Thiam Sokhna, Diène Aminata N, Fuhrimann Samuel, Winkler Mirko S, Sy Ibrahima, Ndione Jacques A, Schindler Christian, Vounatsou Penelope, Utzinger Jürg, Faye Ousmane, Cissé Guéladio
Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.
University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
Infect Dis Poverty. 2017 Jul 6;6(1):109. doi: 10.1186/s40249-017-0323-1.
Diarrhoeal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. In Senegal, diarrhoea is responsible for 15% of all deaths in children under the age of five and is the third leading cause of childhood deaths. For targeted planning and implementation of prevention strategies, a context-specific understanding of the determinants of diarrhoeal diseases is needed. The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour, Senegal.
Between February and March 2014, a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. The zones covered urban central, peri-central, north peripheral and south peripheral areas. Overall, 596 households were surveyed by a questionnaire, yielding information on sociodemographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.
The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18-2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00-3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20-3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11-2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11-2.56).
We found a high prevalence of diarrhoea in children under the age of five in Mbour, with the highest prevalence occurring in the central and peri-central areas. These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups. Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay.
腹泻病仍然是儿童死亡和发病的重要原因，尤其是在低收入和中等收入国家。在塞内加尔，腹泻导致5岁以下儿童死亡总数的15%，是儿童死亡的第三大主要原因。为了有针对性地规划和实施预防策略，需要对腹泻病的决定因素有具体情况的了解。本研究的目的是确定塞内加尔姆布尔5岁以下儿童腹泻病的危险因素。
2014年2月至3月期间，在姆布尔的四个区域进行了一项横断面调查，以估计腹泻病负担（即调查前2周内的腹泻发作情况）及相关危险因素。这些区域涵盖城市中心、中心周边、北部外围和南部外围地区。总体而言，通过问卷调查对596户家庭进行了调查，获取了有关社会人口统计学、环境和卫生行为因素的信息。采用单变量和多变量逻辑回归分析来确定与腹泻发生相关的危险因素。
调查前2周内，报告的5岁以下儿童腹泻患病率为26%。未经调整时，中心周边地区（44.8%）和城市中心地区（36.3%）的腹泻患病率最高。多变量回归显示，腹泻病与母亲失业（调整后的优势比[aOR]=1.62，95%置信区间[CI]：1.18-2.23）、使用敞口袋储存生活垃圾（aOR=1.75，95%CI：1.00-3.02）、在公共街道排放生活垃圾（aOR=2.07，95%CI：1.20-3.55）、未对储存的饮用水进行处理（aOR=1.69，95%CI：1.11-2.56）以及使用共用厕所（aOR=1.69，95%CI：1.11-2.56）之间存在显著关联。
我们发现姆布尔5岁以下儿童腹泻患病率很高，中心和中心周边地区患病率最高。这些发现强调了需要采取公共卫生干预措施来减轻弱势群体的腹泻负担。应立即实施促进固体废物处理和减少废水暴露的措施。
