Diarrhoea among Children Aged under Five Years and Risk Factors in Informal Settlements: A Cross-Sectional Study in Cape Town, South Africa

Nguyen, Thi Yen; Fagbayigbo, Bamidele Oladapo; Cissé, Guéladio; Redi, Nesre; Fuhrimann, Samuel; Okedi, J.; Schindler, Christian; Röösli, Martin; Armitage, Neil; Carden, Kirsty; Dalvie, Mohamed Aqiel

doi:10.3390/ijerph18116043

Cited by 16 publications

(15 citation statements)

References 39 publications

(41 reference statements)

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“…The findings are consistent with the 2017 WHO report that 50% of the 2 million deaths worldwide are due to watery diarrhea, 15% persistent diarrhea, and 35% due to dysentery (WHO, 2017). The findings are way higher than that observed in Senegal 26% (range: 7.1-43.6) [11], South Africa 15.3% (range: 8.6-24.2%) [12] and Nepal 40.2% [13]. The observed difference could be because of the study duration where other studies used 2 weeks compared to the one month used in this current study.…”

Section: Discussioncontrasting

confidence: 76%

Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda

et al. 2022

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Background Despite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda. Methods The study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level. Results The prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality. Conclusion The prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea.

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Section: Discussioncontrasting

confidence: 76%

Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda

et al. 2022

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“…A recent study, 64 in Cape Town, South Africa, found water sources and storage as a risk factor for diarrhea, likewise other African studies. [65][66][67] We observed that household and shared wells were the most common water source used by residents in the areas served by enrollment primary helath care centers (Supplemental Table 3).…”

Section: Chattaway Et Al (2013)mentioning

confidence: 64%

Epidemiology and risk factors for diarrhoeagenic Escherichia coli carriage among children in northern Ibadan, Nigeria

Akinlabi

Nwoko

Dada

et al. 2022

Preprint

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Diarrhea is a leading cause of childhood morbidity in Africa. Outside of multi-country sentinels, of which there are none in Nigeria, few studies focus on bacterial etiology. We performed a case-control study among children under five years of age. Stool specimens were collected from 120 children with, and 357 without, diarrhea attending primary health clinics on the northern outskirts of Ibadan between November 2015 and August 2019. Up to ten E. coli isolates were obtained per specimen and at least three were whole genome-sequenced using Illumina technology. Genomes were assembled using SPAdes, quality evaluated using QUAST, and Virulencefinder was used to identify virulence genes. The microbiological quality of water from 14 wells within the study area was assessed using total and coliform counts. Diarrhoeagenic Escherichia coli (DEC) were isolated from 79 (65.8%) of cases and 217 (60.8%) control children. All DEC pathotypes except Shiga toxin-producing E. coli, a number of hybrid DEC pathotypes, Salmonella and Yersina spp. were detected but no pathogen showed association with disease (p>0.05). Enterotoxigenic E. coli were more commonly recovered from younger controls but exclusively detected in cases aged over nine months. Temporally-linked, highly similar enteroaggregative E. coli were isolated from children in different households in eight instances. No well water sample drawn in the study qualified as potable. Children in northern Ibadan are commonly colonized with DEC. Access to water and sanitation, and vaccines targeting the most abundant pathogens may be critical for protecting children from the less overt consequences of enteric pathogen carriage.

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“…found in a recent study in Cape Town, where a higher prevalence of diarrhoea occurred in children from formal settlements with access to private toilets and piped water compared with informal settlements with access to shared outside toilets and taps. [24] Despite a high number of households sharing the same toilet facility, there was a significantly lower risk of diarrhoea in the study participants.…”

Section: Research Articlementioning

confidence: 81%

“…The extent of the problem is consistent with that in a recent study on diarrhoea in children under 5 years old living in informal and formal settlements in Cape Town. [24] A study undertaken in rural Kenya on animal-related exposures to diarrhoea showed an increased risk of moderate to severe diarrhoea in children exposed to rodent excreta (urine and faeces) outside the house. [25] Exposure of children to rat excreta can result in diarrhoeal disease from Salmonella typhimurium, Escherichia coli and Cryptosporidium parvum.…”

Section: Discussionmentioning

confidence: 99%

Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa

Hendricks

Sambo²,

Laubscher³

et al. 2022

S Afr J Child Health

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Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization’s child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative.Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children’s growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.

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Diarrhoea among Children Aged under Five Years and Risk Factors in Informal Settlements: A Cross-Sectional Study in Cape Town, South Africa

Cited by 16 publications

References 39 publications

Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda

Prevalence and factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso district, Uganda

Epidemiology and risk factors for diarrhoeagenic Escherichia coli carriage among children in northern Ibadan, Nigeria

Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa

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