The Role of Home Environment in Infant Diarrhea in Rural Egypt

Abstract

In 1982 and 1983, a descriptive environmental survey was conducted in 317 households with newborn infants in rural Bilbeis, Egypt. The incidence of infant diarrhea in these households was ascertained by twice-weekly home visits for a 1-year period (1981-1982). Using univariate and multivariate analyses, the authors identified household factors that were statistically associated with infant diarrhea incidence, including number of children in the house under 4 years of age; number of persons per household; incidence of diarrhea in other family members; having a dirt (vs. concrete) dining room floor; having multiple living areas in the house; having a house or roof in need of repair; using well water rather than tap water for cooking or bathin; the absence of a sewer for waste bathwater; food being left out at room temperature between meals; and having many rodents in the house. Two practices involving interaction with the environment appeared to be protective: butchering of cattle by the family for home consumption, and protection of the infant from flies by a veil during napping. The combined household variables explained 25% of the variance in the total incidence of diarrhea. Categories of variables that accounted for most of the total variance explained by environmental factors are, in decreasing order: house structure (28%); water usage (24%); toilet and bathing area (12%); animal management (11%); food preparation area (10%); hygiene (8%); and wastewater management (6%). This approach may be useful in identifying environmental characteristics whose change would reduce diarrheal illness among infants.

Factores de riesgo de la infección por Giardia lamblia en niños de guarderías infantiles de Ciudad de La Habana, Cuba

“…Sin embargo, otros autores han encontrado algunas de estas variables asociadas a la infección por G. lamblia tanto en población total (Norhayati et al, 1998) como en niños de guarderías infantiles (Novotny et al, 1990). En otros estudios se ha demostrado el efecto del manejo del agua de consumo y de algunas medidas higiénicas sobre la transmisión de otras enfermedades de transmisión digestiva (Wrigth et al, 1991).…”

Response to Wang and Hunter: A Systematic Review and Meta-Analysis of the Association between Self-Reported Diarrheal Disease and Distance from Home to Water Source

“…One of their included studies7 (as well as two not included8,9) concluded from multivariate analysis adjusting for socioeconomic status, age, and maternal education that evidence for an association between TTWS and diarrheal morbidity does not exist 7–9…”

Giardia: both a harmless commensal and a devastating pathogen

“…The difference may relate in part to the virulence of various Giardia strains, and more studies are needed to define these differences between Giardia strains and assemblages, many of which are derived from animal sources (20). In the rural developing world, a majority of young children are surrounded by animals that live in and roam about their homes and that may be sources of Giardia infection (21). A more likely explanation for the two faces of Giardia is the variation in host immune makeup and level of nutrition, although undoubtedly, future studies will reveal that host genetic factors also play an important role.…”