BackgroundDiarrhoeal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. In Senegal, diarrhoea is responsible for 15% of all deaths in children under the age of five and is the third leading cause of childhood deaths. For targeted planning and implementation of prevention strategies, a context-specific understanding of the determinants of diarrhoeal diseases is needed. The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour, Senegal.MethodsBetween February and March 2014, a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. The zones covered urban central, peri-central, north peripheral and south peripheral areas. Overall, 596 households were surveyed by a questionnaire, yielding information on sociodemographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.ResultsThe reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18–2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00–3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20–3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11–2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11–2.56).ConclusionWe found a high prevalence of diarrhoea in children under the age of five in Mbour, with the highest prevalence occurring in the central and peri-central areas. These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups. Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0323-1) contains supplementary material, which is available to authorized users.
Summaryobjectives To identify risk factors for Schistosoma mansoni and hookworm infections in urban farming communities, and to investigate small-scale spatial patterns of infection prevalence.methods A cross-sectional survey was carried out in 113 farming households (586 individuals) and 21 non-farming households (130 individuals) from six agricultural zones in the town of Man, western Cô te d'Ivoire. Heads of households were interviewed on common agricultural activities, land and water use, education attainment, socioeconomic status and sanitation facilities. Household members provided stool specimens that were processed by the Kato-Katz technique and a formol-ether concentration method and diagnosed for S. mansoni, hookworms and other soil-transmitted helminths and intestinal protozoa. Bayesian statistics were employed for spatial analyses.results The prevalences of S. mansoni and hookworm in farming households were 51.4% and 24.7%, respectively. Risk factors for a S. mansoni infection comprised living in close proximity to the Kô River, water contact with irrigation wells and ponds and low education attainment. Living in zones of smallholder irrigated rice plots or large rice perimeters, using water from domestic wells, and low socioeconomic status were risk factors for a hookworm infection. We found significant spatial heterogeneity between agricultural zones, with the highest infection prevalences of S. mansoni and hookworm in the zone where there was a large rice perimeter.conclusions In this urban setting, both S. mansoni and hookworm infections were related to specific agricultural activities. Health education and active participation of urban farmers for the control of schistosomiasis and soil-transmitted helminthiasis is recommended.keywords Schistosoma mansoni, hookworm, risk factors, urban agriculture, Cô te d'Ivoire
The journal The Lancet recently published a countdown on health and climate change. Attention was focused solely on humans. However, animals, including wildlife, livestock and pets, may also be impacted by climate change. Complementary to the high relevance of awareness rising for protecting humans against climate change, here we present a One Health approach, which aims at the simultaneous protection of humans, animals and the environment from climate change impacts (climate change adaptation). We postulate that integrated approaches save human and animal lives and reduce costs when compared to public and animal health sectors working separately. A One Health approach to climate change adaptation may significantly contribute to food security with emphasis on animal source foods, extensive livestock systems, particularly ruminant livestock, environmental sanitation, and steps towards regional and global integrated syndromic surveillance and response systems. The cost of outbreaks of emerging vector-borne zoonotic pathogens may be much lower if they are detected early in the vector or in livestock rather than later in humans. Therefore, integrated community-based surveillance of zoonoses is a promising avenue to reduce health effects of climate change.
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