Cha Seungman, Lee Jae Eun, Seo Dong Sik, Park Byoung Mann, Mansiangi Paul, Hwang Jae-Sang, Lee Jungwook
Faculty of Infectious and Tropical Disease, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Korea International Cooperation Agency, Seongnam-si, Republic of Korea.
Am J Trop Med Hyg. 2017 Aug;97(2):460-468. doi: 10.4269/ajtmh.16-0361. Epub 2017 Jul 19.
Despite the importance of sanitation, few studies have assessed the effects of latrines on the health outcomes of children under 5 years of age. We assessed the relations between latrine coverage and the prevalence of diarrhea in children under 4 years of age. In this cross-sectional study, we analyzed the baseline data obtained as part of a longitudinal survey targeting 720 households in Idiofa, Bandundu, Democratic Republic of the Congo. We categorized latrines according to the presence of each major component and investigated whether diarrhea prevalence of children under 4 years of age is associated with latrine availability and improvement. Latrines have health benefits regardless of whether they are improved. Also worth noting is that comparatively well-equipped and more appropriately managed latrines could prevent child diarrhea more effectively than less equipped or inappropriately managed latrines. Households who have a latrine with a superstructure, roof, and no flies (a partly improved latrine) were found to be 52% less likely to report cases of diarrhea than households with unimproved latrines (adjusted odds ratio [OR] = 0.48, confidence interval [CI] = 0.31-0.76), which are all the other latrines not included in the partly improved latrine category. We have observed the profound protective effect of latrines with a superstructure. This study demonstrates that latrines are associated with significant improvements in health even when they do not fully meet the conditions of improved latrines. This study adds value to the limited evidence on the effect of latrines on health parameters by demonstrating that latrines have correlations with health benefits regardless of whether they are improved, as well as by elucidating the most essential components of improved latrines.
尽管卫生设施很重要，但很少有研究评估厕所对5岁以下儿童健康状况的影响。我们评估了厕所覆盖率与4岁以下儿童腹泻患病率之间的关系。在这项横断面研究中，我们分析了作为针对刚果民主共和国班顿杜省伊迪奥法720户家庭的纵向调查一部分而获得的基线数据。我们根据每个主要组成部分的存在情况对厕所进行分类，并调查4岁以下儿童的腹泻患病率是否与厕所的可用性和改善情况相关。无论厕所是否得到改善，都对健康有益。同样值得注意的是，装备相对较好且管理更得当的厕所比装备较差或管理不当的厕所能更有效地预防儿童腹泻。发现拥有带上层结构、屋顶且无苍蝇的厕所（部分改善的厕所）的家庭报告腹泻病例的可能性比没有改善的厕所的家庭低52%（调整后的优势比[OR]=0.48，置信区间[CI]=0.31-0.76），没有改善的厕所是指不包括在部分改善的厕所类别中的所有其他厕所。我们观察到带上层结构的厕所具有深远的保护作用。这项研究表明，即使厕所不完全符合改善后的厕所条件，它们也与健康状况的显著改善相关。这项研究通过证明无论厕所是否得到改善都与健康益处相关，并阐明改善后的厕所的最基本组成部分，为关于厕所对健康参数影响的有限证据增添了价值。
