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Thattil AMT, Agrawal T, Surti AK, Sebastian S, Mirza K, Jacob G, Fathima FN. No Child's Play: Under-five Child Feces Management in a Rural Area of Bengaluru Urban District, India. Indian J Community Med 2024; 49:138-143. [PMID: 38425963 PMCID: PMC10900461 DOI: 10.4103/ijcm.ijcm_141_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/06/2023] [Indexed: 03/02/2024] Open
Abstract
Background Inappropriate feces disposal leads to environmental contamination, and increases the risk of exposure to children. We aimed to estimate the proportion of rural households with knowledge and practice of safe management of feces (SMoF) among under-five children and to identify associated factors. Materials and Methods A cross-sectional study was conducted in eight villages in Bengaluru Urban district over 2 months, using a face-validated semi-structured interview schedule. SMoF was defined based on five criteria - defecation site, transport tool, feces disposal, cleaning of transport tool, and hand washing. Results Out of 320 under-five children surveyed, 15.7% were pre-ambulatory and 84.3% were ambulatory. The majority of the caregivers (92.5%) felt that children should defecate in the latrine and only 23.7% were aware that child feces were more infectious than adult feces. SMoF was only practiced by caregivers of ambulatory children (52.6%). Households with older caregivers (P = 0.01) and those living in a pucca house (P = 0.02) with a latrine inside (P = 0.04) were found to practice SMoF. Children of households that practiced unsafe disposal of child feces experienced more diarrheal episodes (P = 0.04). Caregivers >20 years were found to have better odds of SMoF [20-25 years (adjusted odds ratio, aOR: 9.02), 26-30 years (aOR: 12.17), >30 years (aOR: 8.93)] compared to those <20 years. Conclusion The proportion of households with knowledge and practice of SMoF was low. Awareness of SMoF is essential to reduce the incidence of diarrheal diseases and improve sanitation. Our findings also call for awareness building at schools and colleges.
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Affiliation(s)
| | - Twinkle Agrawal
- Department of Community Health, St. John’s Medical College, Karnataka, India
| | - Abdul Kader Surti
- Department of Community Health, St. John’s Medical College, Karnataka, India
| | - Stallon Sebastian
- Department of Community Health, St. John’s Medical College, Karnataka, India
| | - Kiyana Mirza
- Department of Community Health, St. John’s Medical College, Karnataka, India
| | - George Jacob
- Department of Community Health, St. John’s Medical College, Karnataka, India
| | - Farah Naaz Fathima
- Department of Community Health, St. John’s Medical College, Karnataka, India
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Kouassi HAA, Andrianisa HA, Sossou SK, Traoré MB, Nguematio RM. Sustainability of facilities built under the Community-Led Total Sanitation (CLTS) implementation: Moving from basic to safe facilities on the sanitation ladder. PLoS One 2023; 18:e0293395. [PMID: 37972150 PMCID: PMC10653469 DOI: 10.1371/journal.pone.0293395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023] Open
Abstract
In the context of monitoring progress towards SDG target 6.2, a household is counted to have access to sanitation if it uses at least basic sanitation services. Several approaches have been employed to help rural communities to climb up the sanitation ladder such as Community-led Total Sanitation (CLTS), whose primary target is to end open defecation through behavior change. CLTS does not subsidize sanitation facilities, but let households build their own facilities. The types and sustainability of facilities when construction is entrusted to households without guidelines remain understudied. The contribution of CLTS in achieving SDG6.2 also have not been studied. This paper addresses these gaps. Conducted in the province of Sissili in Burkina Faso, our study involved interviewing CLTS implementers, government officials, and community stakeholders. Coupled with household surveys, the data was analyzed using SPSS and Excel software. Findings indicate that CLTS succeeded in motivating households to build latrines hence escalating latrine coverage from 29.51% in 2016 (pre-CLTS) to 90.44% in 2020 (post-CLTS) in the province. However, 97.53% of latrines built were unimproved pit latrines with superstructures and without/with wooden or clay slabs and no roof, of which 19.76% collapsed during the rainy season. During this period, sanitation access rate rose from 11.9% to 17.00%. The study has therefore revealed that CLTS significantly elevates latrine coverage, yet it does not guarantee a proportional rise in sanitation access. This discrepancy results from the type of technologies generated by CLTS, which are not considered in calculating the sanitation access rate due to their unimproved nature. Consequently, further exploration of social approaches is essential, amalgamating technical and engineering aspects. Beyond socio-economic considerations, the sustainability of CLTS and the achievement of access to adequate and safe sanitation also rely on the robustness and resilience of the implemented facilities.
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Affiliation(s)
- Hemez Ange Aurélien Kouassi
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau et de l’Environnement (2iE), Ouagadougou, Burkina Faso
| | - Harinaivo Anderson Andrianisa
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau et de l’Environnement (2iE), Ouagadougou, Burkina Faso
| | - Seyram Kossi Sossou
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau et de l’Environnement (2iE), Ouagadougou, Burkina Faso
| | - Maïmouna Bologo Traoré
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau et de l’Environnement (2iE), Ouagadougou, Burkina Faso
| | - Rikyelle Momo Nguematio
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau et de l’Environnement (2iE), Ouagadougou, Burkina Faso
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Tsegaw M, Mulat B, Shitu K. Safe stool disposal and associated factors among mothers of children aged under-two years in Gambia: Evidence from Gambia Demographic Health Survey 2019/20. PLoS One 2023; 18:e0284986. [PMID: 37126505 PMCID: PMC10150983 DOI: 10.1371/journal.pone.0284986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/12/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Appropriate disposal of child stool is vital in preventing the spread of faecal-oral diseases. According to WHO/ UNICEF Joint Monitoring Program, Safe child stool disposal includes disposing a stool in a Flush or pour-flush toilet/latrine (to a piped sewer system, septic tank, pit latrine), Ventilated improved pit (VIP) latrine or a Pit latrine with slab. OBJECTIVE The study aimed to assess safe child stool disposal practice and associated factors among mothers with children aged under-two years in Gambia. METHODS This study was based on a large community-based cross-sectional survey, conducted from 21 November 2019 to 30 March 2020 in Gambia. The survey employed a two-staged stratified cluster sampling technique to recruit study participants. Descriptive statistics and logistic regression models were used to summarize descriptive data and identify factors associated with safe waste disposal, respectively. A p-value of less than 0.05 and 95% confidence interval were used to determine statistical significance. RESULTS The prevalence of safe stool disposal among mothers with children aged under-two years were 56.3% (95% CI: 54.6%, 58.1%). Mothers aged 25-34 (AOR = 0.78 (95%CI: 0.62, 0.98)), the highest wealth quintile (AOR = 0.43 (95%CI: 0.33, 0.56)), being exposed to media (AOR = 1.37 (95%CI: 1.07, 1.76)), increasing age of children (AOR = 1.06 (1.05, 1.07)), Being employed (AOR = 1.31 (1.11, 1.55)) and Geographic region were significantly associated with safe child disposal practice. CONCLUSION The prevalence of safe child stool disposal was low in Gambia. Age of the mother, age of the child, region, wealth index, media exposure and occupational status of the mother were significantly associated with safe child stool disposal. Public health intervention strategies designed to promote safe child stools disposal need to conduct thorough community assessments to identify community-specific facilitators, needs and barriers. Additionally, public health experts and policy makers should take into consideration the geographical and wealth inequalities when designing programs aimed to improve safe child stool disposal practice.
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Affiliation(s)
- Menen Tsegaw
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bezawit Mulat
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Xu K, Zhu Y, Li Y, Huang J, Wan Q, Hao J, Ji Z, Liu Y, Tay FR, Jiao K, Niu L. Clinical and pathologic factors associated with the relapse of fibrous gingival hyperplasia. J Am Dent Assoc 2022; 153:1134-1144.e2. [DOI: 10.1016/j.adaj.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/05/2022] [Accepted: 08/17/2022] [Indexed: 11/07/2022]
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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.
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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
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Derseh BT, Tafese NM, Panari H, Bilchut AH, Dadi AF. Behavioral and environmental determinants of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, north Shoa zone, Amhara regional state, Ethiopia: Unmatched case-control study. PLoS One 2021; 16:e0259828. [PMID: 34807922 PMCID: PMC8608321 DOI: 10.1371/journal.pone.0259828] [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: 11/20/2020] [Accepted: 10/27/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Acute diarrhea is a major public health problem in the world. Next to pneumonia, it is the leading cause of death in children under five years old. Globally, even though childhood diarrhea disease kills millions, the interaction of socio-demographic, behavioral, and environmental factors of acute diarrhea in children aged 6-59 months is not investigated yet in the current study area. OBJECTIVE To determine behavioral and environmental predictors of acute diarrhea among under-five children from public health facilities of Siyadebirena Wayu district, North Shoa, Amhara Regional State, Ethiopia, 2019. METHODS A facility-based unmatched case-control study was conducted from March 12, 2019, to May 12, 2019. A total of 315 under-five children were included in the study (105 cases and 210 controls). A systematic random sampling technique was used to select study participants. Data were collected by a structured questionnaire and analyzed by using SPSS. To analyze the data, bivariable and multivariable logistic regression analysis was used. RESULTS The study showed that average family monthly income of 12-23 USD (AOR = 6. 22; 95% CI: 1.30, 29.64), hand washing practice of mothers/ care givers with water only (AOR = 3.75; 95% CI: 1.16, 12.13), improper disposal of infant feces (AOR = 11.01; 95% CI: 3.37, 35.96), not treating drinking water at home (AOR = 9.36; 95% CI: 2.73, 32.08), children consuming left-over food stored at room temperature (AOR = 5.52; 95% CI: 1.60, 19.03) and poor knowledge of the respondents about the risk factors for diarrhea were the determinants that significantly associated with acute childhood diarrhea. CONCLUSION The potential predictors of childhood diarrhea morbidity were improper hand-washing practice, not treating drinking water at home, unsafe disposal of children's feces, children consuming left-over food stored at room temperature, and having poor knowledge about the major risk factors for diarrhea. Thus, awareness of the community on hygiene and sanitation focusing on proper handling of human excreta, safe water handling, proper hand washing practice, and proper management of leftover food should be enhanced to prevent children from acute diarrhea diseases.
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Affiliation(s)
- Behailu Tariku Derseh
- Department of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
- * E-mail:
| | - Natnael Mulushewa Tafese
- Waghimira Health Department, Amhara Region Health Bureau, Health System Strengthening Special Support Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Hazaratali Panari
- Department of Nursing, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Awraris Hailu Bilchut
- Department of Public Health, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Amhara, Ethiopia
| | - Abel Fekadu Dadi
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Determinantes sociais de saúde e autoeficácia de mães/cuidadores para prevenção da diarreia. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Formative Research to Design a Child-Friendly Latrine in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111092. [PMID: 34769612 PMCID: PMC8583528 DOI: 10.3390/ijerph182111092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022]
Abstract
In low- and middle-income countries, most latrines are not accessible to young children. We explored how to modify existing pit latrines to make them child friendly. We conducted four focus group discussions with mothers to explore barriers to child latrine use. We then enrolled 20 households with a child aged 3–7 years old to test six enabling technologies developed based on the identified barriers. Two to three weeks after installing the selected enabling technologies in each household, researchers conducted 19 in-depth interviews with caregivers to explore the technologies’ acceptance and feasibility. Common barriers included the discomfort of squatting on a large pan, fear of darkness, and fear of a slippery floor. Of the potential solutions, a ring to stabilize the child while squatting in the latrine was preferred by children and was affordable and available. A wooden board with a smaller hole than the usual pan reduced fears of falling and helped eliminate discomfort but was inconvenient to handle and clean. A transparent fiberglass roof tile was affordable, available, increased visibility, and kept the latrine floor dry. In conclusion, the fiberglass roof tile and stability ring were two affordable and locally available technologies that facilitated latrine use by children aged 3–7 years.
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Getahun W, Adane M. Prevalence of acute diarrhea and water, sanitation, and hygiene (WASH) associated factors among children under five in Woldia Town, Amhara Region, northeastern Ethiopia. BMC Pediatr 2021; 21:227. [PMID: 33975587 PMCID: PMC8111769 DOI: 10.1186/s12887-021-02668-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhea among children under five is one of the significant public health concerns in developing countries, such as Ethiopia that is mainly attributed to inadequate water, sanitation and hygiene (WASH) services. Lack of data on the prevalence and factors associated with acute diarrhea in Woldia Town impedes the effectiveness of WASH programs in the area. Therefore, the aim of this study was to investigate the prevalence and WASH-associated factors of acute diarrhea among under-five children in this area. This study will help guide local diarrhea prevention and control programs. METHODS A community-based cross-sectional study was conducted among 485 children under age five from March to June 2018. The study participants were allocated proportionally and then households with children of this age group were selected from each kebele (the smallest administrative unit in Ethiopia) using a systematic random sampling technique. Data were collected from mothers/caregivers of the under-five children using a structured questionnaire and on-the-spot observation checklist. A binary logistic regression model with 95 % CI (confidence interval) was used to measure the association between dependent and independent variables. From the multivariable analysis, variables with a p-value < 0.05 were taken as factors significantly associated with acute diarrhea among under-five children. RESULTS The prevalence of acute diarrhea among the children was 17.6 % (95 % CI: 14.2-21.0 %). Almost two-thirds 307 (63.4 %) of study participants' main source of drinking water was a private tap; 320 (66.1 %) of households used less than 20 l per capita per day. About one-fifth 99 (20.5 %) of households used an improved sanitation facility. Only one-fifth (21.1 %) of the latrines had nearby handwashing facilities. Less than half 225 (46.5 %) of mothers/caregivers had good handwashing practice at critical times. Water consumption of less than 20 l per capita per day (adjusted odds ratio [AOR] = 2.45; 95 % CI: 1.36-5.84), unimproved sanitation facility (AOR = 3.57; 95 %CI: 1.64-6.51), practicing unsafe child feces disposal (AOR = 2.51; 95 % CI: 1.69-4.64), poor handwashing practice at critical times (AOR = 1.85; 95 % CI: 1.34-3.56) and having no information about diarrhea being prevented by handwashing with water and soap (AOR = 3.12; 95 % CI: 1.64-6.27) were significantly associated with acute diarrhea. CONCLUSIONS More than one in six children under age five had acute diarrhea, a proportion that could be considered relatively high. We recommend that government organizations and concerned stakeholders strengthen urban WASH programs to focus on increasing the availability of sufficient water for adequate daily consumption, and promote safe disposal of child feces and good handwashing practices at critical times. Further effort is needed to sensitize mothers/caregivers about diarrhea prevention through effective WASH activity to reduce the burden of this problem among children under five.
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Affiliation(s)
- Weldehawariyat Getahun
- Organization for Rehabilitation and Development in Amhara (ORDA) Ethiopia, Bahir Dar, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
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Sahiledengle B, Teferu Z, Tekalegn Y, Awoke T, Zenbaba D, Bekele K, Tesemma A, Seyoum F, Woldeyohannes D. Geographical variation and factors associated with unsafe child stool disposal in Ethiopia: A spatial and multilevel analysis. PLoS One 2021; 16:e0250814. [PMID: 33914836 PMCID: PMC8084221 DOI: 10.1371/journal.pone.0250814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 04/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background Unsafe disposal of children’s stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia. Methods A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0–23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal. Results Unsafe child stool disposal was spatially clustered in Ethiopia (Moran’s Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17–2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23–2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42–0.91), children 6–11 months of age (AOR: 0.65, 95%CI: 0.52–0.83), 12–17 months of age (AOR: 0.68, 95%CI: 0.54–0.86), and 18–23 months of age (AOR: 0.58, 95%CI: 0.45–0.75) had lower odds of unsafe child stool disposal. Conclusions Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
- * E-mail:
| | - Zinash Teferu
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Tadesse Awoke
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Kebebe Bekele
- Department of Surgery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Abdi Tesemma
- Department of Surgery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Fikadu Seyoum
- Department of Pediatrics, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
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Soboksa NE. Associations Between Improved Water Supply and Sanitation Usage and Childhood Diarrhea in Ethiopia: An Analysis of the 2016 Demographic and Health Survey. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211002552. [PMID: 33795933 PMCID: PMC7975481 DOI: 10.1177/11786302211002552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/15/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Diarrheal disease is one of the leading causes of death in children under the age of 5. Access to and use of improved water and sanitation services is associated with this, but there is little country-level evidence for this relationship in Ethiopia. Therefore, associations between improved water supply and sanitation usage and childhood diarrhea in Ethiopia have been identified as the objective of this study. METHODS This study was a cross-sectional study using data from Ethiopia's 2016 Demographic and Health Survey. Through interviews with mothers/caregivers who had children under the age of 5 years, data was collected. The outcome of this study was the response of the mothers/caregivers interviewed to the 2-week occurrence of diarrhea. Logistic regression analysis was used to examine the relationship between dependent and independent variables. RESULTS The survey results found that the use of improved drinking water and latrine facilities was 59.3% (95% CI: 58.36-60.31) and 17.3% (95% CI: 16.59-18.09), respectively. With respect to the handling practices of child feces, 24.8% (95% CI: 23.8-25.70) of the child feces of the interviewed mothers/caregivers were disposed of safely. The prevalence of childhood diarrhea in the preceding 2 weeks was 11% (95% CI: 10.36-11.61). Residence of Somali Region (AOR = 1.81, 95% CI: 1.25-2.61), having more than 2 under-5 children (AOR = 1.21, 95% CI: 1.01-1.46), having more than 5 family members (AOR = 1.18, 95% CI: 1.03-1.36), sex of the indexed child (AOR = 0.88, 95% CI: 0.77-0.99) and unsafe child feces disposal practices (AOR: 1.32; 95% CI: 1.14-1.54) were significantly associated with childhood diarrhea. CONCLUSION Residing in the Somali region, having more than 2 children under the age of 5 and having more than 5 household members, indexed child sex, and safe disposal of child feces were significantly associated with diarrhea. Therefore, in Ethiopia, the prevention of childhood diarrhea should concentrate on eliminating household crowding and encouraging the safe disposal of child feces.
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Affiliation(s)
- Negasa Eshete Soboksa
- Negasa Eshete Soboksa, School of Public
Health, College of Health Sciences and Medicine, Dilla University, P.O. Box,
419, Dilla, Ethiopia.
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Sahiledengle B. Unsafe child feces disposal status in Ethiopia: what factors matter? Analysis of pooled data from four demographic and health surveys. BMC Public Health 2020; 20:800. [PMID: 32460735 PMCID: PMC7254708 DOI: 10.1186/s12889-020-08945-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 05/18/2020] [Indexed: 12/21/2022] Open
Abstract
Background The only safest way to dispose of a child’s feces is to help the child use a toilet or, for very young children, to put or rinse their feces into a toilet, whereas other methods are considered unsafe. This study aimed to determine the magnitude and factors associated with unsafe child feces disposal in Ethiopia. Methods This was a cross-sectional study using pooled data from the four rounds of Demographic and Health Surveys (DHS) conducted in Ethiopia (2000, 2005, 2011, and 2016). Data on child feces disposal practice was collected for all children born during the 5 years preceding survey. Mothers were asked for the youngest child born, “The last time child passed stools, what was done to dispose of the stools?”.Descriptive statistics were computed to illustrate the given data. Multivariable logistic regression was performed to identify factors associated with unsafe child feces disposal. Results The pooled dataset contains data for 40,520 children younger than 5 years, male accounts 20,629 (50.9%). Overall, 77.7% (95%CI: 76.3–79.0) of children feces disposed of unsafely. In the multivariable logistic regression model, those mothers whose child was 13–24 months [AOR: 0.68, 95% CI: (0.60–0.78)] and ≥ 25 months [AOR: 0.66, 95% CI: (0.60–0.72)] were lower odds of unsafe child’s feces disposal. Children born into households having two or fewer children were 33% lower [AOR: 0.67, 95% CI: (0.56–0.79)] odds of unsafe child’s feces disposal than their counterparts. The odds of disposing of feces unsafely among households having improved toilet facility was 76% lower [AOR: 0.24, 95% CI: (0.19–0.29)] that of households lacking such facilities. Further, being an urban resident, having improved drinking water facility, a high level of maternal and paternal education, paternal occupational status (work in non-agriculture), and maternal age (25–34 and ≥ 35 years) were factors that associated with lower odds of unsafe child’s feces disposal. Conclusions Three in four Ethiopian children feces disposed of unsafely. Household and socio-demographic factors, such as access to improved toilet facility, the child’s age (older age), and both higher maternal and paternal education levels were important factors that significantly associated with lower odds of unsafe child feces disposal.
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Affiliation(s)
- Biniyam Sahiledengle
- School of Health Science, Department of Public Health, Madda Walabu University Goba Referral hospital, Bale-Goba, Ethiopia.
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Abitew DB, Worku A, Mulugeta A, Bazzano AN. Rural children remain more at risk of acute malnutrition following exit from community based management of acute malnutrition program in South Gondar Zone, Amhara Region, Ethiopia: a comparative cross-sectional study. PeerJ 2020; 8:e8419. [PMID: 32071802 PMCID: PMC7008819 DOI: 10.7717/peerj.8419] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/17/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Community-based management of acute malnutrition has been reported effective in terms of recovery rate, but recovered children may be at increased risk of developing acute malnutrition after returning to the same household (HH) environment. OBJECTIVE Compare the magnitude and factors associated with acute malnutrition among recovered and never treated children in South Gondar Zone, Amhara Region, Ethiopia. METHOD A comparative cross-sectional study was conducted in three districts of South Gondar Zone by tracing 720 recovered and an equal number of age matched children who were never treated for acute malnutrition. Parents were asked to bring children to health post for survey data collection, anthropometric measurements, and edema assessment. Data were collected using a survey questionnaire, entered in to EpiData and analyzed using SPSS v20. Anthropometric indices were generated according to the WHO's 2006 Child Growth Standards using WHO Anthro software version 3.2.2. Bivariate and multivariable logistic regression was utilized. Values with P < 0.05 were considered statistically significant and Odds Ratio with 95% CI was used to measure strength of association. RESULT A total of 1,440 parents were invited, of which 1,414 participated (98.2% response rate). Mean age in months of children (±SD) was 23.7 (±10.4) for recovered and 23.3 (±10.8) for comparison group. About 49% of recovered and 46% of comparison children were females. A significant difference was observed on magnitude of acute malnutrition between recovered (34.2% (95% CI [30.9-38.0]) and comparison groups (26.7% (95% CI [23.5-30.2]), P = 0.002. Factors associated with acute malnutrition among recovered were district of Ebnat (AOR = 3.7; 95% CI [1.9-7.2]), Tach-Gayint (AOR = 2.4; 95% CI [1.2-4.7]); male child (AOR = 1.4; 95% CI [1.0-2.0]); prelactal feeding (AOR = 2.6; 95% CI [1.3 -5.1]); not feeding colostrum (AOR = 1.5; 95% CI [1.1-2.3]); not consuming additional food during pregnancy/lactation (AOR = 1.6; 95% CI [1.1-2.3]); not given Vitamin A supplement (AOR = 2.1; 95% CI [1.4-3.2]); and safe child feces disposal practice (AOR = 1.7; 95% CI [1.2-2.5]) while district of Tach-Gayint (AOR = 2.5; 95% CI [1.3-4.8]); male child (AOR = 1.5; 95% CI [1.1-2.1]), not feeding colostrum (AOR = 1.7; 95% CI [1.2-2.5]), poor hand washing practice (AOR = 1.6; 95% CI [1.1-2.2]); food insecure HH (AOR = 1.6; 95% CI [1.1-2.4]), birth interval <24 months (AOR = 1.9; 95% CI [1.2-3.2]), and poor access to health facility (AOR = 1.7; 95% CI [1.2-2.4]) were factors associated with acute malnutrition among comparison group. CONCLUSION Recovered children were more at risk of acute malnutrition than the comparison group. Nutrition programs should invest in improving nutrition counseling and education; as well as the hygienic practices to protect children against post-discharge relapse of acute malnutrition.
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Affiliation(s)
- Dereje B. Abitew
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Alessandra N. Bazzano
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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Voth-Gaeddert LE, Jonah C, Momberg D, Ngandu B, Said-Mohamed R, Oerther DB, May J. Assessment of environmental exposure factors on child diarrhea and systemic inflammation in the Eastern Cape. WATER RESEARCH 2020; 169:115244. [PMID: 31707177 DOI: 10.1016/j.watres.2019.115244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 10/04/2019] [Accepted: 10/26/2019] [Indexed: 06/10/2023]
Abstract
Poor environmental technologies and gastrointestinal illnesses have been hypothesized to be a primary cause to the lack of impact of child health programs on child stunting rates (low height-for-age) in South Africa. This study assessed correlations between environmental exposures (water source, water treatment, sanitation, refuse), diarrheal occurrences, and systemic inflammation proxies among female and male children under five years of age in the Eastern Cape. A conceptual model was hypothesized using structural equation (SE) modeling and two sex-specific (female and male) datasets were subsequently generated from the data and applied to the hypothesized SE model. Results suggested that environmental exposure variables associated with diarrhea and systemic inflammation proxies were different between females and males. For diarrheal occurrences among females, an increase in local authority management of refuse (compared to household management) (0.161, p-value (p) = 0.007), sharing sanitation facilities (0.060, p = 0.023), and a decrease in the frequency of the treatment of drinking water (-0.043, p = 0.025) were correlated with an increase in diarrhea. For males, an increase in household use of flush toilets (as compared to ventilated pit latrines) was correlated with an increase in diarrhea (0.113, p = 0.027). For systemic inflammation among both sexes, an increase in household use of water pumped into the premises (as compared to a public water tap) and an increase in diarrheal occurrences were correlated with an increase in systemic inflammation. The data support an increased focus on sex and gender specific factors among field practitioners and policy makers working in the environmental health field in South Africa.
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Affiliation(s)
- Lee E Voth-Gaeddert
- Missouri University of Science and Technology, USA; DST-NRF Centre of Excellence for Food Security, University of the Western Cape, South Africa.
| | - Coretta Jonah
- DST-NRF Centre of Excellence for Food Security, University of the Western Cape, South Africa
| | - Douglas Momberg
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Bwangandu Ngandu
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Rihlat Said-Mohamed
- SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | | | - Julian May
- DST-NRF Centre of Excellence for Food Security, University of the Western Cape, South Africa
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Sumampouw OJ, Nelwan JE, Rumayar AA. Socioeconomic Factors Associated with Diarrhea among Under-Five Children in Manado Coastal Area, Indonesia. J Glob Infect Dis 2019; 11:140-146. [PMID: 31849434 PMCID: PMC6906894 DOI: 10.4103/jgid.jgid_105_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 06/04/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Diarrhea is a condition where individuals experience defecation as much as 3 or more per day with a soft consistency. Diarrhea in children is one of the environmentally-based diseases, and Manado is one of the cities faced with this environmental lead diarrhea problems. The purpose of this study is to analyze the influence of socioeconomic factors on the occurrence of diarrhea among under-five children in the coastal area of Manado city. Materials and Methods: A cross-sectional study design was conducted in August 2017. The numbers of respondents were a total of 120 mothers or caregivers with children under five who suffered from diarrhea in the coastal area of Manado. The respondent candidates were selected from the community health center's records of the diarrhea program and further selected by the inclusion/exclusion criteria. The characteristics of mothers and family income were used as indicators of socioeconomic factors. All of the respondents were questioned about the occurrence of their child's diarrhea that they had experienced in the previous 6 months. A structured and well-designed questionnaire was used to obtain data, which were related to sociodemographic, economic, and diarrhea. Generalized structured component analysis in GeSCA software was applied for data analysis. Results: The findings of this study showed significant influence from socioeconomic factors on diarrhea incidence in under-five children (critical ratio = 2.74). In other words, as socioeconomic factors improve, the incidence of diarrhea decreases (B = −0.246). The characteristics of the mother are the indicator of the highest influence (loading value = 0.846). Conclusions: This study identified that the socioeconomic factors are influencing the diarrhea incidence among children under five in the coastal area of Manado city. Thus, to minimize a childhood diarrheal disease, socioeconomic factors are considered when promoting health and community empowerment among the coastal communities of Manado city.
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Affiliation(s)
- Oksfriani Jufri Sumampouw
- Department of Health Environment, Faculty of Public Health, Sam Ratulangi University, Manado, Indonesia
| | - Jeini Ester Nelwan
- Department of Epidemiology and Biostatistic, Faculty of Public Health, Sam Ratulangi University, Manado, Indonesia
| | - Adisti Aldegonda Rumayar
- Department of Health Administration, Faculty of Public Health, Sam Ratulangi University, Manado, Indonesia
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Hygiene and Sanitation Practices and the Risk of Morbidity among Children 6–23 Months of Age in Kumbungu District, Ghana. ADVANCES IN PUBLIC HEALTH 2019. [DOI: 10.1155/2019/4313759] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Poor hygiene and sanitation (WASH) practices are characterised by the manifestation of disease and infections, notably diarrhoea and respiratory tract infections (RTIs) among children. This study aimed to assess the influence of WASH practices on the occurrence of diarrhoea and RTIs among children 6–23 months of age.Methods. An analytical cross-sectional study design was conducted in June 2017. Systematic random sampling technique was used to select 300 mothers/caregivers with children aged 6–23 months from 9 communities in the Kumbungu District. We assessed the WASH practices, socio-demographic characteristics of the households and the occurrence of diarrhoea and RTIs among the children with a semi-structured questionnaire. The Hygiene Improvement Framework observational guide was adapted for household sanitation. Backward binary multiple logistic regression was used to determine the WASH practices that significantly predicted morbidity.Results. About 53% and 55.3% of the children reportedly experienced diarrhoea and RTIs, respectively, two weeks before the survey. Caregiver handwashing with soap after defecation [OR = 0.32 (95% C.I: 0.19, 0.52)] and before feeding [OR = 0.50 (95% C.I: 0.30, 0.84)] as well as washing the child’s hands with or without soap before feeding [OR = 0.21 (95% C.I: 0.04, 1.01)] were associated with lower odds of diarrhoea morbidity. The main determinants of RTI morbidity included caregiver handwashing with or without soap after defecation [OR = 0.29 (95% C.I: 0.10, 0.81)] and washing of the child’s hands with soap before feeding [OR = 0.60 (95% C.I: 0.37, 0.99)] However, we found no association between household sanitation and diarrhoea as well as RTI among the children.Conclusion. About a half each of the children had diarrhoea and RTI 2 weeks before the survey. The results emphasise the need for urgent targeting of handwashing and waste disposal programmes to avert the high burden of diarrhoea and RTIs among children.
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Dey NC, Parvez M, Islam MR, Mistry SK, Levine DI. Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007-2015) in rural Bangladesh. Int J Hyg Environ Health 2019; 222:1098-1108. [PMID: 31439422 DOI: 10.1016/j.ijheh.2019.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/25/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022]
Abstract
Diarrhoea, the most common disease directly related to water, sanitation, and hygiene (WASH), still remains one of the most significant health problems among children under-five worldwide. In this reality, BRAC, the largest NGO in the world initiated a comprehensive WASH intervention in 50 upazilas (sub-districts) of Bangladesh in 2007 which was later scaled up to cover 150 upazilas in two subsequent phases. The intervention period of the programme was 2007-2011. The present study encompassed 30 upazilas of the first phase of intervention. The aim of the study was to investigate the effectiveness of this intervention on reduction of diarrhoea among under-five children, and to identify the factors associated with childhood diarrhoea. A repeated cross-sectional study design was followed, and a population-based survey was carried out on four occasions: baseline (2007), midline (2009), endline (2011), and post-endline (2015) among 4,775 households. This analysis considers only households having at least one under-five children. Absence of handwashing practice with soap after defecation and before eating food, unclean latrine condition, and unsafe disposal of child faeces were identified as significant risk factors associated with under-five diarrhoea from Log-binomial regression. The prevalence of under-five diarrhoea within the past 2 weeks of the survey declined from 13.7% at baseline to 3.6% at end-line (p < 0.001) in the WASH intervention area. However, the progress seemingly stalled after 2011, which may have occurred due to the lack of improvement in unsafe disposal of child faeces and unclean latrine condition after the intervention period. Study findings suggest that, to reduce the prevalence of childhood diarrhoea it is important to promote safe disposal of child faeces, maintaining cleanliness of latrines, and washing hand with soap at critical times, beyond merely increasing the sanitation coverage. Findings also underline the necessity of maintaining a small-scale monitoring component involving local community, such as a WatSan committee (a local committee comprising the user communities for supervising WASH related activities) for periodic monitoring at household level for a certain period after the program intervention works to make the behavioural change more sustainable and to keep the reduction rate of under-five diarrhoeal prevalence steady.
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Affiliation(s)
- Nepal C Dey
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; SID Foundation, Dhaka, 1216, Bangladesh.
| | - Mahmood Parvez
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Mir Raihanul Islam
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Sabuj K Mistry
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; Center for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
| | - David I Levine
- Haas School of Business, University of California, Berkeley, CA, 94720-1900, USA.
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Lamichhane P, Sharma A, Mahal A. Does safe disposal of child faeces matter? An assessment of access to improved sanitation and child faeces disposal behaviour and diarrhoea in rural Nepal. Int Health 2019; 10:277-284. [PMID: 29757372 DOI: 10.1093/inthealth/ihy030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 04/06/2018] [Indexed: 11/14/2022] Open
Abstract
Background Improper disposal of child faeces is a major source of faecal pathogens that cause diarrhoeal disease. However, this has received relatively less attention in sanitation evaluation literature, which has tended to focus on sanitation provision, implicitly assuming that child faeces disposal behaviour also improves with sanitation. We examined the impact of improved sanitation without safe disposal (households with improved sanitation but not disposing of child faeces in improved sanitation) and improved sanitation with safe disposal (households with improved sanitation and disposal of child faeces in improved sanitation) on diarrhoeal prevalence in rural Nepal. Methods Data from the Nepal Demographic Health Survey 2011 for 3377 children <5 y of age were used to answer the research question using quasi-experimental methods. Results Improved sanitation with safe disposal was associated with a 3.3 percentage point (standard error [SE] 0.016) to 6.6 percentage point (SE 0.023) lower prevalence of diarrhoea among children <5 y of age compared with matched households without access to improved sanitation. No effect was observed for households having improved sanitation without safe disposal compared with matched households without access to improved sanitation. Improved sanitation with safe disposal was also associated with a 4.0 percentage point (SE 0.023) lower prevalence of diarrhoea in low economic status households (bottom two quintiles). Conclusions Our results suggest that sanitation programmes need to focus on behavioural interventions as well as increasing access to sanitation facilities.
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Affiliation(s)
- Prabhat Lamichhane
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia.,School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Anurag Sharma
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Ajay Mahal
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia.,Nossal Institute for Global Health, University of Melbourne, 333 Exhibition Street, Melbourne, VIC, Australia
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Degebasa MZ, Weldemichael DZ, Marama MT. Diarrheal status and associated factors in under five years old children in relation to implemented and unimplemented community-led total sanitation and hygiene in Yaya Gulele in 2017. Pediatric Health Med Ther 2018; 9:109-121. [PMID: 30425600 PMCID: PMC6203109 DOI: 10.2147/phmt.s159366] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The aim of this study was to assess the diarrheal status and associated factors of under five-years old children among implemented and unimplemented community-led total sanitation and hygiene (CLTSH) in Yaya Gulele district, Ethiopia, in 2017. METHODS Community-based comparative cross-sectional study involving 380 households from each implemented and unimplemented CLTSH area was conducted from December 1 to June 30, 2017. Pretested structured questionnaire and a complete observational checklist were used to collect data. Qualitative data were collected via focused group discussions and analyzed manually. Data were checked and entered to Epi-info 3.5.4 and analyzed by SPSS version 20. Bivariate and multivariable logistic regression analyses were computed. RESULTS In this study, 88% implemented and 66% unimplemented CLTSH had latrine. Of households owning latrine, 85% in implemented and 75% in unimplemented CLTSH utilize latrine properly. In the study area, 12% in implemented and 34% in unimplemented CLTSH area practice open defecation. Two weeks period diarrhea prevalence was 13.4% (95% CI: 10.2-17.3%) in implemented CLTSH and 36.3% (95% CI: 31.7-41.6%) in unimplemented CLTSH. Having two or more children under five years old (adjusted odds ratio [AOR] = 2.33; 95% CI: 1.09-4.96), lack of clean water storage (AOR = 2.36; 95% CI: 1.16-4.80), negative attitude of mothers/caregivers toward diarrhea (AOR = 2.07; 95% CI: 1.06-4.04), presence of feces in the compound (AOR = 1.88; 95% CI: 1.10-3.22), and lack of hand washing facility in the compound (AOR = 2.64; 95% CI: 1.47-4.74) were associated factors of the outcome. CONCLUSION Implementation of CLTSH is the applicable tool to reduce diarrhea prevalence. Having two or more children under five years old, unclean water storage, negative attitude of mothers toward diarrhea, existence of feces in the compound, and lack of hand washing facility in the compound were associated factors to the diarrheal status of children under five years old. Health workers and local authorities inspire the community to clean water-storage facilities and the environment, to change mothers' behavior toward diarrhea, as well as construct hand washing facility in the compound.
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Affiliation(s)
- Mamo Z Degebasa
- Department of Maternal and Child Health, Yaya Gulele Woreda, Fitan, Ethiopia
| | | | - Mokonnon T Marama
- Department of Midwifery, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia,
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Knowledge and practice of care-givers who have under-five diarrhoeal children: a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016. GLOBAL HEALTH JOURNAL 2017. [DOI: 10.1016/s2414-6447(19)30077-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Aluko OO, Afolabi OT, Olaoye EA, Adebayo AD, Oyetola SO, Abegunde OO. The management of the faeces passed by under five children: an exploratory, cross-sectional research in an urban community in Southwest Nigeria. BMC Public Health 2017; 17:178. [PMID: 28178955 PMCID: PMC5299761 DOI: 10.1186/s12889-017-4078-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 01/27/2017] [Indexed: 11/10/2022] Open
Abstract
Background Safe management of faeces (SMoF) and environmental contamination by faecal pathogens have been extensively researched although the SMoF in under-five children has been perennially neglected perhaps due to the misconception that it is harmless. This research, therefore, studied the situation, to determine the magnitude and dimensions of the problem aimed at making policy level stakeholders aware of child faeces management systems and so, inform evidence-based implementation of child and health-related programmes in Nigeria. Methods The study utilized an exploratory cross-sectional design and a multi-stage sampling technique to identify 300 respondents from 12 randomly selected streets from 4 wards in Ife central local government area. The study collected data with a pretested questionnaire which included direct observations of child defecation practices and existing toilet facilities. Cleaned data were analyzed by IBM-SPSS version 20 with child faeces management outcomes as the dependent variable. Results The mean age of respondents’ and monthly income (mode) were 30.8 ± 7.5 years and ₦10,000.00 ($28.60). Most respondents were mothers to the under five children (84.7%), had a secondary education (72.0%) and were semi-skilled (57.0%). The caregivers had access to improved water sources (93.7%), improved toilets (64.3%), with 64% and 53.7% having above average scores in knowledge and attitudes, respectively. In the study, 19.7% and 69.0% of caregivers practiced safe disposal of faeces passed by the under five child during the day and at night respectively, though most caregivers (94.3%) omitted steps in the safe management of child faeces chain. The under five diarrhoea prevalence rate was 13.7% and unsanitary passage of child faeces is associated with four folds likelihood of having diarrhoea (p = 0.001). The caregivers whose under five children practiced safe sanitation were rich (p = 0.009) and knowledge was significantly associated with ownership of household toilet (P = 0.037), night faeces management chain practice (P < 0.001) and disposal of anal cleaning materials (P = 0.002). Handwashing was significantly associated with household toilet (P < 0.001), wealth (P < 0.001), under five child defecation preferences during the day (P < 0.001) and at night (P = 0.008). Conclusion The high knowledge and positive attitudes exhibited by the caregivers were at variance with practice. Where under five children defecate during the day were influenced by the disposal of their anal cleaning materials, distance to the toilet and caregivers’ education. The findings highlight the dangers of unsanitary disposal of child faeces and the need to strengthen the related policies that can increase caregivers awareness and practice at all levels and in all livelihood domains. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4078-1) contains supplementary material, which is available to authorized users.
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Freeman MC, Majorin F, Boisson S, Routray P, Torondel B, Clasen T. The impact of a rural sanitation programme on safe disposal of child faeces: a cluster randomised trial in Odisha, India. Trans R Soc Trop Med Hyg 2016; 110:386-92. [PMID: 27496512 PMCID: PMC5916378 DOI: 10.1093/trstmh/trw043] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Unsafe disposal of child faeces is persistent and may lead to considerable impact on the health of young children. Research is limited on the impact of sanitation or hygiene interventions to improve child faeces disposal practices. METHODS In the context of a randomised controlled trial to assess the health impact of a programme in Odisha, India, to promote rural sanitation under the Government of India's Total Sanitation Campaign, we explored whether the intervention affected the safe disposal of faeces of children under-5 years of age. RESULTS At baseline, 1.1% of households practised 'safe' disposal of child faeces, either disposing it in a toilet or by burial. The intervention increased safe disposal of child faeces to 10.4% in intervention households, compared to 3.1% in the control households (RR 3.34; 95% CI 1.99-5.59). This increase in safe disposal is attributable to increases in latrine presence in the intervention communities; the intervention did not change safe disposal practices above and beyond the increase in latrine coverage. CONCLUSIONS The very modest increase in safe disposal, while statistically significant, is not likely to have consequential health benefit. To achieve open defecation free communities, sanitation interventions will need to develop behaviour change approaches to explicitly target safe disposal behaviours.
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Affiliation(s)
- Matthew C Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, Georgia 30322, USA
| | - Fiona Majorin
- Department of Disease Control, Faculty of Infectious and Tropical Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Sophie Boisson
- Department of Disease Control, Faculty of Infectious and Tropical Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Parimita Routray
- Department of Disease Control, Faculty of Infectious and Tropical Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Belen Torondel
- Department of Disease Control, Faculty of Infectious and Tropical Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Thomas Clasen
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, Georgia 30322, USA Department of Disease Control, Faculty of Infectious and Tropical Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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