Hassan Khaled E, Mansour Adel, Shaheen Hind, Amine Mohamed, Riddle Mark S, Young Sylvia Y N, Sebeny Peter, Levin Samuel
US Naval Medical Research Unit No. 3, Bacteriology and Parasitology Diseases Research Program, Cairo, Egypt.
J Infect Dev Ctries. 2014 Dec 15;8(12):1541-51. doi: 10.3855/jidc.4539.
The present study, conducted between January 2004 and April 2007, explored the impact of household hygiene on the risk of bacterial diarrhea, using data from a prospective birth cohort of 348 infants in five villages in the Nile Delta in Egypt.
Neonates were enrolled at birth and followed up until 24 months of age. Children were visited twice a week to survey them for acute diarrhea. A detailed observational household hygiene survey was completed in-house every six months. Adjusted relative risk (aRR) of developing bacterial diarrhea was calculated for exposure to different hygiene variables and examined for specific bacterial pathogens.
Exclusive breastfeeding reduced the risk of bacterial diarrhea by 70%, while bacterial diarrhea cases were 2.6 times higher in the warm season. Risk of Campylobacter diarrhea increased with the absence of barriers to keep birds and animals out of the eating area, the presence of garbage containers and a bathing facility within the compound, and the presence of feces on the floor of the bathing facility. Use of municipal water for drinking and cooking was associated with a lower risk of Campylobacter diarrhea. Risk of enterotoxigenic Escherichia coli diarrhea increased with uncovered garbage containers and the presence of liquid materials in the garbage containers, but decreased with the use of tap water in the washing facility.
The results highlight some potential targets for interventions, such as expanding municipal water supply to all houses and comprehensive mass-media awareness programs to change hygiene-promoting behaviors and practices.
本研究于2004年1月至2007年4月进行，利用埃及尼罗河三角洲五个村庄348名婴儿的前瞻性出生队列数据，探讨家庭卫生对细菌性腹泻风险的影响。
新生儿在出生时登记入组，并随访至24个月龄。每周对儿童进行两次访视，调查他们是否患有急性腹泻。每六个月在家庭内部完成一次详细的家庭卫生观察调查。计算接触不同卫生变量导致细菌性腹泻的调整相对风险（aRR），并针对特定细菌病原体进行检查。
纯母乳喂养使细菌性腹泻风险降低70%，而在温暖季节细菌性腹泻病例高出2.6倍。弯曲杆菌腹泻风险随着饮食区域没有防止禽畜进入的屏障、院子里有垃圾桶和沐浴设施以及沐浴设施地面有粪便而增加。使用市政供水饮用和烹饪与弯曲杆菌腹泻风险较低相关。产肠毒素大肠杆菌腹泻风险随着垃圾桶未覆盖以及垃圾桶内有液体物质而增加，但随着洗涤设施使用自来水而降低。
研究结果突出了一些潜在的干预目标，例如将市政供水扩展到所有家庭，以及开展全面的大众媒体宣传项目，以改变促进卫生的行为和做法。
