Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study.
<h4>Background</h4>Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% redu...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-05-01
|
| Series: | PLoS Medicine |
| Online Access: | https://doi.org/10.1371/journal.pmed.1002010 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850162952746827776 |
|---|---|
| author | Kelly K Baker Ciara E O'Reilly Myron M Levine Karen L Kotloff James P Nataro Tracy L Ayers Tamer H Farag Dilruba Nasrin William C Blackwelder Yukun Wu Pedro L Alonso Robert F Breiman Richard Omore Abu S G Faruque Sumon Kumar Das Shahnawaz Ahmed Debasish Saha Samba O Sow Dipika Sur Anita K M Zaidi Fahreen Quadri Eric D Mintz |
| author_facet | Kelly K Baker Ciara E O'Reilly Myron M Levine Karen L Kotloff James P Nataro Tracy L Ayers Tamer H Farag Dilruba Nasrin William C Blackwelder Yukun Wu Pedro L Alonso Robert F Breiman Richard Omore Abu S G Faruque Sumon Kumar Das Shahnawaz Ahmed Debasish Saha Samba O Sow Dipika Sur Anita K M Zaidi Fahreen Quadri Eric D Mintz |
| author_sort | Kelly K Baker |
| collection | DOAJ |
| description | <h4>Background</h4>Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age.<h4>Methods/findings</h4>The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged <5 y old experiencing MSD and for 12,390 asymptomatic age, gender, and neighborhood-matched controls. An MSD case was defined as a child with a diarrheal illness <7 d duration comprising ≥3 loose stools in 24 h and ≥1 of the following: sunken eyes, skin tenting, dysentery, intravenous (IV) rehydration, or hospitalization. Site-specific conditional logistic regression models were used to explore the association between sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1-2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India.<h4>Conclusions</h4>This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings support the current World Health Organization/ United Nations Children's Emergency Fund (UNICEF) system that categorizes shared sanitation as unimproved. |
| format | Article |
| id | doaj-art-e0dafca353de4aa48430e6adc774d0ad |
| institution | OA Journals |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2016-05-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-e0dafca353de4aa48430e6adc774d0ad2025-08-20T02:22:25ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762016-05-01135e100201010.1371/journal.pmed.1002010Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study.Kelly K BakerCiara E O'ReillyMyron M LevineKaren L KotloffJames P NataroTracy L AyersTamer H FaragDilruba NasrinWilliam C BlackwelderYukun WuPedro L AlonsoRobert F BreimanRichard OmoreAbu S G FaruqueSumon Kumar DasShahnawaz AhmedDebasish SahaSamba O SowDipika SurAnita K M ZaidiFahreen QuadriEric D Mintz<h4>Background</h4>Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age.<h4>Methods/findings</h4>The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged <5 y old experiencing MSD and for 12,390 asymptomatic age, gender, and neighborhood-matched controls. An MSD case was defined as a child with a diarrheal illness <7 d duration comprising ≥3 loose stools in 24 h and ≥1 of the following: sunken eyes, skin tenting, dysentery, intravenous (IV) rehydration, or hospitalization. Site-specific conditional logistic regression models were used to explore the association between sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1-2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India.<h4>Conclusions</h4>This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings support the current World Health Organization/ United Nations Children's Emergency Fund (UNICEF) system that categorizes shared sanitation as unimproved.https://doi.org/10.1371/journal.pmed.1002010 |
| spellingShingle | Kelly K Baker Ciara E O'Reilly Myron M Levine Karen L Kotloff James P Nataro Tracy L Ayers Tamer H Farag Dilruba Nasrin William C Blackwelder Yukun Wu Pedro L Alonso Robert F Breiman Richard Omore Abu S G Faruque Sumon Kumar Das Shahnawaz Ahmed Debasish Saha Samba O Sow Dipika Sur Anita K M Zaidi Fahreen Quadri Eric D Mintz Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. PLoS Medicine |
| title | Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. |
| title_full | Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. |
| title_fullStr | Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. |
| title_full_unstemmed | Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. |
| title_short | Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007-2011: Case-Control Study. |
| title_sort | sanitation and hygiene specific risk factors for moderate to severe diarrhea in young children in the global enteric multicenter study 2007 2011 case control study |
| url | https://doi.org/10.1371/journal.pmed.1002010 |
| work_keys_str_mv | AT kellykbaker sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT ciaraeoreilly sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT myronmlevine sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT karenlkotloff sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT jamespnataro sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT tracylayers sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT tamerhfarag sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT dilrubanasrin sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT williamcblackwelder sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT yukunwu sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT pedrolalonso sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT robertfbreiman sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT richardomore sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT abusgfaruque sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT sumonkumardas sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT shahnawazahmed sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT debasishsaha sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT sambaosow sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT dipikasur sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT anitakmzaidi sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT fahreenquadri sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy AT ericdmintz sanitationandhygienespecificriskfactorsformoderatetoseverediarrheainyoungchildrenintheglobalentericmulticenterstudy20072011casecontrolstudy |