Njuguna John
Mukurwe-ini sub-County Public Health Office, P.O. Box 112-10103, Mukurwe-ini, Kenya.
BMC Public Health. 2016 Aug 4;15:712. doi: 10.1186/s12889-016-3421-2.
Defecating in the open predisposes people to soil transmitted helminthes and diarrhoeal diseases. An estimated 5.6 million Kenyans defecate in the open. Kenya launched a program to eradicate open defecation by 2013 in the rural areas. By end of 2013, only two sub-counties had eliminated open defecation. These are Nambale and Nyando. The study looked at the impact of eradicating open defecation on diarrhea prevalence among children in these two sub-counties.
Data on diarrhoea morbidity among children under 5 years was extracted from the Kenya Health Information System for all the sub-counties in Busia and Kisumu counties for 2012, 2013 and 2014 respectively. Prevalence was calculated for each sub-county in Kisumu for comparison with Nyando's. Prevalence was also calculated for each sub-county in Busia County and compared to that of Nambale sub-county. A Mann-Whitney U Test was done to test the null hypothesis that diarrhoea prevalence was similar in both open defecation and open defecation free sub-counties.
A Mann-Whitney U Test revealed significant difference in diarrhoeal prevalence of open defecation sub-counties (Md = 18.4, n = 34) and open defecation free sub-counties (Md = 9.8, n = 5), U = 9, z = -3.2, p = .001. Among the two Counties, Nambale had the lowest prevalence. It recorded a decline from 9.8 to 5.7 % across the three years. Prevalence for diarrhoea cases in Nyando declined from 19.1 to 15.2 % across the three years. Nyando initially had the second highest prevalence in Kisumu County and by 2014 it had the lowest prevalence.
The two sub-counties with open defecation free status had lower prevalence of diarrhoea cases compared to sub-counties which were yet to attain open defecation free status. This suggests that elimination of open defecation may reduce the number of diarrhoea cases.
在户外排便会使人易感染土壤传播的蠕虫病和腹泻病。据估计，有560万肯尼亚人在户外排便。肯尼亚发起了一项计划，到2013年在农村地区根除户外排便现象。到2013年底，只有两个次县消除了户外排便现象。这两个次县是南巴莱和尼扬多。该研究考察了在这两个次县根除户外排便对儿童腹泻患病率的影响。
分别从肯尼亚卫生信息系统中提取了2012年、2013年和2014年布西亚县和基苏木县所有次县5岁以下儿童腹泻发病率的数据。计算了基苏木县每个次县的患病率，以便与尼扬多的患病率进行比较。还计算了布西亚县每个次县的患病率，并与南巴莱次县的患病率进行比较。进行了曼-惠特尼U检验，以检验户外排便次县和无户外排便次县腹泻患病率相似的零假设。
曼-惠特尼U检验显示，有户外排便现象的次县（中位数=18.4，n=34）和无户外排便现象的次县（中位数=9.8，n=5）的腹泻患病率存在显著差异，U=9，z=-3.2，p=0.001。在这两个县中，南巴莱的患病率最低。在三年时间里，其患病率从9.8%降至5.7%。尼扬多腹泻病例的患病率在三年间从19.1%降至15.2%。尼扬多最初在基苏木县的患病率排名第二，到2014年其患病率最低。
与尚未实现无户外排便的次县相比，两个无户外排便现象的次县腹泻病例的患病率较低。这表明消除户外排便现象可能会减少腹泻病例的数量。
