Abstract
Diarrhoeal disease in children under five in low income settings has been associated with multiple environmental exposure pathways, including complementary foods. Conducted from February to December 2018 in rural Malawi, this before and after trial with a control used diarrhoeal disease as a primary outcome, to measure the impact of a food hygiene intervention (food hygiene + handwashing) relative to a food hygiene and water, sanitation and hygiene (WASH) intervention (food hygiene + handwashing + faeces management + water management). The 31-week intervention was delivered by community-based coordinators through community events (n = 2), cluster group meetings (n = 17) and household visits (n = 14). Diarrhoeal disease was self-reported and measured through an end line survey, and daily diaries completed by caregivers. Difference-in-differences results show a 13-percentage point reduction in self-reported diarrhoea compared to the control group. There were also significant increases in the presence of proxy measures in each of the treatment groups (e.g., the presence of soap). We conclude that food hygiene interventions (including hand washing with soap) can significantly reduce diarrhoeal disease prevalence in children under five years in a low-income setting. Therefore, the promotion of food hygiene practices using a behaviour-centred approach should be embedded in nutrition and WASH policies and programming.
Highlights
Diarrhoeal disease continues to be a leading cause of mortality and morbidity in low and middle income countries, with 62.2% of diarrhoeal disease deaths in children under five attributed to poor water, sanitation and hygiene (WASH) and the associated consumption of contaminated foods in household settings [1,2,3]
The two treatment arms were designed based on formative research: (1) a food hygiene intervention only (n = 400), and (2) an integrated WASH and food hygiene intervention (n = 400) [31], with a control group in which no intervention took place (n = 200)
As with diarrhoea, there was a higher reduction in the number of reported cases of acute respiratory illness (ARI) in the treatment areas within a given month compared to in the control, inferring that improved hygiene practices may have led to an increased reduction in target households. This before and after trial with a control in rural Malawi measured the relative impact of a multi-faceted hygiene intervention on the reduction of diarrhoeal disease in an under five population
Summary
Diarrhoeal disease continues to be a leading cause of mortality and morbidity in low and middle income countries, with 62.2% of diarrhoeal disease deaths in children under five attributed to poor water, sanitation and hygiene (WASH) and the associated consumption of contaminated foods in household settings [1,2,3]. A range of recent studies have examined our current understanding and the efficacy of control measures taken to reduce exposure to enteric pathogens, including attempts to introduce multiple barriers to exposure pathways: enclosed sanitation, household water treatment, Int. J. Res. Public Health 2020, 17, 2648; doi:10.3390/ijerph17082648 www.mdpi.com/journal/ijerph
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International journal of environmental research and public health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
