Abstract
BackgroundDiarrheal and acute respiratory infections remain a major cause of death in developing countries especially among children below 5 years of age. About 80% of all hospital attendances in Kenya can be attributed to preventable diseases and at least 50% of these preventable diseases are linked to poor sanitation. The purpose of this study was to assess the impact of a community-based health education program, called Familia Nawiri, in reducing the risk of diarrhea and respiratory infections among people living in three rural Kenyan communities.MethodsCases were defined as patients attending the health facility due to diarrhea or a respiratory infection while controls were patients attending the same health facility for a non-communicable disease defined as an event other than diarrhea, respiratory infection. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to assess the risk of diarrheal or respiratory infection in association with exposure to the health education program.ResultsThere were 324 cases and 308 controls recruited for the study with 57% of the cases and 59% of the controls being male. Overall, 13% of cases vs. 20% of control patients were exposed to the education program. Participants exposed to the program had 38% lower odds of diarrhea and respiratory infections compared to those not exposed to the program (adjusted OR 0.62, 95% CI 0.41–0.96). A similar risk reduction was observed for participants in the study who resided in areas with water improvement initiatives (adjusted OR 0.65, 95% CI 0.47–0.90). Variables in the adjusted model included water improvement projects in the area and toilet facilities.ConclusionFindings from this study suggest participants exposed to the education program and those residing in areas with water improvement initiatives have a reduced risk of having diarrhea or respiratory infection.
Highlights
Diarrheal and acute respiratory infections remain a major cause of death in developing countries especially among children below 5 years of age
The results from the logistic regression model indicate that exposure to Familia Nawiri health education reduced the risk of being a case with diarrhea or respiratory infection (adjusted Odds Ratio (OR) 0.62, 95% Confidence Interval (CI): 0.41–0.96 (p = 0.03) [adjusted for other water improvement projects and presence of toilet facility]
After adjusting for potential confounders, participants exposed to the hygiene education program had 38% lower odds of having diarrhea or a respiratory infection compared to participants who were not exposed to the hygiene education program
Summary
Diarrheal and acute respiratory infections remain a major cause of death in developing countries especially among children below 5 years of age. About 80% of all hospital attendances in Kenya can be attributed to preventable diseases and at least 50% of these preventable diseases are linked to poor sanitation. Diarrhea and acute respiratory infections remain a major cause of death in low income countries especially among children below 5 years of age accounting for about 9 and 13% of annual deaths respectively [1,2,3]. In Kenya, about 80% of all hospital attendances can be attributed to preventable diseases Among these preventable diseases, approximately 50% of them are water, sanitation and hygiene related. In Kenya diarrheal diseases cause 16% of deaths among children below 5 years of age followed by pneumonia [4]. The negative impact of poor sanitary conditions on health remains as much of a public health concern in the developing world today as when it was a surprising revelation to London during John Snow’s pioneering epidemiological work on cholera infection over 150 years ago [9]
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