Prevalence Of Diarrheal Disease Research Articles

Determinants of diarrhoeal diseases among under-five children in Africa (2013–2023): a comprehensive systematic review highlighting geographic variances, socioeconomic influences, and environmental factors

BackgroundDiarrhea diseases continue to present a significant threat to the well-being of children under the age of five in Africa, thereby contributing substantially to both morbidity and mortality rates. The period spanning between January 2013 and December 2023 has witnessed persistent challenges in the fight against these diseases, thereby necessitating a thorough investigation into the factors that determine their occurrence. It is important to note that the burden of diarrhea diseases is not evenly distributed across the continent, with residence, socioeconomic, and environmental factors playing pivotal roles in shaping the prevalence and incidence rates. Consequently, this systematic review aimed to consolidate and analyze the existing body of literature on the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023.MethodThe systematic review employed a rigorous methodological approach to examine the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. A comprehensive search strategy was implemented, utilizing databases such as PubMed, Scopus, and Web of Science, and incorporating relevant keywords. The inclusion criteria focused on studies published within the specified timeframe, with a specific focus on the determinants of diarrhea disease among children under the age of five in Africa. The study selection process involved a two-stage screening, with independent reviewers evaluating titles, abstracts, and full texts to determine eligibility. The quality assessment, employing a standardized tool, ensured the inclusion of studies with robust methodologies. Data extraction encompassed key study details, including demographics, residence factors, socioeconomic influences, environmental variables, and intervention outcomes.ResultsThe search yielded a total of 12,580 articles across 25 African countries; however, only 97 of these articles met the inclusion criteria and were ultimately included in the systematic review. The systematic review revealed geographic and seasonal disparities in the prevalence of diarrhoeal diseases across different countries in Africa. Factors such as age-related vulnerabilities, gender disparities, maternal occupation, disposal of young children’s stools, and economic status were identified as significant determinants of the prevalence of diarrhea disease.ConclusionThis systematic review provides a comprehensive understanding of the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. The nuanced analysis of residence variations, socioeconomic influences, environmental factors, and intervention outcomes underscores the complex nature of this issue. The findings highlight the necessity for region-specific and context-sensitive interventions to address the unique challenges faced by diverse communities. This review serves as a valuable resource for policymakers, healthcare professionals, and researchers, guiding the development of evidence-based strategies aimed at reducing the burden of diarrhea diseases and improving child health outcomes in Africa.

Hubungan Sanitasi Pasar dengan Tingkat Kepadatan Lalat di Pasar Tradisional Pancur Batu

A vector is an anthropoid that carries or transmits an infectious agent from an infectious source to a susceptible host. This study aims to understand the relationship between market sanitation and the impact of the number of flies in traditional markets. The design of this research is a qualitative descriptive research that conducts face-to-face visits and the material is in the form of a collection of observations and interviews. The results of this study indicate that there is a very large effect between the density of flies and the prevalence of diarrheal diseases. In traditional markets, among other things, there is a density of flies, namely the level of sanitation in traditional markets which can be seen from the cleanliness of the market and piles of garbage and plant residues from traders, where rot can then occur. ; Go produce an unpleasant odor to detect the presence of flies. This research concludes that there is a relationship between fly density and the prevalence of diarrheal diseases in the Pancur Batu traditional market. Therefore, it is suggested that the Pancur Batu traditional market attracts direct action from the local government to promote cleanliness and implement a clean environment.

Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study

BackgroundDiarrhea is a serious health problem in children under the age of five that is both preventable and treatable. In low-income countries like Ethiopia, children under the age five years frequently experience diarrhea. However, the burden and associated factors of these diarrheal diseases are understudied in Eastern Ethiopia, Thus, this study aimed to determine the factors associated with the prevalence of diarrheal diseases in Eastern Ethiopia from September 1–30, 2022.MethodsA cross-sectional study was conducted on the total of 602 children aged 6 to 59 months in Oda Bultum district in eastern Ethiopia. A multistage sampling method was used. Three kebeles were selected from nine kebeles by the lottery method. Data was entered into Epi data 4.0.2 and exported to SPSS version 21 for analysis. Descriptive analysis was used for frequency, mean, and standard deviations. In addition, bivariable, and multivariable Poisson regression model was used to identify predictors of diarrhea along with a 95% confidence interval. Finally, statistical significance was declared at a p-value of 0.05.ResultA total of 602 children were included in this study. The prevalence of diarrhea 7.4% (47/602), 95% CI; 5.5–9.7%) among the children. Factors such as being unvaccinated for any vaccine (AOR = 10.82, 95%CI; 4.58–25.48) and born from a mother who had medium level of empowerment (AOR = 0.34, 95%CI; 0.11–0.88) in the household had statistically significant association with diarrhea among the children compared to their counterparts.ConclusionThe study found that nearly one out of thirteen children aged 6 to 59 months had any form of diarrheal diseases in Oda Bultum District, Eastern Ethiopia. In addition, the study revealed that children who were vaccinated for their age developed diarrhea less likely compared to those who did not receive any form of vaccine for their age. Moreover, children with mothers who had a medium level of empowerment were less likely to get diarrhea than children with mothers who had a low level of empowerment.

A 6-year retrospective study of clinical features, microbiology, and genomics of Shiga toxin-producing Escherichia coli in children who presented to a tertiary referral hospital in Costa Rica.

Shiga-toxin-producing Escherichia coli (STEC) is associated with diarrhea and hemolytic uremic syndrome (HUS). STEC infections in Costa Rica are rarely reported in children. We gathered all the records of STEC infections in children documented at the National Children's Hospital, a tertiary referral hospital, from 2015 to 2020. Clinical, microbiological, and genomic information were analyzed and summarized. A total of 3,768 diarrheal episodes were reviewed. Among them, 31 STEC were characterized (29 fecal, 1 urine, and 1 bloodstream infection). The prevalence of diarrheal disease due to STEC was estimated at 0.8% (n = 29/3,768), and HUS development was 6.4% (n = 2/31). The stx1 gene was found in 77% (n = 24/31) of STEC strains. In silico genomic predictions revealed a predominant prevalence of serotype O118/O152:H2, accompanied by a cluster exhibiting allele differences ranging from 33 to 8, using a core-genome multilocus sequence typing (cgMLST) approach. This is the first study using a genomic approach for STEC infections in Costa Rica.IMPORTANCEThis study provides a comprehensive description of clinical, microbiological, genomic, and demographic data from patients who attended the only pediatric hospital in Costa Rica with Shiga-toxin-producing Escherichia coli (STEC) infections. Despite the low prevalence of STEC infections, we found a predominant serotype O118/O152:H2, highlighting the pivotal role of genomics in understanding the epidemiology of public health threats such as STEC. Employing a genomic approach for this pathogen for the first time in Costa Rica, we identified a higher prevalence of STEC in children under 2 years old, especially those with gastrointestinal comorbidities, residing in densely populated regions. Limitations such as potential geographic bias and lack of strains due to direct molecular diagnostics are acknowledged, emphasizing the need for continued surveillance to uncover the true extent of circulating serotypes and potential outbreaks in Costa Rica.

Household Water Treatment Practice and Associated Factors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Introduction: Household water treatment practices, also known as point-of-use water management, offer means to enhance the overall drinking water quality and reduce the prevalence of diarrheal diseases. Nevertheless, there is a scarcity of information on household water treatment practices and related factors in sub-Saharan Africa. Objective: This study aimed to determine the pooled prevalence of water treatment practices and associated factors in sub-Saharan Africa. Methods: We conducted a search of eligible primary studies in PubMed, Google Scholar, and Hinari, as well as gray literature available in online repositories. The Stata v.17 software was utilized to extract and analyze the data obtained from these studies. To determine the overall pooled prevalence of water treatment practices and their predictors, a weighted inverse-variance random-effects model was employed. We assessed variations across the included studies using forest plots, funnel plots, I2 statistics, and Egger’s tests. Results: In this study, we reviewed a total of 927 articles, 28 of which were eligible for inclusion. The overall pooled prevalence of water treatment practices in sub-Saharan Africa was 36.31(95% CI: 27.64, 44.98). The factors associated with water treatment practices included having formal education (AOR: 2.38, 95% CI: 1.70, 3.34), being male (AOR: 1.78, 95% CI: 1.39, 2.29), having a higher income (AOR: 2.12, 95% CI: 1.39, 3.25), and having received training in water treatment (AOR: 2.25, 95% CI: 1.59, 3.18). Conclusions: In this review, the pooled prevalence of water treatment practices in sub-Saharan Africa was found to be considerably low. Therefore, we recommend that household heads receive enhanced information on water treatment practices through strengthened health education and intensive training in small-scale water treatment practices.

Temperature and Precipitation anomaly and diarrheal disease prevalence in Taiwan

Temperature and Precipitation anomaly and diarrheal disease prevalence in Taiwan

Circulation of enterotoxigenic Escherichia coli (ETEC) isolates expressing CS23 from the environment to clinical settings.

Enterotoxigenic Escherichia coli (ETEC) is one of the leading causes of infant diarrhea in low- and middle-income countries (LMICs). Diarrheal pathogens are transmitted through environmental reservoirs; however, the bacterial clones that spread across the human-environment interface remain unexplored. We aimed to determine the relationship and clonal dissemination of ETEC between children with diarrhea and polluted water samples from a local river in La Paz, Bolivia. By using WGS and the PhenePlates phenotypic system to analyze ETEC strains, we showed that ST218 and ST410 LT+STh ETEC expressing the colonization factor (CF) CS23 were found with high frequency in both samples. The CS23 ETEC isolates were found within several STs, E. coli phylogroups, and across ETEC lineages. Comparative genomic evaluation and PhenePlate screening of globally distributed clinical ETEC strains suggest that the CS23 gene is likely carried on plasmids acquired independently of the bacterial chromosomal background. Clinical strains were more often multidrug-resistant (MDR) than environmental isolates and harbored the class 1 integron-integrase gene intI1 next to the MDR cassettes. Retrospective analysis of antibiotic resistance in ETEC revealed a high frequency of MDR in clinical isolates. The LT+STh CS23 environmental ETEC isolates, showed an increased biofilm ability at environmental temperature, equal cytotoxicity, and significantly lower adherence to human epithelial cells compared to ETEC expressing other CFs. Together, we suggest that CS23 is more prevalent in ETEC than previously estimated, and the Choqueyapu River is a reservoir for LT+STh CS23 ETEC containing strains capable of causing diarrheal cases in children. IMPORTANCE The importance of clean water cannot be overstated. It is a vital resource for maintaining health and well-being. Unfortunately, water sources contaminated with fecal discharges from animal and human origin due to a lack of wastewater management pose a significant risk to communities, as they can become a means of transmission of pathogenic bacteria like enterotoxigenic E. coli (ETEC). ETEC is frequently found in polluted water in countries with a high prevalence of diarrheal diseases, such as Bolivia. This study provides novel insights into the circulation of ETEC between diarrheal cases and polluted water sources in areas with high rates of diarrheal disease. These findings highlight the Choqueyapu River as a potential reservoir for emerging pathogens carrying antibiotic-resistance genes, making it a crucial area for monitoring and intervention. Furthermore, the results demonstrate the feasibility of a low-cost, high-throughput method for tracking bacterial pathogens in low- and middle-income countries, making it a valuable tool for One Health monitoring efforts.

Diarrhea Prevalence and Associated Factors among Children in Azezo Sub-City, Northwest Ethiopia: A Community-Based Cross-Sectional Study.

Globally, diarrheal disease continues to be a major cause of morbidity and mortality among children under 5 years of age, especially in low-income countries such as Ethiopia. However, there is still limited evidence in the study area quantifying the burden of diarrheal disease among children under 5 years. A community-based cross-sectional study was conducted in April 2019 to estimate the prevalence of childhood diarrhea and to identify its associated factors in Azezo sub-city, northwest Ethiopia. A simple random sampling technique was applied to recruit the eligible cluster villages with children under 5 years. Data were collected by interviewing mothers or guardians using structured questionnaires. The completed data were entered into EpiInfo version 7 and exported to SPSS version 20 for analysis. Binary logistic regression model was used to identify factors associated with diarrheal disease. Adjusted odds ratio (AOR) with 95% CI was used to measure the strength of association between the dependent and independent variable. The period prevalence of diarrheal disease among children under 5 years was 24.9% (95% CI: 20.4-29.7%). Age group between 1 and 12 months [AOR: 9.22, 95% CI: (2.93-29.04)] and 13 and 24 months [AOR: 4.44, 95% CI: (1.87-10.56)], as well as low monthly income (AOR: 3.68, 95% CI: (1.81-7.51)] and poor handwashing practice [AOR: 8.37, 95% CI: (3.12-22.52), were significantly associated with high risk of childhood diarrhea. In contrast, small family size [AOR: 0.32, 95% CI: (0.16-0.65)], and immediate consumption of prepared meals [AOR: 0.39, 95% CI: (0.19-0.81)] were significantly associated with low risk of childhood diarrhea. Diarrheal diseases were a common health problem among children under 5 years of age in Azezo sub-city. Therefore, an appropriate hygiene intervention program through health education is recommended with a focus on identified risk factors to reduce the burden of diarrheal diseases.

Sociodemographic and environmental factors associated with diarrhoeal illness in children under 5 years in Uganda, 2016: a cross-sectional study

BackgroundUganda is among the 10 countries in the sub-Saharan Africa region that have the highest prevalence of diarrhoeal disease. Evidence suggests that the severity of childhood diarrhoeal disease is escalated through various sociodemographic and environmental factors.ObjectivesTo assess prevalence of diarrheal illness in children below the age of 5 years in Uganda in 2016 and associated factors.MethodsA cross-sectional study was employed that analyzed secondary data from the 2016 Uganda Demography and Health Surveys. Children with and without diarrhea were compared. A logistic regression was used to determine sociodemographic and environmental factors associated with diarrheal illness in children with statistical significance at p < 0.05.ResultsThe prevalence of childhood diarrhoeal illness for children below the age of 5 years in Uganda was 20.9% (n = 2838/13,753). There was a statistically significant difference when comparing children diarrhoeal with the following sociodemographic factors: caregiver’s age, child’s age and gender and duration of breastfeeding (p < 0.0001). Children with a caregiver aged between 15 and 24 years (aOR;1.42; 95% CI:1.24–1.62) and 25–34 years (aOR;1.19; 95% CI:1.04–1.37) were more likely to report diarrhoeal disease, compared to those with a caregiver aged 35–49 years. For environmental factors, households using springs water, access to health facility and children who received a dose of vitamin A had a decreased risk of reporting children diarrhoeal.ConclusionSignificant factors in the study like caregiver’s age, gender and duration of breastfeeding will create the opportunity for all interventions to shift their focus to these factors thus a better evidence-based approach to reducing of diarrhoeal disease will be achieved in the country.

Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study

ObjectiveTo determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in...

Potential impact of rotavirus vaccination on reduction of childhood diarrheal disease in India: An analysis of National Family Health Survey-5

Rotavirus is one of the leading causes of diarrhea in infants and young children worldwide. In this study, we investigated the impact of rotavirus vaccination on the prevalence of diarrheal disease among children under five years of age in India. Research on the impact of the rotavirus vaccine on reducing diarrheal disease is therefore important in contributing to the growing body of evidence on the effectiveness of this intervention in improving child health outcomes. We adopted multivariate logistic regression and propensity score matching analysis to examine the association between diarrhea and the rotavirus vaccine. The bivariate analysis finding shows that the prevalence of diarrhea was remarkably higher (9.1%) among children who had not received rotavirus and the prevalence was 7.5%, 7.5%, and 7.2% among children who received one dose, two doses, and three rotavirus doses (all) respectively. The result of multivariate logistic regression shows that children who received all three doses of the rotavirus vaccine were 16% less likely to experience diarrhea compared to those who did not receive any rotavirus vaccine. Our analysis also found that the prevalence of diarrhea decreased significantly in the years following the introduction of the vaccine. The results of this study suggest that the rotavirus vaccine has a significant impact on reducing childhood diarrheal disease in India. These results have the potential to inform policy decisions and enable healthcare professionals to concert their efforts in reducing the diarrheal disease burden and its timely prevention in children. The study will also contribute to the existing literature on the impact of rotavirus vaccination in reducing the prevalence of diarrhea among children in India.

Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment

Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was to investigate the sources of drinking water, sanitation and hygiene practices, and the incidence of diarrhoeal diseases among children during the war in Tigray, Ethiopia. A cross—sectional study was conducted to collect data on selected WASH indicators in six zones of Tigray from August 4-20, 2021. Data were collected from a total of 4381 sample households selected by lottery. Descriptive analysis was performed and the analysed data are presented in tables, figures and explanatory notes. Binary logistic regression was performed to examine the relationship between independent and dependent variables. A total of 4381 households from 52 woredas participated in the study. Approximately 67.7% of the study participants reported that they relied on an improved source of drinking water during the war. Coverage of sanitation, hand washing, and menstrual hygiene during the war was reported as 43.9%, 14.5%, and 22.1%, respectively. The prevalence of diarrhoeal diseases among children was 25.5% during the war. Water source, latrine type, solid waste disposal and health extension worker visits were the significant predictors of the likelihood of diarrhoea in children (p < 0.05). The results of the study show that a decrease in services from WASH is associated with a higher prevalence of diarrhoeal disease among children during the war in Tigray. To prevent the high prevalence of diarrhoeal disease among children in war-torn Tigray, Ethiopia, improved access to water and sanitation is recommended. In addition, collaborative efforts are needed to engage health extension workers to provide appropriate promotion and prevention services to war-affected communities in Tigray, Ethiopia. Further comprehensive surveys of households with children over one year of age are recommended to assess access to WASH and the burden of WASH associated diseases.

Hubungan Sanitasi Pasar dengan Tingkat Kepadatan Lalat di Pasar Tradisional Pancur Batu

&#x0D; A vector is an anthropoid that carries or transmits an infectious agent from an infectious source to a susceptible host. This study aims to understand the relationship between market sanitation and the impact of the number of flies in traditional markets. The design of this research is a qualitative descriptive research that conducts face-to-face visits and the material is in the form of a collection of observations and interviews. The results of this study indicate that there is a very large effect between the density of flies and the prevalence of diarrheal diseases. In traditional markets, among other things, there is a density of flies, namely the level of sanitation in traditional markets which can be seen from the cleanliness of the market and piles of garbage and plant residues from traders, where rot can then occur. ; Go produce an unpleasant odor to detect the presence of flies. This research concludes that there is a relationship between fly density and the prevalence of diarrheal diseases in the Pancur Batu traditional market. Therefore, it is suggested that the Pancur Batu traditional market attracts direct action from the local government to promote cleanliness and implement a clean environment.&#x0D; Keywords : Density of flies, Diarrhea, Garbage

Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study.

Diarrheal illnesses are a long-standing public health problem in developing countries due to numerous sanitation issues and a lack of safe drinking water. Floods exacerbate public health issues by spreading water-borne infectious diseases such as diarrhea through the destruction of sanitation facilities and contamination of drinking water. There has been a shortage of studies regarding the magnitude of diarrheal disease in flood-prone areas. Therefore, this research aimed to evaluate the prevalence of diarrheal disease and its predictors among under-five children living in flood-prone localities in the south Gondar zone of Northwest Ethiopia. A community-based cross-sectional research was carried out in flood-prone villages of the Fogera and Libokemkem districts from March 17 to March 30, 2021. Purposive and systematic sampling techniques were used to select six kebeles and 717 study units, respectively. Structured and pretested questionnaires were used to collect the data. A multivariable analysis was performed to determine the predictors of diarrheal disease, with P-value <0.05 used as the cut-off point to declare the association. The prevalence of a diarrheal disease among under-five children was 29.0%. The regular cleaning of the compound [AOR: 2.13; 95% CI (1.25, 3.62)], source of drinking water [AOR: 2.36; 95% CI: (1.26, 4.41)], animal access to water storage site [AOR: 3.04; 95% CI: (1.76, 5.24)], vector around food storage sites [AOR: 9.13; 95% CI: (4.06, 20.52)], use of leftover food [AOR: 4.31; 95% CI: (2.64, 7.04)], and fecal contamination of water [AOR: 12.56; 95% CI: (6.83, 23.20)] remained to have a significant association with diarrheal diseases. The present study found that the prevalence of the diarrheal disease among under-five children was high. Routine compound cleaning, the source of drinking water, animal access to a water storage site, vectors near food storage sites, consumption of leftover food, and fecal contamination of water were significant predictors of diarrheal disease. Therefore, it is advised to provide improved water sources, encourage routine cleaning of the living area, and offer health education about water, hygiene, and sanitation.

Improvements in Diarrheal Disease Prevalence with Point-of-use Water Filter Implementation in the Informal Settlement of Kibera, Kenya

Background: There is increasing evidence of the efficacy of point-of-use water filters on diarrhea prevalence in numerous global settings, in both observational studies and randomized experiments. Most studies, however, are focused on rural locations. Here we use self-report household surveys, and select drinking water testing, to monitor a set of approximately 10,000 households receiving Sawyer® point-of-use water filters, WASH training, and Albendazole in Kibera, Kenya.

The rise of diarrheal illnesses in the children of Pakistan amidst COVID-19: A narrative review.

In Pakistan, 74 children out of 1000 lose their lives annually due to diarrheal illness. This commentary addresses the contributing factors aggravating this growing dilemma and the effect of a simultaneous rise in COVID-19 cases in a healthcare system ready to collapse, along with providing recommendations to alleviate the problems causing this spike in diarrheal cases. This narrative review has emphasized the causes of the spike in pediatric diarrheal illnesses in Pakistan as well as recommendations offered to lessen the burden by incorporating recent literature (n = 68). Tactics to tackle COVID-19 alongside diarrheal illnesses were also included. Pakistan was chosen to be assessed due to its high burden of child and infant mortality due to preventable causes. The provision of safe drinking water, the proper use of Integrated Management of Newborn and Childhood Illnesses (IMNCI), adequate awareness of the benefits of breastfeeding, the use of correct rehydration techniques such as Oral Rehydration Therapy, and the crucial implementation of the EPI vaccination schedule can curb this increase in diarrheal cases. The increased prevalence of diarrheal diseases amongst the pediatric population of Pakistan can be attributed largely due to unsanitary drinking water. Emphasis must be put in the provision of safe drinking water. During the first years of life, children can be kept safe from deadly pathogens just by adequate breastfeeding. IMNCI and EPI must also be properly implemented.

Equity in access to safely managed sanitation and prevalence of diarrheal diseases in Bangladesh: a national and sub-national analysis

BackgroundIn Bangladesh, safely managed sanitation (SMS) coverage is low, and diarrheal disease is a significant health problem. This study estimated the inequality in access to SMS facilities at the national and sub-national levels and assessed the prevalence of diarrheal diseases in connection with these improved facilities.MethodsData were extracted from the Bangladesh Demographic and Health Survey, conducted during 2017–2018. SMS was defined as using an improved sanitation facility, which designed to hygienically separate excreta from human contact and include the use of a flush toilet connected to piped sewer system, septic tank, ventilated improved pit latrine, pit latrine with a slab, and composting toilet. The slope index of inequality (SII) and multi-level regression models were used for inequality and risk factors of SMS respectively.ResultsThe national coverage of SMS was 44.0% (45.3% and 43.5% in urban and rural areas, respectively). At the sub-national level, the lowest and highest coverage of SMS was observed in Mymensingh (32.9%) and Chittagong (54.1%) divisions, respectively. The national level SII indicated that wealthy households had access to higher SMS by 60.8 percentage points than poor households. Additionally, greater inequality was observed in rural areas, which was 71.9 percentage points higher in the richest households than in the poorest households. The coverage gap between the rich and poor was highest in the Sylhet division (85.3 percentage points higher in rich than in poor) and lowest in Dhaka (34.9 percentage points). Old and highly educated household heads and richest households had better access to higher levels of adequate sanitation. After adjusting for confounding variables, the prevalence of diarrheal disease was 14.0% lower in the SMS user group than in their counterparts.ConclusionSubstantial inequalities in access to SMS exist at both national and sub-national levels of Bangladesh, with the prevalence of diarrhea being lower among SMS users. These findings may help to prioritize resources for reducing inequality and expanding the coverage of improved sanitation in Bangladesh.

Prevalence and associated factors of diarrhea among under-five children in the Jawi district, Awi Zone Ethiopia, 2019. Community based comparative cross-sectional study.

IntroductionAlthough most deaths are preventable with simple and inexpensive measures, death from diarrhea accounts for one out of nine deaths in children worldwide which makes it the disease with the highest mortality rate in children under the age of five. Therefore, this study is aims to investigate diarrhea prevalence and risk factors among children under the age of five in Jawi district, Awi Zone, Ethiopia.Materials and methodsA comparative cross-sectional study was done among 440 study participants from March to June 2019. Data were collected with a face-to-face interviewer-administered questionnaire. Data was entered into EPI Info version 7 software and cleaned and analyzed using SPSS version 20 software. Binary logistic regression was done to assess independent factors associated with the dependent variable. A significant association was determined using an adjusted odds ratio at a confidence level of 95% and a p-value of less than or equal to 0.05.ResultsIn the current study, the overall under-five children diarrheal disease was found to be 15.5%. Diarrheal disease prevalence in model and non-model households was 10.9 and 20%, respectively. Shallow water [AOR: 6.12, 95%CI; (1.52, 24.58)], and maternal diarrhea [AOR: 4.11, 95%CI; (1.75, 9.61)] were determinants of childhood diarrhea. Place of birth [OR: 2.52, 95%CI (1.16, 5.49)] and maternal diarrhea [AOR: 3.50; 95%CI (1.28, 9.56)] in non-model households were also determinants of childhood diarrhea.ConclusionUnder-five children diarrheal disease was found to be high in the Jawi District. Thus, to decrease the disease prevalence in the study area, the health extension workers aim to better educate the mothers on how to handle diarrheal diseases. It is also better for concerned stakeholders to promote institutional delivery and to give access to safe water for the community.

Influence of community-level sanitation coverage and population density on environmental fecal contamination and child health in a longitudinal cohort in rural Bangladesh.

BackgroundHousehold-level sanitation interventions have had limited effects on child health or environmental contamination, potentially due to low community coverage. Higher community-level coverage with safely managed sanitation can reduce opportunities for disease transmission.MethodsWe estimated associations between community sanitation coverage, environmental fecal contamination, and child health among 360 compounds in the control arm of the WASH Benefits trial in rural Bangladesh (NCT01590095). In each compound, we enumerated E. coli in environmental samples and recorded the 7-day prevalence of caregiver-reported diarrheal disease and acute respiratory infections (ARI) in children under five. We observed indicators of latrine access and quality among all neighboring compounds within 100 m of study compounds. We defined community coverage as the proportion of neighboring compounds with (1) at least one latrine, and (2) exclusively hygienic latrines (improved facility observed to safely contain feces), within both 50 m and 100 m of study compounds. We assessed effect modification by population density and season.ResultsAdjusted for confounders, study compounds surrounded by 100% coverage of at least one latrine per compound within 50 m had slightly lower log10E. coli counts in stored water (Δlog = −0.13, 95% CI -0.26, −0.01), child hand rinses (Δlog = −0.13, 95% CI -0.24, −0.02), and caregiver hand rinses (Δlog = −0.16, 95% CI -0.29, −0.03) and marginally lower prevalence of diarrheal disease (prevalence ratio [PR] = 0.82, 95% CI 0.64, 1.04) and ARI (PR = 0.84, 95% CI 0.69, 1.03) compared to compounds surrounded by <100% coverage. Effects were similar but less pronounced at 100 m. At higher population densities, community latrine coverage was associated with larger reductions in E. coli on child and caregiver hands and prevalence of diarrheal disease. Coverage with exclusively hygienic latrines was not associated with any outcome.ConclusionHigher community sanitation coverage was associated with reduced fecal contamination and improved child health, with stronger effects at highly local scales (50m) and at high population densities. Our findings indicate that the relationship between community sanitation coverage, environmental contamination, and child health varies by definition of coverage, distance, and population density. This work highlights significant uncertainty around how to best measure sanitation coverage and the expected health effects of increasing sanitation coverage using a specific metric. Better understanding of community-level sanitation access is needed to inform policy for implementing sanitation systems that effectively protect community health.

HYGIENE AND SANITATION PRACTICES OF MOTHERS AND PREVALENCE OF DIARRHEA AMONG ≤ 2 YEARS OF CHILDREN IN A RESETTLEMENT COLONY

Diarrhea is the major health issue in developing countries with high morbidity and mortality rate among children below 2 years of age.Mothers hygiene behaviour is associated with occurrence of diarrhea in children as they are the primary care givers. We carried out a survey to assess the behavioural practices of mother regarding hygiene and sanitation and prevalence of diarrheal diseases in children below 2 years of age. Stratified systemic sampling technique was used to draw sampling frame.Based on the calculated sample size of 84, a total of 101 subjects were enrolled for the study. Data was collected in the month of July-Nov, 2014 by using interview schedule and observational checklist. 62 variables were used in the checklist to measure the behaviour score of mothers on hygiene and sanitation practices. The mean score of hygiene and sanitation practices of mother was 48 out of 62 and the range was 32-52. The diarrhea episodes in the past 3 months were considered for measuring the prevalence of diarrhea among children below 2 years of age. Mean no. of diarrheal episode occurred in children was1and the range was 1-3.The prevalence of diarrhea among children was 89%. It seems that the hygiene and sanitation practices of mothers are associated with occurrence of diarrhea among children.