 2022. Methods A community-based cross-sectional study was conducted using a multistage sampling technique. The study was conducted on 536 mothers of children aged 6-24 months in Borecha Woreda from 1 March to 1 April 2022. Data were collected using an interviewer-administered questionnaire. The data were coded, cleaned, edited, and entered into Epi-Data version 4.6 and then exported to SPSS version 20.0 for further analysis. Both bivariate and multivariable logistic regression models were fitted. Moreover, crude (for bivariate) and adjusted (multivariable) odds ratios (AORs) with 95% confidence intervals (CIs) were computed to assess the association between independent factors and outcome variables. A p-value of <0.05 was considered statistically significant. Result Out of 536 respondents, 350 (65.3%) exhibited poor hygienic practices during complementary feeding. The risk of poor hygienic practices was about two times higher among women over 30 than those under 25 (AOR: 1.8; 95% CI: 1.11-2.90). Mothers whose husbands had primary education or higher had a 50% reduced risk (AOR: 0.50; 95% CI 0.31-0.83) of poor hygienic care practices during complementary feeding compared to their counterparts. The odds of poor hygiene practice among mothers with poor knowledge of hygienic care were 2.71 times higher than those with good knowledge (AOR: 2.71; 95% CI: 1.60-4.61). Conclusion The prevalence of poor hygienic practices during the preparation and handling of complementary foods among mothers in Borecha Woreda is high compared to other studies. Therefore, improving hygiene practices during complementary food preparation requires the involvement and responsibility of policymakers, the community, and families.
Collapse
Affiliation(s)
- Rabira Tariku Birdida
- Department of Public Health, Mettu University College of Health Sciences, Mettu, Ethiopia
| | - Erean Shigign Malka
- Department of Public Health, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| | - Efrem Negash Kush
- Department of Public Health, Mettu University College of Health Sciences, Mettu, Ethiopia
| | - Fikadu Tolesa Alemu
- Department of Midwifery, College of Medicine and Health Sciences, Salale University, Fitche, Ethiopia
| |
Collapse
|
2
|
Zemariam AB, Abey W, Kassaw AK, Yimer A. Comparative analysis of machine learning algorithms for predicting diarrhea among under-five children in Ethiopia: Evidence from 2016 EDHS. Health Informatics J 2024; 30:14604582241285769. [PMID: 39270135 DOI: 10.1177/14604582241285769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Background: Diarrhea is a major cause of mortality and morbidity in under-5 children globally, especially in developing countries like Ethiopia. Limited research has used machine learning to predict childhood diarrhea. This study aimed to compare the predictive performance of ML algorithms for diarrhea in under-5 children in Ethiopia. Methods: The study utilized a dataset of 9501 under-5 children from the Ethiopia Demographic and Health Survey 2016. Five ML algorithms were used to build and compare predictive models. The model performance was evaluated using various metrics in Python. Boruta feature selection was employed, and data balancing techniques such as under-sampling, over-sampling, adaptive synthetic sampling, and synthetic minority oversampling as well as hyper parameter tuning methods were explored. Association rule mining was conducted using the Apriori algorithm in R to determine relationships between independent and target variables. Results: 10.2% of children had diarrhea. The Random Forest model had the best performance with 93.2% accuracy, 98.4% sensitivity, 85.5% specificity, and 0.916 AUC. The top predictors were residence, wealth index, and child age, number of living children, deworming, wasting, mother's occupation, and education. Association rule mining identified the top 7 rules most associated with under-5 diarrhea in Ethiopia. Conclusion: The RF achieved the highest performance for predicting childhood diarrhea. Policymakers and healthcare providers can use these findings to develop targeted interventions to reduce diarrhea. Customizing strategies based on the identified association rules has the potential to improve child health and decrease the impact of diarrhea in Ethiopia.
Collapse
Affiliation(s)
- Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Wondosen Abey
- Departments of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Abdulaziz Kebede Kassaw
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ali Yimer
- Departments of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| |
Collapse
|
3
|
Khales P, Razizadeh MH, Ghorbani S, Moattari A, Sarvari J, Saadati H, Sayyahfar S, Salavatiha Z, Hasanabad MH, Poortahmasebi V, Tavakoli A. Human adenoviruses in children with gastroenteritis: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:478. [PMID: 38724898 PMCID: PMC11084101 DOI: 10.1186/s12879-024-09386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
PURPOSE Human adenoviruses (HAdVs) have always been suggested as one of the main causes of gastroenteritis in children. However, no comprehensive report on the global epidemiology of these viruses in pediatric gastroenteritis is available. METHODS A systematic search was conducted to obtain published papers from 2003 to 2023 in three main databases PubMed, Scopus, and Web of Science. RESULTS The estimated global pooled prevalence of HAdV infection in children with gastroenteritis was 10% (95% CI: 9-11%), with a growing trend after 2010. The highest prevalence was observed in Africa (20%, 95% CI: 14-26%). The prevalence was higher in inpatients (11%; 95% CI: 8-13%) and patients aged 5 years old and younger (9%; 95% CI: 7-10%). However, no significant difference was observed between male and female patients (P = 0.63). The most prevalent species was found to be the species F (57%; 95% CI: 41-72%). The most common HAdVs observed in children with gastroenteritis were types 40/41, 38, and 2. Analysis of case-control studies showed an association between HAdV and gastroenteritis in children (OR: 2.28, 95% CI; 1.51-3.44). CONCLUSION This study provided valuable insights into the importance of HAdVs in children with gastroenteritis, especially in hospitalized and younger children. The results can be used in future preventive measurements and the development of effective vaccines.
Collapse
Affiliation(s)
- Pegah Khales
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Razizadeh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Saied Ghorbani
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afagh Moattari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamal Sarvari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Saadati
- Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Shirin Sayyahfar
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Salavatiha
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Haghighi Hasanabad
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Vahdat Poortahmasebi
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Tavakoli
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Birhanu MT, Liga AD, Jabir YN. Practices of hygiene during complementary food feeding and associated factors among women with children aged 6-24 months in Dedo district, Southwest Ethiopia: A cross-sectional study. Health Sci Rep 2023; 6:e1771. [PMID: 38111740 PMCID: PMC10725999 DOI: 10.1002/hsr2.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023] Open
Abstract
Background and Aims Poor food handling practices contribute to food contamination, leading to food-borne illnesses and childhood diarrhea in developing countries like Ethiopia. This study examines hygienic complementary food feeding practices and associated characteristics among women with children ages 6-24 months in the Dedo District. Method A community-oriented cross-sectional study design was used in a multistage sampling strategy to gather information from 501 mothers of children between May 25 and July 10, 2022. There were absolute and relative frequencies assigned to each variable. Multiple logistic models have been used for factors that were 20% significant in univariate analysis. Odds ratios with corresponding 95% confidence intervals (CI) were produced to identify the important predictors. Results This study showed that mothers with a diploma (adjusted odds ratio [AOR]: 11.2; CI: 5.51-22.8), urban residency (AOR = 6.35; CI: 3.57-11.3), a positive attitude toward hygienic complementary food feeding (AOR = 2.23; CI: 1.19-4.20), good knowledge of complementary food feeding practices (AOR = 3.95; CI: 2.39-6.55), access to a hand washing facility close to the latrine (AOR = 2.60; CI: 1.55-4.36), and access to water close to their home (AOR = 2.42; CI: 1.27-4.59) were highly associated with good hygiene practices of mothers. Conclusion This study shows that mothers of children aged between 6 and 24 months have a very low overall prevalence of good hygienic complementary feeding practices. The concerned parties should therefore establish a healthcare educational program for mothers that emphasizes the importance of hand washing and informs them about the dangers of improper complementary feeding practices.
Collapse
Affiliation(s)
| | - Abebe D. Liga
- Department of Statistics, College of Natural and Computational SciencesWolkite UniversityWolkiteEthiopia
| | - Yasin N. Jabir
- Department of Statistics, College of Natural ScienceJimma UniversityJimmaEthiopia
| |
Collapse
|
5
|
Kassie GA, Gebeyehu NA, Gesese MM, Chekol Abebe E, Mengstie MA, Seid MA, Alebachew Bayih W, Feleke SF, Amare Tesfa N, Dejenie TA, Bantie B, Solomon Kebede Y, Zemene MA, Mengist Dessie A, Anley DT, Asmare Adella G. Hygienic practice during complementary feeding and its associated factors among mothers/caregivers of children aged 6-24 months in Wolaita Sodo town, southern Ethiopia. SAGE Open Med 2023; 11:20503121231195416. [PMID: 37655302 PMCID: PMC10467249 DOI: 10.1177/20503121231195416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction Complementary feeding is an important stage in a child's development as it provides the necessary nutrients for optimal growth and development. However, improper handling, storage, and preparation of complementary foods can result in contamination by microorganisms, leading to foodborne illnesses and malnutrition. Therefore, this study aimed to determine hygienic practices during complementary feeding and associated factors among mothers of children aged 6-24 months in Wolaita Sodo town, southern Ethiopia. Methods A community-based, cross-sectional study was undertaken among mothers/caregivers of children aged 6-24 months from December 1-30, 2022. A total of 602 participants were recruited using a simple random sampling procedure. The hygienic practice of complementary feeding was assessed based on a related seven items questionnaire (Cronbach's alpha 0.72). Data were entered into Epi-data version 4.6 and analyzed using Statistical Package for Social Science version 26. Multivariable binary logistic regression was used to identify the statistically significant factors associated with proper hygienic practice of complementary feeding. Variables with a p-value of <0.05 in the multivariable logistic regression analysis model were considered statistically significant. Results The study indicated that 42.0%, (95% confidence interval (CI): 38, 45.8) of the mothers/caregivers of children aged 6-24 months had proper hygienic practices during complementary feeding. Mothers who could read and write (adjusted odd ratio (AOR): 3.36, 95% CI (1.53, 7.41)) and those who had completed primary school (AOR: 1.7, 95% CI (1.02, 2.85)), media exposure (AOR: 3.38, 95% CI (2.1, 5.4)), and attitude toward hygienic practice (AOR: 3.29, 95% CI (2.2, 4.91)) were independent predictors of hygiene practices during complementary feeding. Conclusion This study found that the prevalence of hygiene practices during complementary feeding was relatively low. Being educated, access to media, and positive attitudes toward hygienic practices were predicting factors. As a result, strengthening training and counseling services for mothers regarding complementary feeding and processing is recommended.
Collapse
Affiliation(s)
- Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Molalegn Mesele Gesese
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of Physiology, Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Natnael Amare Tesfa
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yenealem Solomon Kebede
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Asmare Adella
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
6
|
Obande D, Young I, Gao JL, Pearl DL, Papadopoulos A. Systematic review and meta-regression of food safety knowledge and behaviour of primary food preparers for young children in the home setting. Food Control 2023. [DOI: 10.1016/j.foodcont.2022.109455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Kelly GC, Rachmat A, Hontz RD, Sklar MJ, Tran LK, Supaprom C, Luy M, Lina S, Gregory MJ, Sopheab H, Brooks JS, Sutherland IW, Corson KS, Letizia AG. Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012-2018. PLoS One 2023; 18:e0283871. [PMID: 37000848 PMCID: PMC10065300 DOI: 10.1371/journal.pone.0283871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 03/19/2023] [Indexed: 04/03/2023] Open
Abstract
Diarrheal diseases are a leading cause of mortality and morbidity, disproportionally affecting persons residing in low and middle-income countries. Accessing high-resolution surveillance data to understand community-level etiology and risk remains challenging, particularly in remote and resource limited populations. A multi-year prospective cohort study was conducted in two rural and two peri-urban villages in Cambodia from 2012 to 2018 to describe the epidemiology and etiology of acute diarrheal diseases within the population. Suspected diarrheal episodes among participants were self-reported or detected via routine weekly household visits. Fresh stool and fecal swabs were tested, and acute-illness and follow-up participant questionnaires collected. Of 5027 enrolled participants, 1450 (28.8%) reported at least one diarrheal incident. A total of 4266 individual diarrhea case events were recorded. Diarrhea incidence rate was calculated to be 281.5 persons per 1000 population per year, with an event rate of 664.3 individual diarrhea events occurring per 1000 population per year. Pathogenic Escherichia coli, Aeromonas spp., and Plesiomonas shigelloides were the most prevalent bacterial infections identified. Hookworm and Strongyloides stercoralis were the predominant helminth species, while Blastocystis hominis and Giardia lamblia were the predominant protozoan species found. Norovirus genotype 2 was the predominant virus identified. Mixed infections of two or more pathogens were detected in 36.2% of positive cases. Risk analyses identified unemployed status increased diarrhea risk by 63% (HR = 1.63 [95% CI 1.46, 1.83]). Individuals without access to protected water sources or sanitation facilities were 59% (HR = 1.59 [95% CI 1.49, 1.69]) and 19% (HR = 1.19 [95% CI 1.12, 1.28]) greater risk of contracting diarrhea, respectively. Patient-level surveillance data captured in this long-term study has generated a unique spatiotemporal profile of diarrheal disease in Cambodia. Understanding etiologies, together with associated epidemiological and community-level risk, provides valuable public health insight to support effective planning and delivery of appropriate local population-targeted interventions.
Collapse
Affiliation(s)
- Gerard C. Kelly
- Vysnova Partners, Inc., Landover, Maryland, United States of America
- * E-mail:
| | - Agus Rachmat
- AC Investment Co, Contractor for NAMRU-2 Phnom Penh, Phnom Penh, Cambodia
| | | | | | - Long Khanh Tran
- Vysnova Partners, Inc., Landover, Maryland, United States of America
| | - Chonthida Supaprom
- AC Investment Co, Contractor for NAMRU-2 Phnom Penh, Phnom Penh, Cambodia
| | - Malen Luy
- AC Investment Co, Contractor for NAMRU-2 Phnom Penh, Phnom Penh, Cambodia
| | - Sin Lina
- AC Investment Co, Contractor for NAMRU-2 Phnom Penh, Phnom Penh, Cambodia
| | | | - Heng Sopheab
- National Institute of Public Health, Ministry of Health, Cambodia
| | - John S. Brooks
- U.S. Naval Medical Research Unit TWO, Phnom Penh, Cambodia
| | | | - Karen S. Corson
- U.S. Naval Medical Research Unit TWO, Singapore, Singapore
- U.S. Naval Medical Research Unit TWO, Phnom Penh, Cambodia
| | | |
Collapse
|
8
|
Zeleke AM, Bayeh GM, Azene ZN. Hygienic practice during complementary food preparation and associated factors among mothers of children aged 6-24 months in Debark town, northwest Ethiopia, 2021: An overlooked opportunity in the nutrition and health sectors. PLoS One 2022; 17:e0275730. [PMID: 36490237 PMCID: PMC9733846 DOI: 10.1371/journal.pone.0275730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hygienic practices during complementary food preparation are suboptimal in developing countries, in Ethiopia in particular. Hygienic complementary food preparation is crucial to prevent childhood communicable diseases like diarrhea and associated malnutrition among children aged 6-24 months. However, in Ethiopia, there is a paucity of evidence on the practice of hygiene during complementary food preparation. Thus, this study is aimed to assess the hygienic practice of complementary food preparation and associated factors among women having children aged 6-24 months in Debark town, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 423 mothers with 6-24 months of age children from December 1 to January 30, 2021. A simple random sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-data version 4.6 and SPSS version 23 software were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable logistic regression model. RESULTS The study revealed that 44.9% (95% CI (40.2, 49.4%)) of the mothers having children aged 6-24 months had good practice of complementary food preparation. Maternal age of 25-29 years[AOR:3.23, 95% CI: (1.555-9.031)], husband's attained secondary school and above (AOR:2.65, 95% CI (1.211-5.783)], using modern stove for cooking [AOR:3.33,95% CI (1.404-7.874)], having a separate kitchen[AOR: 8.59, 95%Cl: (2.084-35.376], and having a three bowl dishwashing system(AOR: 8.45, 95% CL: (4.444-16.053)) were significantly associated with good hygiene practice of complementary food preparation. CONCLUSIONS The findings have indicated that the majority of the mothers had poor hygienic practices of complementary food preparation. Mother's age, husband's educational status, type of stove used for cooking, having a separate kitchen, having a three bowl dishwashing system were factors that significantly influenced the hygiene practice of mothers during complementary food preparation. Therefore, training and counseling mothers and caregivers on complementary food processing and preparation is important and such endeavors which inform the development and implementation of complementary food hygiene interventions in urban communities are recommended.
Collapse
Affiliation(s)
- Agerie Mengistie Zeleke
- Department of Midwifery, School of Public Health, Teda Health Science College, Gondar, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, School of Public Health, Teda Health Science College, Gondar, Ethiopia
| | - Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
9
|
Ahinkorah BO, Aboagye RG, Seidu AA, Frimpong JB, Cadri A, Afaya A, Hagan JE, Yaya S. Prevalence and predictors of oral rehydration therapy, zinc, and other treatments for diarrhoea among children under-five in sub-Saharan Africa. PLoS One 2022; 17:e0275495. [PMID: 36227873 PMCID: PMC9560133 DOI: 10.1371/journal.pone.0275495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 09/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background Despite the evidence-based effectiveness of diarrhoea treatment in preventing diarrhoea-related child mortality, the accessibility and utilization of diarrhoea treatments remain low in sub-Saharan Africa, even though these treatments are available. Therefore, this study aimed to assess the prevalence and predictors of diarrhoea treatment among under-five children in sub-Saharan Africa. Methods This study involved cross-sectional analyses of secondary data from the most recent Demographic and Health Surveys of 30 countries in sub-Saharan Africa. Percentages with their respective 95% confidence intervals (CI) were used to summarise the prevalence of diarrhoea treatment. A multivariable multilevel binary logistic regression analysis was employed to examine the predictors of diarrhoea treatment among children under five years in sub-Saharan Africa. The regression results were presented using adjusted odds ratio with their accompanying 95% confidence intervals. Statistical significance was set at p<0.05. Stata software version 16.0 was used for the analyses. Results The overall prevalence of diarrhoea treatment among under-five children in sub-Saharan Africa was 49.07% (95% CI = 44.50–53.64). The prevalence of diarrhoea treatment ranged from 23.93% (95% CI = 20.92–26.94) in Zimbabwe to 66.32% (95% CI = 61.67–70.97) in Liberia. Children aged 1 to 4 years, those whose mothers had at least primary education, those whose mothers had postnatal care visits, those whose mothers believed that permission to go and get medical help for self was a big problem, and those whose mothers’ partners had at least primary education were more likely to undergo diarrhoea treatment as compared to their counterparts. The odds of diarrhoea treatment increased with increasing wealth index with the highest odds among those in the richest quintile. Also, the odds of diarrhoea treatment was higher in the Central, Eastern, and Western geographical subregions compared to those in the Southern geographical subregion. However, children whose mothers were cohabiting, those whose mothers were exposed to watching television, and those living in female-headed households were less likely to undergo diarrhoea treatment. Conclusion The study found that the prevalence of diarrhoea treatment among children in sub-Saharan Africa was relatively low and varied across countries. The sub-regional estimates of diarrhoea treatment and identified associated factors can support country-specific needs assessments targeted at improving policy makers’ understanding of within-country disparities in diarrhoea treatment. Planned interventions (e.g., provision of quality and affordable supply of oral rehydration salts and zinc) should seek to scale up diarrhoea treatment uptake among under-five children in sub-Saharan Africa with much focus on the factors identified in this study.
Collapse
Affiliation(s)
- Bright Opoku Ahinkorah
- REMS Consult Limited, Sekondi Takoradi, Western Region, Ghana
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- REMS Consult Limited, Sekondi Takoradi, Western Region, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Abdul Cadri
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon- Accra, Ghana
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Agani Afaya
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
- * E-mail:
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
| |
Collapse
|
10
|
Arifin H, Rakhmawati W, Kurniawati Y, Pradipta RO, Efendi F, Gusmaniarti G, Pramukti I, Acob JRU, Soares A, Myint NMM, Setyowati S, Rosnani R, Mediarti D, Chou KR. Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey. J Pediatr Nurs 2022; 66:e37-e45. [PMID: 35717424 DOI: 10.1016/j.pedn.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/30/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey. DESIGN AND METHODS Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed. RESULTS A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors. CONCLUSION The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches. PRACTICE IMPLICATION The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.
Collapse
Affiliation(s)
- Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia; School of Nursing, College of Nursing, Taipei Medical University, Taiwan, R.O.C
| | - Windy Rakhmawati
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia.
| | - Yulia Kurniawati
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- Department of Advanced Nursing Care, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Gusmaniarti Gusmaniarti
- Early Childhood Teacher Education Study Program, Faculty of Teacher Training and Education, Universitas Muhammadiyah Surabaya, Surabaya, Indonesia
| | - Iqbal Pramukti
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Joel Rey U Acob
- Faculty of Nursing, Visayas State University, Philippine Visca, City of Baybay, Leyte, Philippines
| | - Agoestina Soares
- Department of Pediatric, Hospital Nasional Guido Valadares, Dili, Timor Leste
| | | | - Setyowati Setyowati
- Department of Maternity Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Rosnani Rosnani
- Politeknik Kesehatan Kemenkes Palembang, Palembang, Indonesia
| | - Devi Mediarti
- Politeknik Kesehatan Kemenkes Palembang, Palembang, Indonesia
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan, R.O.C
| |
Collapse
|
11
|
Okafor IP, Akinyemi OT, Wika-Kobani BN, Olubodun T, Eze UT. Childhood diarrhoea: a cross-sectional survey on maternal knowledge, hygienic practices and use of oral zinc for home management in a Nigerian community. Pan Afr Med J 2022; 42:123. [PMID: 36060848 PMCID: PMC9430891 DOI: 10.11604/pamj.2022.42.123.33829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/19/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction diarrhoea is the second leading cause of morbidity and mortality in young children. The aim was to assess maternal knowledge, hygienic practices and home management (HM) of diarrhoea with oral rehyrdation therapy (ORT) and oral zinc in children aged 6-23 months in western Nigeria. Predictors of good knowledge and practice were also assessed. Methods this was a community based analytic cross-sectional study. Multistage sampling was used to select mothers of children 6-23 months of age. Data were collected using pre-tested, interviewer administered questionnaires and analyzed using SPSS version 20. Bivariate analysis and multiple logistic regression for predictor variables were done. Level of significance was set at 0.05. Results three hundred and seventy one (371) respondents were interviewed (mean age 30.4 ± 5.02 years). 305 (82.2%) had good knowledge of diarrhoeal diseases, 208(56.1%) had good knowledge of home management of childhood diarrhoea, 274 (73.9%) had good maternal hygienic practices and 161 (61.2%) of the 263 mothers who had managed diarrhoea in their children, had good practice. Only 34 (12.9%) of them used zinc tablets and 11 (32.4%) did not complete the full course. Maternal age 30-39 years predicted good knowledge (AOR 3.19 CI 2-6.05). Predictors of good home management practices were: maternal age 30-39 years (AOR 2.78 CI 1.44-5.37), >40 years (AOR 5.55 CI 1.54-20.01) and younger age of the index child, 6-11 months (AOR 4.83 CI 2.29-10.18). Conclusion mothers had poor knowledge of the role of zinc supplementation in childhood diarrhoea and use of zinc tablets for diarrhoea was very low. Community based health education should be carried out.
Collapse
Affiliation(s)
- Ifeoma Peace Okafor
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003 Lagos, Lagos, Nigeria,,Corresponding author: Ifeoma Peace Okafor, Department of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003 Lagos, Lagos, Nigeria.
| | - Olufunsho Tope Akinyemi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003 Lagos, Lagos, Nigeria
| | | | - Tope Olubodun
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | | |
Collapse
|
12
|
Kuddus MA, Sunny AR, Sazzad SA, Hossain M, Rahman M, Mithun MH, Hasan SE, Ahmed KJ, Zandonadi RP, Han H, Ariza-Montes A, Vega-Muñoz A, Raposo A. Sense and Manner of WASH and Their Coalition With Disease and Nutritional Status of Under-five Children in Rural Bangladesh: A Cross-Sectional Study. Front Public Health 2022; 10:890293. [PMID: 35655458 PMCID: PMC9152106 DOI: 10.3389/fpubh.2022.890293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/11/2022] [Indexed: 12/07/2022] Open
Abstract
This study aimed to assess the knowledge and practice of caregivers and their relationship to the disease and nutritional status of children under 5 years of age in rural areas of Sylhet, Bangladesh. A total of 110 households with at least a child aged 6 to 59 months were selected by simple random method from 10 rural communities of three Upazila of Sylhet from September 2019 to February 2020. Descriptive statistics were used to assess the "Water Access, Sanitation, and Hygiene" (WASH) knowledge and practice, and multivariate chi-square analyses were performed to assess associations among diseases and nutritional status with WASH following a structured questionnaire. The study found a significant association between WASH with childhood disease and nutritional status, and 65% of children were found to be in a diseased state and 35% of children were found in a no exposure of disease state within the last 6 months. The findings sketched that mother with poor WASH knowledge and practice was at greater risk for disease outbreaks, disease frequency, and duration. The highest incidence of diarrhea was 17% in children aged 12 to 23 months. A significant effect of WASH was also found in children's nutritional status, which was reflected in the ratio of stunted, underweight, and wasted children. Integrated convergent work focusing on providing clean water within the household, stopping open defecation, promoting handwashing, behavior change, and poverty alleviation is needed to improve the situation. Health, nutrition, and livelihood programs should be uninterrupted, and mothers or caregivers should be encouraged to participate in these programs.
Collapse
Affiliation(s)
| | - Atiqur Rahman Sunny
- Suchana Project, WorldFish, Bangladesh Office, Dhaka, Bangladesh.,Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | | | - Monayem Hossain
- EcoFish Project, WorldFish, Bangladesh Office, Dhaka, Bangladesh
| | - Mizanur Rahman
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | | | | | - Khandaker Jafor Ahmed
- Department of Geography, Environment, and Population, The University of Adelaide, Adelaide, SA, Australia
| | | | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, Seoul, South Korea
| | | | | | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| |
Collapse
|
13
|
Masinaei M. Estimating the seasonally varying effect of meteorological factors on the district-level incidence of acute watery diarrhea among under-five children of Iran, 2014-2018: a Bayesian hierarchical spatiotemporal model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1125-1144. [PMID: 35288786 DOI: 10.1007/s00484-022-02263-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 05/16/2023]
Abstract
Under-five years old acute watery diarrhea (U5AWD) accounts for most diarrheal diseases' burden, but little is known about the adjusted effect of meteorological and socioeconomic determinants. A dataset containing the seasonal numbers of U5AWD cases at the district level of Iran is collected through MOHME. Accordingly, the district-level standardized incidence ratio and Moran's I values are calculated to detect the significant clusters of U5AWD over sixteen seasons from 2014 to 2018. Additionally, the author tested twelve Bayesian hierarchical models in order to determine which one was the most accurate at forecasting seasonal number of incidents. Iran features a number of U5AWD hotspots, particularly in the southeast. An extended spatiotemporal model with seasonally varying coefficients and space-time interaction outperformed other models, and so became the paper's proposal in modeling U5AWD. Temperature demonstrated a global positive connection with seasonal U5AWD in districts (IRR: 1.0497; 95% CrI: 1.0254-1.0748), owing to its varying effects during the winter ((IRR: 1.0877; 95% CrI: 1.0408-1.1375) and fall (IRR: 1.0866; 95% CrI: 1.0405-1.1357) seasons. Also, elevation (IRR: 0.9997; 95% CrI: 0.9996-0.9998), piped drinking water (IRR: 0.9948; 95% CrI: 0.9933-0.9964), public sewerage network (IRR: 0.9965; 95% CrI: 0.9938-0.9992), years of schooling (IRR: 0.9649; 95% CrI: 0.944-0.9862), infrastructure-to-household size ratio (IRR: 0.9903; 95% CrI: 0.986-0.9946), wealth index (IRR: 0.9502; 95% CrI: 0.9231-0.9781), and urbanization (IRR: 0.9919; 95% CrI: 0.9893-0.9944) of districts were negatively associated with seasonal U5AWD incidence. Strategically, developing geoinformation alarm systems based on meteorological data might help predict U5AWD high-risk areas. The study also anticipates increased rates of U5AWD in districts with poor sanitation and socioeconomic level. Therefore, governments should take appropriate preventative actions in these sectors.
Collapse
Affiliation(s)
- Masoud Masinaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Mwapasa T, Chidziwisano K, Lally D, Morse T. Hygiene in early childhood development centres in low-income areas of Blantyre, Malawi. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022:1-17. [PMID: 35272551 DOI: 10.1080/09603123.2022.2048802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
Diarrhoeal disease remains a leading cause of death in children in sub-Saharan Africa, attributed to environmental health factors such as inadequate water, sanitation and hygiene (WASH) and food hygiene. This formative study in low-income areas of Blantyre focussed on the practices in Early Childhood Development Centre (ECDCs) environments where children spend a significant amount of time. A mixed-methods approach was applied to identify key hygiene behaviours in ECDCs through; checklist and structured observations (n = 849 children; n = 33 caregivers), focus group discussions (n = 25) and microbiological sampling (n = 261) of drinking water, food handler's hands, and eating utensils. ECDCs had inadequate WASH infrastructure; coupled with poor hygiene practices and unhygienic environments increased the risk of faecal-oral disease transmission. Presence of E. coli in drinking water confirmed observed poor water handling habits by staff and children. Addressing undesired hygiene practices in ECDCs has the potential to improve the health outcomes of children in low-income settings.
Collapse
Affiliation(s)
- Taonga Mwapasa
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), University of Malawi - The Polytechnic, Blantyre, Malawi
| | - Kondwani Chidziwisano
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), University of Malawi - The Polytechnic, Blantyre, Malawi
- Department of Environmental Health, University of Malawi - The Polytechnic, Blantyre, Malawi
| | - David Lally
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), University of Malawi - The Polytechnic, Blantyre, Malawi
| | - Tracy Morse
- Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), University of Malawi - The Polytechnic, Blantyre, Malawi
- Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, UK
| |
Collapse
|
15
|
Yemane B, Tamene A. Understanding Domestic Food Safety: An Investigation into Self-Reported Food Safety Practice and Associated Factors in Southern Ethiopian Households. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221103881. [PMID: 35707631 PMCID: PMC9189514 DOI: 10.1177/11786302221103881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/29/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND According to available studies, 12%-20% of reported foodborne outbreaks start in the household. It is projected that 1 out of every 10 persons will become ill as a result of consuming tainted food. Poor food handling practices cause 600 million foodborne illnesses each year. In a given year, this leads to 420 000 deaths. In Ethiopia, there is a scarcity of studies on home-food-safety practices and the factors that affect them. This has resulted in a shortage of relevant information on the status of home-food-related illnesses in the country. METHODS A community-based cross-sectional study was carried out from May to June 23, 2021. A standardized and pre-tested questionnaire was used to collect data from 622 households. The total plate count method was used to analyze bacteria on cleaned plates. Epi data version 3.1 was used to enter data, while SPSS version 25 was used to analyze the data. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with food safety practices. RESULT 51.1% of the study participants had a safe food handling practice. The mean total plate count was 2.34 CFU/cm2. In the multivariable regression, Household wealth (AOR = 2.05, 95% CI [1.01-3.16]), Education (AOR = 3.33, 95% CI [1.41-6.31]), Training (AOR = 2.85, 95% CI: [1.31-3.19]), Knowledge of safe practices (AOR = 1.95, 95% CI [1.23-3.08], and Attitude (AOR = 2.04, 95% CI [1.09, 3.82]) were associated with safe food handling practices. CONCLUSION Although data gathering systems for food-borne diseases typically overlook a large number of home-based outbreaks of sporadic infection, it is now widely understood that many episodes of food-borne sicknesses are caused by individuals' inappropriate food handling and preparation in their kitchens. In the current study, educational status, household wealth, food safety training, attitude, and knowledge about FBDs were found to be strongly associated with safe practices. This implies that public education is a key factor in improving food safety practices at home.
Collapse
Affiliation(s)
- Bethlehem Yemane
- Environmental Health Department, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Bethlehem Yemane, Environmental Health Department, College of Medicine and Health Sciences, Hawassa University, Hawassa 1530, Ethiopia.
| | - Aiggan Tamene
- Environmental Health Department, School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| |
Collapse
|
16
|
Dolstad HA, Franke MF, Vissieres K, Jerome JG, Ternier R, Ivers LC. Factors associated with diarrheal disease among children aged 1-5 years in a cholera epidemic in rural Haiti. PLoS Negl Trop Dis 2021; 15:e0009726. [PMID: 34679083 PMCID: PMC8535179 DOI: 10.1371/journal.pntd.0009726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Diarrheal illness is a major cause of morbidity and mortality among children in Haiti, and the impact of diarrheal illness was compounded by a cholera outbreak between 2010 and 2019. Our understanding of risk factors for diarrhea among children during this outbreak is limited. We conducted a secondary analysis of data collected as part of a cholera vaccine effectiveness study to identify factors associated with medically attended diarrhea among children in central Haiti from October of 2012 through November of 2016. We identified 47 children aged one to five years old who presented to medical clinics with acute, watery diarrhea, and 166 matched controls who did not have diarrhea, and we performed conditional logistic regression to identify factors associated with diarrhea. Discontinuing exclusive breastfeeding within one month of birth was associated with increased risk of diarrhea (RR 6.9, 95% CI 1.46–32.64), and diarrhea was inversely associated with reported history of supplementation with vitamin A (RR 0.05, 95% CI 0.004–0.56) and zinc (reported among 0% of cases vs. 17% of controls). Because of the concordance in supplementation patterns, it was not possible to attribute the association to vitamin A or zinc independently. While having a respondent who correctly identified ≥3 means of avoiding cholera was associated with reduced risk of diarrhea (RR 0.43, 95% CI 0.19–1.01), reported household sanitation practices and knowledge of cholera were not consistently associated with risk of diarrhea. These findings support ongoing efforts to reduce barriers to breastfeeding and promote pediatric supplementation with vitamin A and zinc in Haiti. Given the reduced efficacy of current oral cholera vaccines (OCV) among children, the results reinforce the importance of breastfeeding and micronutrient supplementation in preventing all-cause pediatric diarrheal illness generally and during cholera outbreaks. Diarrheal diseases are leading causes of illness and death among children throughout the world, and children in Haiti were particularly impacted by diarrhea during the cholera outbreak that started in 2010. Between 2012 and 2016, data were collected as part of a case-control study of oral cholera vaccine (OCV) effectiveness in Haiti. We analyzed data from that study to identify factors associated with diarrheal illness, including cholera and non-cholera diarrhea, among children ages one through five years old. We found a direct association between longer duration of exclusive breastfeeding and supplementation with vitamin A and zinc and a reduced risk of diarrhea. These findings shed light on potentially important components of efforts to reduce pediatric diarrheal illness in Haiti generally, and to reduce pediatric diarrhea in the context of cholera outbreaks in Haiti and elsewhere.
Collapse
Affiliation(s)
- Hilary A. Dolstad
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Molly F. Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | | | - Louise C. Ivers
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| |
Collapse
|
17
|
Contextual Determinants of General Household Hygiene Conditions in Rural Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111064. [PMID: 34769584 PMCID: PMC8582855 DOI: 10.3390/ijerph182111064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
Household hygiene is critical to prevent pathogen transmission at the household level. Assessing household hygiene conditions and their determinants are needed to improve hygiene conditions, especially in rural and less developed areas where the housing conditions are relatively worse than they are in urban areas. This study used data from 278 household interviews and observations in rural areas in the district of East Sumba, province East Nusa Tenggara, Indonesia. The data were analyzed using statistical methods. In general, the household hygiene conditions in the study need to be improved. The main potential sources of pathogen transmission were from the surrounding environment, i.e., non-permanent floor and garbage, and personal hygiene, i.e., handwashing facilities with water and soap were only observed in the homes of four out of ten respondents. The presence of livestock roaming freely in the house’s yard was another source of contamination. Easy access to water and wealth significantly influenced the hygiene conditions. Implementing low-cost interventions, i.e., cleaning the house of garbage and animal feces and cleaning nails, should be the priority in immediate intervention, while providing easier access to water supply, especially during the dry season, could be a long-term intervention. This paper also argues that analyzing household hygiene conditions or practices should be complemented by analyzing contextual determinants of the hygiene conditions or practices, so that we can develop more precise intervention by considering the local or household context.
Collapse
|
18
|
Limon MR. Food safety practices of food handlers at home engaged in online food businesses during COVID-19 pandemic in the Philippines. Curr Res Food Sci 2021; 4:63-73. [PMID: 33665620 PMCID: PMC7903060 DOI: 10.1016/j.crfs.2021.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/31/2020] [Accepted: 01/10/2021] [Indexed: 11/28/2022] Open
Abstract
This study was conducted to assess the self-reported and observed food safety practices (FSP) of food handlers, who deliver food products that are prepared and cooked at home during the COVID-19 pandemic in the Philippines. 751 participated in the online survey who were selected using criterion sampling. A questionnaire developed by the researcher was used to gather data with Cronbach Alpha of 0.91. t-test, ANOVA, and Fleiss kappa were performed to treat data. There were no significant differences between self-reported FSP in four dimensions and demographic characteristics, except for age, where a significant difference exists between the FSP of the four age groups along food preparation (F = 4.530,ρ<0.01). The FSP in the four dimensions obtained a weighted x¯ and σ of 1.72 ± 0.69 which is interpreted as Sometimes Practiced. The food handlers at home inadequately and inappropriately practiced the protocols in keeping the food safe to eat. The observed reports showed that the food handlers at home do not meet food safety standards as indicated in the weighted x¯ and σ in the four dimensions 1.63 ± 0.11, with a description of Sometimes Practiced. Observed practices further show very poor adherence to guidelines. Test for inter-rater reliability yielded almost perfect agreement (κ = 0.81, ρ<0.05). There exists a significant difference with the FSP in personal hygiene (t = 0.964, ρ<0.05), cross-contamination prevention and sanitation (t = 0.815, ρ<0.05), food preparation (t = 0.753, ρ<0.05), and food delivery (t = 0.794, ρ<0.05). Government and non-government agencies should work together towards educating the food handlers at home on effective ways to learn about food safety concepts so they could become advocates of safer food practices. Online food business is growing due to restrictions brought about by the pandemic. Self-reported FSP of food handlers reveal compliance to food safety standards. Food handlers violate food safety protocols based on expert observations. There is significant difference between the self-reported and the observed FSP. Food safety training involving food handlers in online businesses is imperative.
Collapse
Affiliation(s)
- Mark Raguindin Limon
- Office of the Product Safety and Standards, Science and Technology Park, Mariano Marcos State University, Philippines
| |
Collapse
|
19
|
Biswas SK, Thomas ED, Masud J, Zohura F, Hasan T, Parvin T, Islam Bhuyian MS, Minhaj MI, Johura F, Sultana M, Tahmina S, Monira S, Perin J, Alam M, George CM. Formative Research for the Design of a Baby Water, Sanitation, and Hygiene Mobile Health Program in Bangladesh (CHoBI7 Mobile Health Program). Am J Trop Med Hyg 2021; 104:357-371. [PMID: 33025876 DOI: 10.4269/ajtmh.20-0456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Poor food hygiene practices, child feces not being disposed of in a latrine, child mouthing of contaminated fomites, and poor hand hygiene of caregivers have been associated with diarrheal diseases, environmental enteropathy, and impaired growth in young children. Mobile health (mHealth) programs present a low-cost approach to delivering water, sanitation, and hygiene (WASH) programs. We conducted a theory-driven and evidence-based approach to formative research and intervention development to design and pilot test a Baby WASH mHealth program targeting food hygiene, child mouthing, and child feces disposal behaviors in urban Dhaka, Bangladesh. Formative research activities included 31 semi-structured interviews, five group discussions, six mHealth workshops, and a three-phase iterative pilot study among 102 households. Findings from semi-structured interviews and group discussions indicate that caregivers of young children have relatively high awareness of the need for safer food hygiene, child mouthing, and child feces disposal practices, but are limited by existing household responsibilities and restricted access to enabling technology that would facilitate practicing recommended behaviors. The piloted Baby WASH mHealth program was well-received by households. This study presents a theory-driven and evidence-based approach for intervention development that can be implemented for the development of future WASH mHealth programs in low-resource settings.
Collapse
Affiliation(s)
- Shwapon Kumar Biswas
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,2Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Elizabeth D Thomas
- 3Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland
| | - Jahed Masud
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Zohura
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tasdik Hasan
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmina Parvin
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Md Ismat Minhaj
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Fatema Johura
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Marzia Sultana
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sanya Tahmina
- 2Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Shirajum Monira
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jamie Perin
- 2Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Munirul Alam
- 1International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Christine Marie George
- 3Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland
| |
Collapse
|
20
|
Niedfeldt HJ, Beckstead E, Chahalis E, Jensen M, Reher B, Torres S, Rachmi CN, Jusril H, Hall C, West JH, Crookston BT. Use of Technology to Access Health Information/Services and Subsequent Association With WASH (Water Access, Sanitation, and Hygiene) Knowledge and Behaviors Among Women With Children Under 2 Years of Age in Indonesia: Cross-sectional Study. JMIR Public Health Surveill 2021; 7:e19349. [PMID: 33443485 PMCID: PMC7843201 DOI: 10.2196/19349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/17/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Water access, sanitation, and hygiene (WASH) remain a public health concern in Indonesia. Proper WASH practices can decrease risk of stunting, wasting, and disease in children under the age of 2. OBJECTIVE The purpose of our study is to examine if using technology to access health information and services among Indonesian women affects knowledge and behaviors regarding handwashing and defecation practices. METHODS Our study is an interview-based cross-sectional survey. Participants included 1734 mothers of children under 2 years of age. These women were randomly selected and interviewed as part of a 3-stage cluster sampling technique. Our study uses data regarding WASH knowledge which includes benefits of handwashing with soap, 5 critical times of handwashing, risks of open defecation, media of disease transmission, defecation locations, and risks of open defecation. Data regarding WASH behaviors were also included: handwashing with soap, type of latrine used at home, and where defecation took place. This investigation used adjusted and unadjusted logistic and linear regression models to determine differences in WASH outcomes between those who use technology to access health information and services and those who did not. RESULTS One result is that Indonesian women with children under 2 years of age who use technology to access health information and services are more likely to know the advantages of proper handwashing (odds ratio [OR] 2.603, 95% CI 1.666-4.067) and know the 5 critical times of handwashing (OR 1.217, 95% CI 0.969-1.528). Women who use technology to access health information are also more likely to know the risks of open defecation (OR 1.627, 95% CI 1.170-2.264) and use a type of toilet (such as a gooseneck or squat toilet) that limits risk (OR 3.858, 95% CI 2.628-5.665) compared to women who did not use technology to access health information. CONCLUSIONS Using technology to access health information and services was associated with an increase in handwashing and defecation knowledge. In the future, promoting mothers of children under 2 years of age to access health information through technology might be used to increase handwashing and defecation knowledge as well as safe defecation practices. However, further research should be done to determine how technology may increase the frequency of recommended handwashing behaviors.
Collapse
Affiliation(s)
| | - Emmalene Beckstead
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Emily Chahalis
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Mindy Jensen
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Britton Reher
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Scott Torres
- RTI International, Washington, DC, United States
| | | | | | - Cougar Hall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Joshua H West
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | | |
Collapse
|
21
|
Hygienic Practice during Complementary Feeding and Associated Factors among Mothers of Children Aged 6–24 Months in Bahir Dar Zuria District, Northwest Ethiopia, 2019. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020. [DOI: 10.1155/2020/2075351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction. Breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore food is needed. Microbiologically contaminated food is particularly harmful for children <2 years of age. There is scanty of information on hygienic practice and associated factors during complementary feeding among mothers of children aged 6 to 24 months in the country, particularly in the study setting. Objective. The study was aimed to assess hygienic practices and associated factors during complementary feeding among children aged 6 to 24 months in Bahir Dar Zuria District, Northwest Ethiopia. Methods. A community-based cross sectional study was conducted from March 20 to April 20, 2019. A multistage sampling technique was used to select the study participants. Data were collected using the structured interviewer administered questionnaire. Bivariable and multivariable logistic regression analyses were used to identify the factors associated with hygienic practice during complementary feeding. Data were entered by using Epi Data version 3.1, and then it was exported to SPSS version 21 for analysis, and at 95% CI, p value <0.05 was considered statistically significant. Result. Among 604 respondents, 235 (38.9%) of study participants had good hygienic practice during complementary feeding. Access to media (AOR: 8.8, 95% confidence interval (CI): 3.8–20.3), private latrine ownership (AOR: 4.11, 95% CI: 1.90–8.49), presence of hand washing facility at doorstep (AOR: 6.75 95% CI: 3.16–14.41), and residence of the study participants (AOR: 85.42, 95% CI: 1.94–15.2) were significantly associated with good hygienic practice of mothers during complementary feeding. Conclusion. Majority of mothers had poor hygienic practice during complementary feeding. Attitude of mothers, access to media, household private latrine ownership, presence of handwashing facility, and residence of the study participants were significantly associated with hygiene practice of mothers during complementary feeding. The health sector should train mothers on good hygiene practices during complementary feeding.
Collapse
|
22
|
Occurrence of Diarrhea and Feeding Practices among Children below Two Years of Age in Southwestern Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030722. [PMID: 31979127 PMCID: PMC7036833 DOI: 10.3390/ijerph17030722] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 01/01/2023]
Abstract
Growing evidence suggests that feeding practices in early childhood play a major role in the occurrence of childhood diarrhea. However, there is a lack of information regarding feeding practices and its relationship with occurrences of diarrhea in young children from Saudi Arabia. The present study is aimed to measure the prevalence of diarrhea and assess its relationship with feeding practices among children between two months and two years of age in Saudi Arabia. A cross-sectional study was carried out in two large cities in the Aseer region in southwest Saudi Arabia. A total of 302 mothers attending well-baby clinics across six primary health centers were included. A structured questionnaire was used to collect data. Factors associated with diarrheal disease were identified by multivariable logistic regression analysis. The prevalence of diarrhea among children during the study period was 56.3% (95% CI: 50.7%–61.8%). Only 15.9% of children in our study were exclusively breastfed. The occurrence of diarrhea was significantly associated with age 7–12 months (aOR = 2.64, 95% CI: 1.42–4.91). We found that diarrhea was prevalent among children between two months and two years of age, and that exclusive breastfeeding was not a common practice in this region. Health education programs should be directed towards mothers to improve rates of breastfeeding, weaning practices, food hygiene, and childcare. Special attention and support should be provided for working mothers.
Collapse
|
23
|
Mumma JAO, Cumming O, Simiyu S, Czerniewska A, Aseyo RE, Muganda DN, Davis E, Baker KK, Dreibelbis R. Infant Food Hygiene and Childcare Practices in Context: Findings from an Urban Informal Settlement in Kenya. Am J Trop Med Hyg 2020; 102:220-222. [PMID: 31746311 PMCID: PMC6947802 DOI: 10.4269/ajtmh.19-0279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/18/2019] [Indexed: 11/17/2022] Open
Abstract
Complementary food hygiene is important to reduce infant exposures to enteric pathogens; however, interventions to improve food hygiene in low- and middle-income countries often ignore the larger context in which childcare occurs. In this study, we explore on observational and qualitative information regarding childcare in an informal community in Kenya. Our findings demonstrate that behaviors associated with food contamination, such as hand feeding and storing food for extended periods, are determined largely by the larger social and economic realities of primary caretakers. Data also show how caregiving within an informal settlement is highly dynamic and involves multiple individuals and locations throughout the day. Findings from this study will help inform the development and implementation of food hygiene interventions in informal urban communities.
Collapse
Affiliation(s)
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sheillah Simiyu
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
| | - Alexandra Czerniewska
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Emily Davis
- Department of International Health—Social and Behavioral Interventions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kelly K. Baker
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Robert Dreibelbis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
24
|
Contreras JD, Eisenberg JN. Does Basic Sanitation Prevent Diarrhea? Contextualizing Recent Intervention Trials through a Historical Lens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E230. [PMID: 31905628 PMCID: PMC6981821 DOI: 10.3390/ijerph17010230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/19/2019] [Accepted: 12/25/2019] [Indexed: 12/14/2022]
Abstract
Three of four recent major sanitation intervention trials found no effect on diarrhea. These results conflicted with longstanding beliefs from decades of literature. To understand this discordance, we placed recent trials into the historical context that preceded them in two ways. First, we evaluated the history of published literature reviews on sanitation and diarrhea. Second, we conducted meta-analyses on studies from the most recent systematic review to uncover features that predict effectiveness. We found that 13 literature reviews dating to 1983 consistently estimated a significant protective effect of sanitation against diarrhea. However, these were marred by flawed studies and inappropriately averaged effects across widely heterogeneous interventions and contexts. Our meta-analyses highlight that the overall effect of sanitation on diarrhea was largely driven by sewerage and interventions that improved more than sanitation alone. There is no true overall effect of sanitation because variability between intervention types and implementation contexts is too complex to average. Ultimately, the null effects of recent latrine interventions are not surprising. Instead, the one trial that found a strong relative reduction in diarrhea is the historical outlier. The development of transformative sanitation interventions requires a better understanding of the social and environmental contexts that determine intervention effectiveness.
Collapse
|
25
|
Melese B, Paulos W, Astawesegn FH, Gelgelu TB. Prevalence of diarrheal diseases and associated factors among under-five children in Dale District, Sidama zone, Southern Ethiopia: a cross-sectional study. BMC Public Health 2019; 19:1235. [PMID: 31492123 PMCID: PMC6729095 DOI: 10.1186/s12889-019-7579-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally childhood diarrhoeal diseases continue to be the second leading cause of death, while in Ethiopia it kills half-million under-five children each year. Sanitation, unsafe water and personal hygiene are responsible for 90% of the occurrence. Thus, this study aimed to assess the prevalence and associated factors of diarrheal diseases among under-five children in Dale District, Sidama Zone, Southern Ethiopia. METHODS A community-based cross-sectional study was conducted. A face to face interview using a structured questionnaire and observation checklist was used. A total of 546 households with at least one under-five children were selected using simple random sampling techniques. The data entry and cleaning were performed using Epidemiological information software (EPI Info) 3.5.1 and then exported to Statistical Package for Social Science (SPSS) version 16.0 for analysis. Frequencies and proportions were computed as descriptive analysis. Initially using bivariate analysis a crude association between the independent and dependent variables was investigated. Then, those variables with p-value ≤0.25 were included in multivariable analysis to determine the predictor variables for the outcome variables. Finally, further analyses were carried out using multivariable analysis at a significance level of p-value ≤0.05. RESULTS A total of 537 children under the age of 5 years were included. The 2 weeks prevalence of diarrhea among children under the age of 5 years was 13.6, 95% CI (10.7, 16.5%). Educational level [AOR: 3.97, 95% CI (1.60, 8.916)], age of indexed child [AOR: 12.18, 95% CI (1.78, 83.30)], nutritional status [AOR: 6.41, 95% CI (2.47, 16.77.)], hand washing method [AOR, 3.10, 95% CI (1.10, 8.67)], hand washing after latrine [AOR: 2.73, 95% CI (1.05, 6.56)], refuse disposal method [AOR, 3.23, 95% CI (1.37, 7.60)] and housing floor material [AOR: 3.22, 95% CI (1.16, 8.91] were significantly associated with the occurrence of childhood diarrheal diseases. CONCLUSION Childhood diarrhea remains the commonest health problem in the study area. The findings have important policy implications for childhood diarrhoeal disease intervention programs. Thus, activities focusing on proper handwashing techniques at all appropriate times, proper refuse disposal, improving nutrition and better childcare also highly recommended.
Collapse
Affiliation(s)
| | - Wondimagegn Paulos
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Temesgen Bati Gelgelu
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
26
|
Tsai K, Simiyu S, Mumma J, Aseyo RE, Cumming O, Dreibelbis R, Baker KK. Enteric Pathogen Diversity in Infant Foods in Low-Income Neighborhoods of Kisumu, Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030506. [PMID: 30759722 PMCID: PMC6388216 DOI: 10.3390/ijerph16030506] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/05/2019] [Accepted: 02/07/2019] [Indexed: 01/01/2023]
Abstract
Pediatric diarrheal disease remains the second most common cause of preventable illness and death among children under the age of five, especially in low and middle-income countries (LMICs). However, there is limited information regarding the role of food in pathogen transmission in LMICs. For this study, we examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods in Kisumu, Kenya, using a multi-pathogen PCR diagnostic tool, and assessed household food hygiene risk factors for contamination. Bacterial, viral, and protozoan enteric pathogen DNA and RNA were detected in 62% of the infant weaning food samples collected, with 37% of foods containing more than one pathogen type. Multivariable generalized linear mixed model analysis indicated type of infant food best explained the presence and diversity of enteric pathogens in infant food, while most household food hygiene risk factors considered in this study were not significantly associated with pathogen contamination. Specifically, cow’s milk was significantly more likely to contain a pathogen (adjusted risk ratio = 14.4; 95% confidence interval (CI) 1.78–116.1) and more likely to have higher number of enteric pathogen species (adjusted risk ratio = 2.35; 95% CI 1.67–3.29) than porridge. Our study demonstrates that infants in this low-income urban setting are frequently exposed to diarrhoeagenic pathogens in food and suggests that interventions are needed to prevent foodborne transmission of pathogens to infants.
Collapse
Affiliation(s)
- Kevin Tsai
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52246, USA.
| | - Sheillah Simiyu
- Center of Research, Great Lakes University of Kisumu, Kisumu 40100, Kenya.
| | - Jane Mumma
- Center of Research, Great Lakes University of Kisumu, Kisumu 40100, Kenya.
| | - Rose Evalyne Aseyo
- Center of Research, Great Lakes University of Kisumu, Kisumu 40100, Kenya.
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Robert Dreibelbis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Kelly K Baker
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52246, USA.
| |
Collapse
|
27
|
Co-Infection by Waterborne Enteric Viruses in Children with Gastroenteritis in Nepal. Healthcare (Basel) 2019; 7:healthcare7010009. [PMID: 30642113 PMCID: PMC6473710 DOI: 10.3390/healthcare7010009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/22/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022] Open
Abstract
Enteric viruses are highly contagious and a major cause of waterborne gastroenteritis in children younger than five years of age in developing world. This study examined the prevalence of enteric virus infection in children with gastroenteritis to identify risk factors for co-infections. In total, 107 stool samples were collected from patients with acute gastroenteritis along with samples of their household drinking water and other possible contamination sources, such as food and hand. The presence of major gastroenteritis-causing enteric virus species (group A rotaviruses, enteroviruses, adenoviruses, and noroviruses of genogroup I) in stool and water samples was examined using quantitative polymerase chain reaction. Among the 107 stool samples tested, 103 (96%) samples contained at least one of the four tested enteric viruses, and the combination of group A rotaviruses and enteroviruses was the most common co-infection (52%, n = 54/103). At least one viral agent was detected in 16 (16%) of 103 drinking water samples. Identical enteric viruses were detected in both the stool and water samples taken from the same patients in 13% of cases (n = 13/103). Group A rotaviruses were most frequently found in children suffering from acute diarrhea. No socio-demographic and clinical factors were associated with the risk of co-infection compared with mono-infection. These less commonly diagnosed viral etiological agents in hospitals are highly prevalent in patients with acute gastroenteritis.
Collapse
|
28
|
Risk factors for diarrhoea and malnutrition among children under the age of 5 years in the Tigray Region of Northern Ethiopia. PLoS One 2018; 13:e0207743. [PMID: 30475875 PMCID: PMC6257922 DOI: 10.1371/journal.pone.0207743] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 11/06/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diarrhoea and malnutrition are the leading cause of morbidity and mortality among children in areas with poor access to clean water, improved sanitation, and with low socioeconomic status. This study was designed to determine the prevalence of diarrhoea, malnutrition and risk factors among children aged 6-59 months in the Tigray Region of Northern Ethiopia. METHODS A community based cross-sectional study design was conducted from June to August 2017 to assess the magnitude and factors associated with diarrhoea and malnutrition among children. A standardized questionnaire was used to collect data on diarrhoea, environmental, demographic and behavioural factors from 610 mother-child pairs. Anthropometric measurements were collected from the children. SPSS ver.21 statistical software was used for analysis. Factors associated with diarrhoea and nutritional status were identified using bivariate and multivariate logistic regression. A p-value ≤ 0.05 was considered statistically significant. RESULTS Of the 610 children monitored in this study, the incidence of diarrhoea among 6-59 month-old children in the two weeks preceding the day of the interview day was 27.2% (95% CI: 23.6-31%). Specifically, 35.9%, 9.7%, and 1.8% had 1-2, 3-4 and 5-6 times of diarrhoea episodes in a one year of time, respectively. The prevalence of stunting, underweight, wasting, and acute under-nutrition were 36.1% (95% CI: 31-38.6%), 37% (95% CI: 32-39.6%), 7.9% (95% CI: 5.5-9.7%), and 5.4% (95% CI: 3.8-7.4%), respectively. In a multivariate logistic regression analysis, type of drinking water source [AOR = 3.69; 95% CI: 2.03-6.71], mothers not hand washing at critical times [AOR = 15.42; 95% CI: 2.02-117.78], improper solid waste disposal [AOR = 12.81; 95% CI: 2.50-65.62], and child age (36-47 months) [AOR = 2.57; 95% CI: 1.45-4.55] were found to be predictors of diarrhoea. Being within the age range of 12-23 months was a predictor for wasting [AOR = 4.38; 95% CI: 1.61-11.90] and being underweight [AOR = 4.4; 95% CI: 1.7-11.2]. Similarly, the age range of 36-47 months was associated with wasting [AOR = 2.3; 95% CI: 1.45-3.85] and stunting [AOR = 1.7; 95% CI: 1.03-2.67]. Family size (less than 4) [AOR = 0.56; 95% CI: 0.368-0.959] was inversely associated for wasting. CONCLUSIONS Our study revealed that the problem of diarrhoea and malnutrition amongst 6-59 months children in the study area was significant. Access to clean water was the main problem in the study area. Hence, improving access to clean water and providing health education to mothers on personal and environmental hygiene, and proper waste disposal could improve diarrhoea in the study area. Intervention on children's nutrition should also be implemented to minimize the problem of malnutrition.
Collapse
|
29
|
Diarrhoeal Disease in Relation to Possible Household Risk Factors in South African Villages. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081665. [PMID: 30082638 PMCID: PMC6121382 DOI: 10.3390/ijerph15081665] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 11/18/2022]
Abstract
Diarrhoeal disease is a significant contributor to child morbidity and mortality, particularly in the developing world. Poor sanitation, a lack of personal hygiene and inadequate water supplies are known risk factors for diarrhoeal disease. Since risk factors may vary by population or setting, we evaluated the prevalence of diarrhoeal disease at the household level using a questionnaire to better understand household-level risk factors for diarrhoea in selected rural areas in South Africa. In a sub-sample of dwellings, we measured the microbial quality of drinking water. One in five households had at least one case of diarrhoea during the previous summer. The most widespread source of drinking water was a stand-pipe (inside yard) (45%) followed by an indoor tap inside the dwelling (29%). Storage of water was common (97%) with around half of households storing water in plastic containers with an opening large enough to fit a hand through. After adjusting for confounders, the occurrence of diarrhoea was statistically significantly associated with sourcing water from an indoor tap (Adjusted Odds Ratio (AOR): 2.73, 95% CI: 2.73, 1.14–6.56) and storing cooked/perishable food in non-refrigerated conditions (AOR: 2.17, 95% CI: 2.17, 1.44–3.26). The highest total coliform counts were found in water samples from kitchen containers followed by stand-pipes. Escherichia coli were most often detected in samples from stand-pipes and kitchen containers. One in four households were at risk of exposure to contaminated drinking water, increasing the susceptibility of the study participants to episodes of diarrhoea. It is imperative that water quality meets guideline values and routine monitoring of quality of drinking water is done to minimise diarrhoea risk in relevant rural communities. The security of water supply in rural areas should be addressed as a matter of public health urgency to avoid the need for water storage.
Collapse
|
30
|
Dodos J, Altare C, Bechir M, Myatt M, Pedro B, Bellet F, Lapegue J, Peeters J, Altmann M. Individual and household risk factors of severe acute malnutrition among under-five children in Mao, Chad: a matched case-control study. Arch Public Health 2018; 76:35. [PMID: 30083315 PMCID: PMC6069951 DOI: 10.1186/s13690-018-0281-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in Chad. The reasons behind persistently high prevalence of SAM in the Kanem region are still poorly understood, leaving national and international partners without clearly identified drivers to address. Current knowledge of SAM determinants in this context is largely based on very limited data. The aim of this study was thus to investigate individual and household-level risk factors for SAM among under-five children in Mao health district. METHODS A matched case-control study was conducted on 411 (137 cases and 274 controls) children aged 6-59 months with their caretakers from mid-February to August 2017. Data were collected by using a structured interviewer administered questionnaire, anthropometric measurements and through direct observations of household environment. Controls were matched to their cases on place of residence and on age (± 3 months). Data were double-entered, processed and analysed using Epi Info 7.2.0.1. Conditional logistic regression was used to analyse the association of independent variables with SAM. For multivariable analysis, two models were constructed to investigate risk factors for SAM, at individual and household level. A stepwise backwards elimination approach with a significance level of p = 0.05 was used to build the final models. RESULTS At the individual level, SAM was significantly associated with diarrhoea [AOR (95% CI) = 10.7 (4.2-27.3)], fever [AOR (95% CI) = 8.4 (3.1-22.8)], vomiting [AOR (95% CI) = 7.6 (3.0-19.7)], being stunted [AOR (95% CI) = 5.3 (1.7-16.3)], and type of complementary meal [AOR (95% CI) = 4.4 (1.0-19.6)]. At the household level, SAM was significantly associated with undernourished caretaker [AOR (95% CI) = 2.6 (1.2-5.5)], caretaker's hand washing habits [AOR (95% CI) = 1.9 (1.2-3.1)], absence of toilet [AOR (95% CI) = 1.9 (1.1-3.6)], caretaker's marriage status [AOR (95% CI) = 7.7 (2.0-30.1)], and low household food diversity [AOR (95% CI) = 1.8 (1.0-3.1)]. CONCLUSION The present study identified the need to address both treatment and prevention of infections in children through an integrated approach. Well-organized efforts to improve child feeding practices, household hygiene and sanitation conditions, women's nutritional status, along with increasing household food diversity are likely to lead to improved nutritional status of children in this setting.
Collapse
Affiliation(s)
- Jovana Dodos
- Action Contre la Faim, 14/16 Boulevard Douaumont - CS 80060, 75854 PARIS, CEDEX 17 France
| | - Chiara Altare
- Action Contre la Faim, 14/16 Boulevard Douaumont - CS 80060, 75854 PARIS, CEDEX 17 France
| | - Mahamat Bechir
- Alliance Sahélienne de Recherches Appliquées pour le Développement Durable ASRADD, N’djamena, Chad
| | | | | | - Francois Bellet
- UNICEF Regional Office for West and Central Africa, Dakar, Senegal
| | - Jean Lapegue
- Action Contre la Faim, 14/16 Boulevard Douaumont - CS 80060, 75854 PARIS, CEDEX 17 France
| | - Joachim Peeters
- Action Contre la Faim, 14/16 Boulevard Douaumont - CS 80060, 75854 PARIS, CEDEX 17 France
| | - Mathias Altmann
- Action Contre la Faim, 14/16 Boulevard Douaumont - CS 80060, 75854 PARIS, CEDEX 17 France
| |
Collapse
|
31
|
Voth-Gaeddert LE, Stoker M, Cornell D, Oerther DB. What causes childhood stunting among children of San Vicente, Guatemala: Employing complimentary, system-analysis approaches. Int J Hyg Environ Health 2018; 221:391-399. [DOI: 10.1016/j.ijheh.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/01/2018] [Accepted: 01/02/2018] [Indexed: 01/27/2023]
|
32
|
Gizaw Z, Woldu W, Bitew BD. Acute malnutrition among children aged 6-59 months of the nomadic population in Hadaleala district, Afar region, northeast Ethiopia. Ital J Pediatr 2018; 44:21. [PMID: 29415750 PMCID: PMC5803907 DOI: 10.1186/s13052-018-0457-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/16/2018] [Indexed: 01/12/2023] Open
Abstract
Background Acute malnutrition to be a major health burden in the world, particularly in the developing world. Acute malnutrition is associated with more than one third of the global disease burden for children. Malnourished children are physically, emotionally and intellectually less productive and suffer more from chronic illnesses and disabilities. The nature, magnitude and determinants of acute malnutrition are determined among the general populations; however, there is a lack of evidence in the nomadic communities. Methods A cross-sectional study was conducted to assess the magnitude and factors associated with acute malnutrition among children aged 6–59 months in Hadaleala district, Afar Region. A total of 591 under-five children were included in this study, and subjects were recruited by the multistage cluster sampling technique. Data were collected by a pre-tested questionnaire and a simple anthropometric index so called mid-upper arm circumference (MUAC). The multivariable binary logistic regression analysis was used to identify factors associated with acute malnutrition on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. Results The prevalence of acute malnutrition was 11.8% (95% CI = 9.3, 14.8%). The highest prevalence (50%) of acute malnutrition occurred among children aged between 12.0–23.0 months. Childhood acute malnutrition was associated with the presence of two (AOR = 2.49, p < 0.05) and three (AOR = 12.87, p < 0.001) children in each household, unprotected drinking water sources (AOR = 3.78, p < 0.05), absence of the latrine (AOR = 5.24, p < 0.05), hand washing with soap (AOR = 0.21, p < 0.05), childhood diarrheal disease (AOR = 2.72, p < 0.05), and child vaccination (AOR = 0.15, p < 0.001). Conclusion The prevalence of acute malnutrition among children aged 6-59 months was was higher than the national prevalence. The number of children in each household, drinking water sources, latrine availability, hand washing practice before food preparation and child feeding, childhood diarrheal disease, and child vaccination were identified as factors affecting the childhood acute malnutrition in the nomadic community. Protecting drinking water sources from possible contaminants, improving hand washing practices, utilization of latrine, preventing diarrheal diseases and vaccinating children integrated with the access of nutrition education is important to improve nutrition of children of the nomadic people.
Collapse
Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia.
| | - Wondwoson Woldu
- Hadaleala District Health Office, Hadaleala District, Afar Regional State, Ethiopia
| | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
33
|
Chandra KA, Wanda D. Traditional Method of Initial Diarrhea Treatment in Children. Compr Child Adolesc Nurs 2017; 40:128-136. [DOI: 10.1080/24694193.2017.1386980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kristian Ade Chandra
- Faculty of Nursing, Universitas Indonesia, Jalan Bahder Djohan Campus, Depok, Indonesia
| | - Dessie Wanda
- Faculty of Nursing, Universitas Indonesia, Jalan Bahder Djohan Campus, Depok, Indonesia
| |
Collapse
|
34
|
Desyanti C, Nindya TS. Hubungan Riwayat Penyakit Diare dan Praktik Higiene dengan Kejadian Stunting pada Balita Usia 24-59 Bulan di Wilayah Kerja Puskesmas Simolawang, Surabaya. AMERTA NUTRITION 2017. [DOI: 10.20473/amnt.v1i3.2017.243-251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Stunting among children is a chronic impact of a long-term low quality dietary intake accompanied by infectious diseases and environmental issues. Bad hygiene practices can lead to diarrheal disease that can make children loss some essential nutrients for body growth. Objectives: This research aimed to analyze the relations between history of diarrheal disease and hygiene practices with stunting incidences among children aged 24-59 months. Methods: This research was designed with case control. The case was stunting children and the control was non-stunting children in the work area of Puskesmas Simolawang with sample of 33 children each. The relation between variables was tested using Chi Square and Odd Ratio. Results: The majority of children in stunting group had the diarrheal disease frequently (72.7%), whereas children in non stunting group had the diarrheal disease rarely (57.6%). Most of children caretaker in stunting group had bad hygiene practices (75.8%), whereas children caretaker in non stunting group had good hygiene practices (60.6%). The history of diarrheal disease (p=0.025, OR=3.619) and hygiene practices (p=0.006, OR=4.808) had significant relation with stunting. Conclusion: The frequent diarrheal diseases and poor hygiene practices increase the risk of stunting 3.619 and 4.808 times among children aged 24-59 months. It can be recommended that there should be a monitoring of infectious disease among children held by Intergrated Health Post and should be held an education related to parenting styles, especially hygiene practices, because a good parenting styles could lead to a better nutritional status.ABSTRAK Latar belakang: Stunting pada anak merupakan dampak yang bersifat kronis dari konsumsi diet berkualitas rendah yang terus menerus dan didukung oleh penyakit infeksi dan masalah lingkungan. Praktik higiene yang buruk dapat menyebabkan balita terserang penyakit diare yang nantinya dapat menyebabkan anak kehilangan zat-zat gizi yang penting bagi pertumbuhan.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan riwayat penyakit diare dan praktik higiene dengan kejadian stunting pada balita usia 24-59 bulan.Metode: Penelitian menggunakan desain kasus kontrol. Sampel kasus adalah balita stunting dan sampel kontrol adalah balita tidak stunting di wilayah kerja Puskesmas Simolawang dengan jumlah masing-masing 33. Hubungan dan besar risiko antara variabel diuji menggunakan Chi Square dan Odd Ratio.Hasil: Sebagian besar anak pada kelompok stunting sering mengalami diare (72,7%) sedangkan pada kelompok tidak stunting jarang mengalami diare (57,6%). Sebagian besar pengasuh pada kelompok stunting memiliki praktik higiene yang buruk (75,8%), sedangkan pada kelompok tidak stunting memiliki praktik higiene yang baik (60,6%). Riwayat penyakit diare (p=0,025, OR=3,619) dan praktik higiene (p=0,006, OR=4,808) memiliki hubungan yang signifikan dengan kejadian stunting. Kesimpulan: Riwayat diare yang terjadi secara sering dalam 3 bulan terakhir dan praktik higiene yang buruk meningkatkan risiko sebesar 3,619 dan 4,808 kali terhadap kejadian stunting pada balita usia 24-59 bulan. Hal yang dapat disarankan adalah adanya pemantauan terkait riwayat penyakit infeksi pada balita oleh posyandu setempat dan diadakan penyuluhan terkait dengan pola asuh pada anak, khususnya praktik higiene, karena pola asuh yang baik dapat berdampak kepada status gizi yang lebih baik.
Collapse
|
35
|
Gibson S, Sahanggamu D, Fatmaningrum D, Curtis V, White S. 'Unfit for human consumption': a study of the contamination of formula milk fed to young children in East Java, Indonesia. Trop Med Int Health 2017; 22:1275-1282. [PMID: 28712156 DOI: 10.1111/tmi.12927] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine levels of bacterial contamination in formula feeding bottles in Sidoarjo, East Java, and to assess the preparation practices that may have been responsible. METHODS A cross-sectional study was conducted among 92 randomly selected households with children under the age of two who were bottle-fed formula. In each household, we carried out video observation of mothers/caregivers preparing bottles, and examined samples of formula for coliform bacteria and Escherichia coli (E. coli). In-depth interviews were conducted with a subsample of 20 mothers. RESULTS A total of 88% of the formula feeds were contaminated with total coliforms at a level >10 MPN/ml, and 45% contained E. coli. These feeds were defined as 'unfit for human consumption'. In the video observations, none of the mothers complied with all five WHO-recommended measures of hygienic formula feed preparation. Only two mothers washed their hands with soap prior to formula preparation. Most mothers also failed to clean or sterilise the bottle and clean the preparation area. In-depth interviews confirmed that such suboptimal hygiene practices were common. CONCLUSION The high levels of contamination found highlight that bottles are an important faecal-oral exposure pathway resulting from poor hygiene practices during bottle preparation.
Collapse
Affiliation(s)
- Sarah Gibson
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Sahanggamu
- Regional Centre for Food and Nutrition, Southeast Asian Ministers of Education Organization, Jakarta, Indonesia
| | - Dewi Fatmaningrum
- Regional Centre for Food and Nutrition, Southeast Asian Ministers of Education Organization, Jakarta, Indonesia
| | - Val Curtis
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Sian White
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
36
|
Gizaw Z, Woldu W, Bitew BD. Child feeding practices and diarrheal disease among children less than two years of age of the nomadic people in Hadaleala District, Afar Region, Northeast Ethiopia. Int Breastfeed J 2017; 12:24. [PMID: 28592985 PMCID: PMC5460459 DOI: 10.1186/s13006-017-0115-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhea is a serious public health problem in Ethiopia. It is responsible for 24-30% of all infant deaths and there is a lack of evidence on the health burdens among the nomadic people. This study was therefore designed to assess the prevalence of diarrhea among children less thanvtwo year's of age and its association with feeding practices among the nomadic people in Hadaleala district, northeast Ethiopia. METHODS A cross-sectional study was conducted in Hadaleala district. A total of 367 children less than two years of age were included using the multistage cluster sampling technique. Data were collected by a structured questionnaire. Multivariable binary logistic regression analysis was used to identify variables associated with diarrheal disease. RESULTS The prevalence of diarrhea among children less than two year's of age during the two week period was 31.3% (95% CI, 25.9, 36.1%). Diarrhea occurrence was associated with; children aged between 6-11 months (AOR 6.28, 95% CI, 3.00, 13.12), aged between 12-24 months (AOR 6.21, 95% CI, 3.13, 12.30), illiterate mothers (AOR 6.61, 95% CI, 2.27, 19.21), delay to initiate early breastfeeding for children aged less than six months (AOR 9.13, 95% CI, 1.78, 46.72), children less than six months of age not currently exclusively breastfed (AOR 13.33, 95% CI, 1.59, 112.12), delay to initiate early breastfeeding for children aged 6-24 months (AOR 2.87, 95% CI, 1.49, 5.51), no breastfeeding at the time of the survey (AOR 3.51, 95% CI, 1.57, 7.82), children aged 6-24 months who didn't exclusively breastfeed in the first six months (AOR 19.24, 95% CI, 8.26, 44.82), consuming uncooked foods (AOR 6.99, 95% CI, 2.89, 16.92), not eating cooked foods immediately after cooking (AOR 3.74, 95% CI, 1.48, 9.45), hand washing with only water (AOR 24.94, 95% CI, 6.68, 93.12), and rotavirus vaccination (AOR 0.09, 95% CI, 0.03, 0.29). CONCLUSIONS The prevalence of diarrhea among children less than two year's of age in Hadaleala district was high. To prevent diarrhea, the mothers should start breastfeeding early and practice exclusive breastfeeding. Moreover, mothers should improve the hygiene of supplementary foods.
Collapse
Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwoson Woldu
- Hadaleala District Health Office, Hadaleala District, Afar Regional State Ethiopia
| | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
37
|
Jung YT, Hum RJ, Lou W, Cheng YL. Effects of neighbourhood and household sanitation conditions on diarrhea morbidity: Systematic review and meta-analysis. PLoS One 2017; 12:e0173808. [PMID: 28296946 PMCID: PMC5351971 DOI: 10.1371/journal.pone.0173808] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/27/2017] [Indexed: 11/19/2022] Open
Abstract
Sanitation in neighbourhood and household domains can provide primary protection against diarrhea morbidity, yet their distinct health benefits have not been succinctly distinguished and reviewed. We present here the first systematic review and meta-analysis of the distinct effect of neighbourhood and household sanitation conditions on diarrhea morbidity. We identified studies reporting the effect of neighbourhood-level exposure to wastewater or household sanitation facilities on diarrhea, by performing comprehensive search on five databases, namely the Cochrane library, PubMed, Embase, Scopus and Web of Science, from the earliest date available to February 2015. Twenty-one non-randomized studies and one randomized controlled trial met the pre-determined inclusion criteria, consisting of six datasets on neighbourhood sanitation conditions (total 8271 subjects) and 20 datasets on household sanitation (total 20021 subjects). We calculated the pooled effect estimates of neighbourhood and household sanitation conditions on diarrhea morbidity using the inverse variance random-effects model. The pooled effect estimates showed that both neighbourhood sanitation conditions (odds ratio = 0.56, 95%CI: 0.40-0.79) and household sanitation (odds ratio = 0.64, 95%CI: 0.55-0.75) are associated with reduced diarrheal illness, and that the magnitudes of the associations are comparable. Evidence of risk of bias and heterogeneity were found in the included studies. Our findings confirm that both neighbourhood sanitation conditions and household sanitation are associated with considerable reduction in diarrhea morbidity, in spite of a number of methodological shortcomings in the included studies. Furthermore, we find evidence that neighbourhood sanitation conditions is associated with similar magnitude of reduction in diarrhea morbidity as household sanitation. The findings suggest that, in addition to household sanitation provision, dual emphasis on neighbourhood sanitation through public sanitation infrastructure provision and community-wide sanitation adoption is advisable for effective reduction of diarrheal disease burden.
Collapse
Affiliation(s)
- Youngmee Tiffany Jung
- Centre for Global Engineering and the Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - Ryan James Hum
- Centre for Global Engineering and the Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yu-Ling Cheng
- Centre for Global Engineering and the Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
38
|
Parvez SM, Kwong L, Rahman MJ, Ercumen A, Pickering AJ, Ghosh PK, Rahman MZ, Das KK, Luby SP, Unicomb L. Escherichia coli contamination of child complementary foods and association with domestic hygiene in rural Bangladesh. Trop Med Int Health 2017; 22:547-557. [PMID: 28164415 DOI: 10.1111/tmi.12849] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the frequency and concentration of Escherichia coli in child complementary food and its association with domestic hygiene practices in rural Bangladesh. METHOD A total of 608 households with children <2 years were enrolled. We collected stored complementary food samples, performed spot checks on domestic hygiene and measured ambient temperature in the food storage area. Food samples were analysed using the IDEXX most probable number (MPN) method with Colilert-18 media to enumerate E. coli. We calculated adjusted prevalence ratios (APR) to assess the relationship between E. coli and domestic hygiene practices using modified Poisson regression, adjusting for clustering and confounders. RESULT Fifty-eight percentage of stored complementary food was contaminated with E. coli, and high levels of contamination (≥100 MPN/dry g food) were found in 12% of samples. High levels of food contamination were more prevalent in compounds where the food was stored uncovered (APR: 2.0, 95% CI: 1.2-3.2), transferred from the storage pot to the serving dish using hands (APR: 2.0, 95% CI: 1.3-3.2) or stored for >4 h (APR: 2.5, 95% CI: 1.5, 4.2), in compounds where water was unavailable in the food preparation area (APR: 2.6, 95% CI: 1.6, 4.2), where ≥1 fly was captured in the food preparation area (APR: 1.6, 95% CI: 1.0, 2.6), or where the ambient temperature was high (>25-40 °C) in the food storage area (APR: 2.7, 95% CI: 1.5, 4.4). CONCLUSION Interventions to keep stored food covered and ensure water availability in the food preparation area would be expected to reduce faecal contamination of complementary foods.
Collapse
Affiliation(s)
- Sarker Masud Parvez
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Musarrat Jabeen Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ayse Ercumen
- University of California Berkeley, Berkeley, CA, USA
| | | | - Probir K Ghosh
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Zahidur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kishor Kumar Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
39
|
Joventino ES, Ximenes LB, da Penha JC, Andrade LCDO, de Almeida PC. The use of educational video to promote maternal self-efficacy in preventing early childhood diarrhoea. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/01/2016] [Accepted: 12/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Emanuella Silva Joventino
- Nursing School; University of International Integration of African-Brazilian Lusophony; Redenção Ceará Brazil
| | | | | | | | | |
Collapse
|
40
|
Nizame FA, Leontsini E, Luby SP, Nuruzzaman M, Parveen S, Winch PJ, Ram PK, Unicomb L. Hygiene Practices During Food Preparation in Rural Bangladesh: Opportunities to Improve the Impact of Handwashing Interventions. Am J Trop Med Hyg 2016; 95:288-97. [PMID: 27296388 DOI: 10.4269/ajtmh.15-0377] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 04/14/2016] [Indexed: 11/07/2022] Open
Abstract
This study explored the steps of food preparation, related handwashing opportunities, current practices, and community perceptions regarding foods at high-risk of contamination such as mashed foods and salads. In three rural Bangladeshi villages, we collected qualitative and observational data. Food preparation was a complex and multistep process. Food preparation was interrupted by tasks that could contaminate the preparers' hands, after which they continued food preparation without washing hands. Community members typically ate hand-mixed, uncooked mashed food and salad as accompaniments to curry and rice at meals. Hand-mixed dried foods were mostly consumed as a snack. Observers recorded handwashing during preparation of these foods. Among 24 observed caregivers, of 85 opportunities to wash hands with soap during food preparation, washing hands with soap occurred twice, both times after cutting fish, whereas washing hands with water alone was common. A simple and feasible approach is promotion of handwashing with soap upon entering and re-entering the food preparation area, and ensuring that everything needed for handwashing should be within easy reach.
Collapse
Affiliation(s)
- Fosiul A Nizame
- The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
| | - Elli Leontsini
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Md Nuruzzaman
- The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shahana Parveen
- The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Peter J Winch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pavani K Ram
- University at Buffalo, State University of New York, Buffalo, New York
| | - Leanne Unicomb
- The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
41
|
Mohammed AI, Zungu L. Environmental health factors associated with diarrhoeal diseases among under-five children in the Sebeta town of Ethiopia. S Afr J Infect Dis 2016. [DOI: 10.1080/23120053.2016.1156876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
42
|
Oriá RB, Murray-Kolb LE, Scharf RJ, Pendergast LL, Lang DR, Kolling GL, Guerrant RL. Early-life enteric infections: relation between chronic systemic inflammation and poor cognition in children. Nutr Rev 2016; 74:374-86. [PMID: 27142301 DOI: 10.1093/nutrit/nuw008] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The intestinal microbiota undergoes active remodeling in the first 6 to 18 months of life, during which time the characteristics of the adult microbiota are developed. This process is strongly influenced by the early diet and enteric pathogens. Enteric infections and malnutrition early in life may favor microbiota dysbiosis and small intestinal bacterial overgrowth, resulting in intestinal barrier dysfunction and translocation of intestinal bacterial products, ultimately leading to low-grade, chronic, subclinical systemic inflammation. The leaky gut-derived low-grade systemic inflammation may have profound consequences on the gut-liver-brain axis, compromising normal growth, metabolism, and cognitive development. This review examines recent data suggesting that early-life enteric infections that lead to intestinal barrier disruption may shift the intestinal microbiota toward chronic systemic inflammation and subsequent impaired cognitive development.
Collapse
Affiliation(s)
- Reinaldo B Oriá
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA.
| | - Laura E Murray-Kolb
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Rebecca J Scharf
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Laura L Pendergast
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Dennis R Lang
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Glynis L Kolling
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Richard L Guerrant
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
43
|
Cronin AA, Sebayang SK, Torlesse H, Nandy R. Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E310. [PMID: 26978379 PMCID: PMC4808973 DOI: 10.3390/ijerph13030310] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 11/17/2022]
Abstract
Indonesia still faces several challenges in the areas of water, sanitation, and hygiene (WASH). Diarrhea remains a major killer of children and it is important to understand the local diarrhea transmission pathways to prioritise appropriate WASH interventions to reduce diarrhea burden. This study used a cross-sectional data set from a recent national household survey (the 2012 Indonesia Demographic and Health Survey) to examine the associations between diarrhea in children aged less than 24 months with WASH interventions and population characteristics. Unsafe disposal of child feces was strongly associated with an increased odds of child diarrhea (OR: 1.46; 95% CI: 1.18-1.82, p = 0.001). However, other WASH practices were not found to be associated. The findings underline the dangers of unsafe disposal of child feces and highlight the need for strengthening the related policies and program strategies and their implementation.
Collapse
Affiliation(s)
- Aidan A Cronin
- UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
| | - Susy Katikana Sebayang
- Faculty of Public Health, Universitas Airlangga, Banyuwangi Campus, Jalan Wijaya Kusuma No 113, Banyuwangi 68414, Indonesia.
| | - Harriet Torlesse
- UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
| | - Robin Nandy
- UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
| |
Collapse
|
44
|
Rahman MJ, Nizame FA, Nuruzzaman M, Akand F, Islam MA, Parvez SM, Stewart CP, Unicomb L, Luby SP, Winch PJ. Toward a Scalable and Sustainable Intervention for Complementary Food Safety. Food Nutr Bull 2016; 37:186-201. [PMID: 26944506 DOI: 10.1177/0379572116631641] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Contaminated complementary foods are associated with diarrhea and malnutrition among children aged 6 to 24 months. However, existing complementary food safety intervention models are likely not scalable and sustainable. OBJECTIVE To understand current behaviors, motivations for these behaviors, and the potential barriers to behavior change and to identify one or two simple actions that can address one or few food contamination pathways and have potential to be sustainably delivered to a larger population. METHODS Data were collected from 2 rural sites in Bangladesh through semistructured observations (12), video observations (12), in-depth interviews (18), and focus group discussions (3). RESULTS Although mothers report preparing dedicated foods for children, observations show that these are not separate from family foods. Children are regularly fed store-bought foods that are perceived to be bad for children. Mothers explained that long storage durations, summer temperatures, flies, animals, uncovered food, and unclean utensils are threats to food safety. Covering foods, storing foods on elevated surfaces, and reheating foods before consumption are methods believed to keep food safe. Locally made cabinet-like hardware is perceived to be acceptable solution to address reported food safety threats. CONCLUSION Conventional approaches that include teaching food safety and highlighting benefits such as reduced contamination may be a disincentive for rural mothers who need solutions for their physical environment. We propose extending existing beneficial behaviors by addressing local preferences of taste and convenience.
Collapse
Affiliation(s)
- Musarrat J Rahman
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Fosiul A Nizame
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Nuruzzaman
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Farhana Akand
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Aminul Islam
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sarker Masud Parvez
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Leanne Unicomb
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Stephen P Luby
- International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
| | - Peter J Winch
- Social and Behavioral Interventions (SBI) Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
45
|
Komarulzaman A, Smits J, de Jong E. Clean water, sanitation and diarrhoea in Indonesia: Effects of household and community factors. Glob Public Health 2016; 12:1141-1155. [PMID: 26758565 DOI: 10.1080/17441692.2015.1127985] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Diarrhoea is an important health issue in low- and middle-income countries, including Indonesia. We applied a multilevel regression analysis on the Indonesian Demographic and Health Survey to examine the effects of drinking water and sanitation facilities at the household and community level on diarrhoea prevalence among children under five (n = 33,339). The role of the circumstances was explored by studying interactions between the water and sanitation variables and other risk factors. Diarrhoea prevalence was reported by 4820 (14.4%) children, who on average were younger, poorer and were living in a poorer environment. At the household level, piped water was significantly associated with diarrhoea prevalence (OR = 0.797, 95% CI: 0.692-0.918), improved sanitation had no direct effect (OR = 0.992, 95% CI: 0.899-1.096) and water treatment was not related to diarrhoea incidence (OR = 1.106, 95% CI: 0.994-1.232). At the community level, improved water coverage had no direct effect (OR = 1.002, 95% CI: 0.950-1.057) but improved sanitation coverage was associated with lower diarrhoea prevalence (OR = 0.917, 95% CI: 0.843-0.998). Our interaction analysis showed that the protective effects of better sanitation at the community level were increased by better drinking water at the community level. This illustrates the importance of improving both drinking water and sanitation simultaneously.
Collapse
Affiliation(s)
- Ahmad Komarulzaman
- a Department of Economics, Faculty of Economics & Business , Universitas Padjadjaran , Bandung , Indonesia.,b Radboud University Nijmegen, Institute for Management Research , Nijmegen , The Netherlands
| | - Jeroen Smits
- b Radboud University Nijmegen, Institute for Management Research , Nijmegen , The Netherlands
| | - Eelke de Jong
- b Radboud University Nijmegen, Institute for Management Research , Nijmegen , The Netherlands
| |
Collapse
|
46
|
da Rocha Mendes ER, da Penha JC, do Nascimento LA, de Sabino LMM, Joventino ES, Ferreira ÁMV, Teixeira OCM, de Sousa Galvão MDFP, Ximenes LB. Assessment of Educational Videos on the Prevention and Management of Infant Diarrhea: Documental Study. Health (London) 2015. [DOI: 10.4236/health.2015.79136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
47
|
Sarker MHR, Das SK, Ahmed S, Ferdous F, Das J, Farzana FD, Shahid ASMSB, Shahunja KM, Afrad MH, Malek MA, Chisti MJ, Bardhan PK, Hossain MI, Mamun AA, Faruque ASG. Changing characteristics of rotavirus diarrhea in children younger than five years in urban Bangladesh. PLoS One 2014; 9:e105978. [PMID: 25171098 PMCID: PMC4149481 DOI: 10.1371/journal.pone.0105978] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 07/28/2014] [Indexed: 11/25/2022] Open
Abstract
Background Childhood rotavirus diarrhea is still one of the major public health challenges. The present study aimed to determine changing characteristics of rotavirus diarrhea in under-5 children at two periods of time. Methods We enrolled 5,357 under-5 children with rotavirus positive in two different time periods; i) 1993-1997 (n = 2,493), and ii) 2008–2012 (n = 2,864) considering beginning and ending of two decades. These children were enrolled in the urban Dhaka Hospital of icddr,b. Results Overall, proportion of rotavirus was about 25% in 1993–97, which was 42% in 2008–12 (68% rise; p<0.001). Significant higher proportion of children were stunted [38% vs. 22%; aOR-1.33 (95% CI-1.09-1.62)], had vomiting [87% vs. 74%; aOR-2.58 (95% CI-2.02-3.28)], fever [10% vs. 8%; aOR-1.31 (95% CI-0.96-1.78)], family members >5 [38% vs. 35%; aOR-1.32 (95% CI-1.10-1.58)] required more intravenous fluid [9% vs. 3%; aOR-4.93 (95% CI-3.19-7.63)], had higher co-infection with Shigella [3% vs. 1%; aOR-3.36 (95% CI-1.61-7.03)], Vibrio cholerae [4% vs. 1%; aOR-3.70 (95% CI-2.12-6.46)]; and ETEC [13% vs. 7%; aOR-2.21 (95% CI-1.65-2.97)]; however, significantly lower proportion of them used sanitary toilets [54% vs. 78%; aOR-0.66 (95% CI-0.54-0.80)], boiled drinking water [16% vs. 38%; aOR-0.60 (95% CI-0.48-0.74)], used antimicrobial at home [63% vs. 82%; aOR-0.56 (95% CI-0.46-0.69)] and had some or severe dehydration [18% vs. 34%; aOR-0.15 (95% CI-0.12-0.20)] in 1st observation period compared to that of 2nd. Conclusion Proportion of episodes of under-5 rotavirus diarrhea increased over the period. Concomitant changes in host, socio-demographic and clinical characteristics, and co-infections were also observed. Thus, vaccination campaign which is prevailing in private sector should also be introduced in public sector.
Collapse
Affiliation(s)
| | - Sumon Kumar Das
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
- School of Population Health, The University of Queensland, Brisbane, Australia
- * E-mail:
| | - Shahnawaz Ahmed
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Farzana Ferdous
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Jui Das
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Fahmida Dil Farzana
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | | | - K. M. Shahunja
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Mokibul Hassan Afrad
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Mohammad Abdul Malek
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | | | - Pradip Kumar Bardhan
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Md Iqbal Hossain
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Abdullah Al Mamun
- School of Population Health, The University of Queensland, Brisbane, Australia
| | - Abu S. G. Faruque
- International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
48
|
Agustina R, Shankar AV, Ayuningtyas A, Achadi EL, Shankar AH. Maternal Agency Influences the Prevalence of Diarrhea and Acute Respiratory Tract Infections Among Young Indonesian children. Matern Child Health J 2014; 19:1033-46. [DOI: 10.1007/s10995-014-1603-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
49
|
Joventino ES, Ferreira ÁMV, Sousa MDFPD, Penha JCD, Oriá MOB, Almeida PCD, Ximenes LB. Educational Video Increases Maternal Self-Efficacy for Prevention of Diarrhoea in Young Children: A Randomised Clinical Trial. Health (London) 2014. [DOI: 10.4236/health.2014.621325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|