Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth

George, Christine Marie; Oldja, Lauren; Biswas, Shwapon; Perin, Jamie; Sack, R. Bradley; Ahmed, Shahnawaz; Shahnaij, Mohammad; Haque, Rashidul; Parvin, Tahmina; Azmi, Ishrat J.; Bhuyian, Sazzadul Islam; Talukder, Kaisar A.; Faruque, Abu G.

doi:10.1016/j.jpeds.2016.05.035

Cited by 58 publications

(71 citation statements)

References 41 publications

(65 reference statements)

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“…Our recent work has found significant associations between poor household hygiene practices and elevated faecal markers of EE and impaired growth among young children [6,7,19,28,29]. In our cohort study in rural Bangladesh, we found that animals in the child's sleeping space and poor caregiver hand hygiene were associated with elevated faecal markers of EE [7].…”

Section: Introductionmentioning

confidence: 47%

“…The cohort size was based on the number of households that could be recruited between February and April 2014. Our previous work among this cohort in rural Bangladesh found that 84% of households had an unsafe child faeces disposal event during structured observation, 16% had an unimproved sanitation option, 72% had no soap present near the household tubwell during spot checks and 21% of caregivers had hands with visible dirt [7,19].…”

Section: Methodsmentioning

confidence: 84%

“…Previous work from our cohort study found poor child and caregiver hygiene practices were significantly associated with elevated EE markers and impaired growth among young children . This study has built on this previous work by investigating the influence of enteric infections on faecal markers of EE and impaired growth.…”

Section: Discussionmentioning

confidence: 93%

“…In our cohort study in rural Bangladesh, we found that animals in the child's sleeping space and poor caregiver hand hygiene were associated with elevated faecal markers of EE . Unsafe child faeces disposal practices and young children putting dirt or dirty objects in their mouth were also associated with EE and impaired growth . Building on this previous work, we investigated the relationship between environmental contamination in child play spaces, enteric pathogens, EE and impaired growth among our cohort of young children in rural Bangladesh.…”

Section: Introductionmentioning

confidence: 81%

“…EE is characterised by abnormal intestinal morphology, increased inflammation and reduced intestinal barrier function [10][11][12][13][14][15][16][17][18]. This condition occurs from unsanitary environments resulting in repeated exposure to faecal pathogens and reduced nutrient absorption [5][6][7]19].…”

Section: Introductionmentioning

confidence: 99%

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Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth

George

Burrowes

Perin

et al. 2017

Tropical Med Int Health

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Section: Introductionmentioning

confidence: 47%

Section: Methodsmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth

George

Burrowes

Perin

et al. 2017

Tropical Med Int Health

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Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection

Majorin

Torondel

Chan

et al. 2019

Cochrane Database of Systematic Reviews

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BackgroundDiarrhoea and soil‐transmitted helminth (STH) infections represent a large disease burden worldwide, particularly in low‐income countries. As the aetiological agents associated with diarrhoea and STHs are transmitted through faeces, the safe containment and management of human excreta has the potential to reduce exposure and disease. Child faeces may be an important source of exposure even among households with improved sanitation.ObjectivesTo assess the effectiveness of interventions to improve the disposal of child faeces for preventing diarrhoea and STH infections.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, Embase, and 10 other databases. We also searched relevant conference proceedings, contacted researchers, searched websites for organizations, and checked references from identified studies. The date of last search was 27 September 2018.Selection criteriaWe included randomized controlled trials (RCTs) and non‐randomized controlled studies (NRS) that compared interventions aiming to improve the disposal of faeces of children aged below five years in order to decrease direct or indirect human contact with such faeces with no intervention or a different intervention in children and adults.Data collection and analysisTwo review authors selected eligible studies, extracted data, and assessed the risk of bias. We used meta‐analyses to estimate pooled measures of effect where appropriate, or described the study results narratively. We assessed the certainty of the evidence using the GRADE approach.Main resultsSixty‐three studies covering more than 222,800 participants met the inclusion criteria. Twenty‐two studies were cluster RCTs, four were controlled before‐and‐after studies (CBA), and 37 were NRS (27 case‐control studies (one that included seven study sites), three controlled cohort studies, and seven controlled cross‐sectional studies). Most study sites (56/69) were in low‐ or lower middle‐income settings. Among studies using experimental study designs, most interventions included child faeces disposal messages along with other health education messages or other water, sanitation, and hygiene (WASH) hardware and software components. Among observational studies, the main risk factors relevant to this review were safe disposal of faeces in the latrine or defecation of children under five years of age in a latrine.Education and hygiene promotion interventions, including child faeces disposal messages (no hardware provision)Four RCTs found that diarrhoea incidence was lower, reducing the risk by an estimated 30% in children under six years old (rate ratio 0.71, 95% confidence interval (CI) 0.59 to 0.86; 2 trials, low‐certainty evidence). Diarrhoea prevalence measured in two other RCTs in children under five years of age was lower, but evidence was low‐certainty (risk ratio (RR) 0.93, 95% CI 0.84 to 1.04; low‐certainty evidence).Two controlled cohort studies that evaluated such an intervention in Bangladesh did not detect a difference on diarrhoe...

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Stunting, a linear growth anomaly in under-five year (U5) children: A risk factors’ analysis from maternal, household and individual background in Indian context

Das

Roy

2022

Child Ind Res

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Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth

Abstract: Unsafe child feces disposal was significantly associated with environmental enteropathy and impaired growth in a pediatric population in rural Bangladesh. Interventions are needed to reduce this high-risk behavior to protect the health of susceptible pediatric populations.

Cited by 58 publications

References 41 publications

Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth

Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth

Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection

Stunting, a linear growth anomaly in under-five year (U5) children: A risk factors’ analysis from maternal, household and individual background in Indian context

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