Environmental sanitation conditions and health impact: a case-control study

Abstract

This epidemiological investigation examines the impact of several environmental sanitation conditions and hygiene practices on diarrhea occurrence among children under five years of age living in an urban area. The case-control design was employed; 997 cases and 999 controls were included in the investigation. Cases were defined as children with diarrhea and controls were randomly selected among children under five years of age. After logistic regression adjustment, the following variables were found to be significantly associated with diarrhea: washing and purifying fruit and vegetables; presence of wastewater in the street; refuse storage, collection and disposal; domestic water reservoir conditions; feces disposal from swaddles; presence of vectors in the house and flooding in the lot. The estimates of the relative risks reached values up to 2.87. The present study revealed the feasibility of developing and implementing an adequate model to establish intervention priorities in the field of environmental sanitation. Key-words: Diarrhea. Hygiene practices. Model for priority setting. Urban refuse. Water supply.Resumo Esta investigação epidemiológica estuda o impacto das condições de saneamento ambiental e de práticas higiênicas sobre a ocorrência de diarréia entre crianças menores de 5 anos, residentes em uma área urbana. O delineamento caso-controle foi utilizado; 997 casos e 999 controles foram incluidos na investigação. Casos foram definidos como crianças com diarréia e controles foram selecionados, aleatoriamente, entre crianças com menos de 5 anos. Após ajustamento (regressão logística), as seguintes variáveis foram detectadas como significativamente associadas à diarréia: lavar e higienizar frutas e vegetais; presença de água de esgoto na rua; coleta, armazenagem e disposição do lixo; condições dos reservatórios domésticos de água; disposição das fezes de fraldas, presença de vetores nas casas e inundação do lote da casa. As estimativas pontuais do risco relativo alcançaram valores até 2,87. O presente estudo mostra a factibilidade de desenvolvimento e implementação de modelos adequados para estabelecer prioridades de intervenção no campo do saneamento ambiental. Palavras-chaves: Abastecimento de água. Diarréia. Lixo urbano. Modelo para estabelecer prioridades. Práticas higiênicas.

Factors Contributing to Diarrheal Diseases among Children Less than Five Years in Nyarugenge District, Rwanda

“…The practice of unsafe child feaces disposal contaminates the surrounding environment with human excreta which carries many infectious organisms that can cause enteric diseases such as childhood diarrhea [26][27][28]. This result was consistent with other reports, where environmental sanitations most often linked with the diarrhoea is refuse disposal [29][30][31]. Therefore, safe feaces disposal practice may be particularly important in prevention of fecal-oral transmission as children are more susceptible to these diseases and are often defecating in areas where other children could be exposed.…”

Principais causas da mortalidade na infância no Brasil, em 1990 e 2015: estimativas do estudo de Carga Global de Doença

“…A positive change has occurred for diarrheal diseases, which in 1990 were the second leading cause of death, and in 2015 moved to the seventh position, with expressive rate reduction. This change indicates improvements in sanitation and nutritional conditions in the country [17][18][19] , as well as access to health care, besides the possible impact of specific actions, such as the introduction of a vaccine against rotavirus in 2006 20 , and oral rehydration therapy in primary care 21 . Respiratory conditions, and particularly whooping cough had similar results.…”

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

“…Multi-sectoral interventions in these areas have resulted in major reductions in the incidence and prevalence of some NDs and mortality in infants and young children in poor communities [58]. A recent systematic review and meta-analysis presents the positive impacts of water supply and hygiene interventions in reducing diarrhea in less-developed countries [59].…”