Regional Institute for Population Studies (RIPS), University of Ghana, Legon, Accra, Ghana.
Department of Sociology and Criminology, The Pennsylvania State University, State College, Pennsylvania, United States of America.
PLoS One. 2021 Jan 28;16(1):e0245466. doi: 10.1371/journal.pone.0245466. eCollection 2021.
Diarrhoeal diseases remain a significant cause of morbidity and mortality, particularly in poor urban communities in the Global South. Studies on food access and safety have however not considered the sources of discrete food categories and their propensity to harbour and transmit diarrhoeal disease pathogens in poor urban settings. We sought to contribute to knowledge on urban food environment and enteric infections by interrogating the sources and categories of common foods and their tendency to transmit diarrhoea in low-income communities in Accra. We modelled the likelihood of diarrhoea transmission through specific food categories sourced from home or out of home after controlling for alternate transmission pathways and barriers. We used structured interviews where households that participated in the study were selected through a multi-stage systematic sampling approach. We utilized data on 506 households from 3 low-income settlements in Accra. These settlements have socio-economic characteristics mimicking typical low-income communities in the Global South. The results showed that the incidence of diarrhoea in a household is explained by type and source of food, source of drinking water, wealth and the presence of children below five years in the household. Rice-based staples which were consumed by 94.5% of respondents in the week preceding the survey had a higher likelihood of transmitting diarrhoeal diseases when consumed out of home than when eaten at home. Sources of hand-served dumpling-type foods categorized as "staple balls" had a nuanced relationship with incidence of diarrhoea. These findings reinforce the need for due diligence in addressing peculiar needs of people in vulnerable conditions of food environment in poor urban settlements in order to reap a co-benefit of reduced incidence of diarrhoea while striving to achieve the global development goal on ending hunger.
腹泻病仍然是发病率和死亡率的一个重要原因，特别是在全球南方贫穷的城市社区。然而，关于食物获取和安全的研究并没有考虑离散食物类别的来源及其在贫穷城市环境中滋生和传播腹泻病病原体的倾向。我们试图通过调查阿克拉低收入社区常见食物的来源和类别及其传播腹泻的倾向，为城市食物环境和肠道感染方面的知识做出贡献。我们通过控制其他传播途径和障碍，对家庭或外出购买的特定食物类别的腹泻传播可能性进行建模。我们使用结构化访谈，通过多阶段系统抽样方法选择参与研究的家庭。我们利用了来自阿克拉 3 个低收入住区的 506 户家庭的数据。这些住区具有模仿全球南方典型低收入社区的社会经济特征。结果表明，家庭中腹泻的发生由食物的类型和来源、饮用水的来源、家庭的财富和 5 岁以下儿童的存在来解释。在调查前一周，94.5%的受访者食用的以大米为主的主食，如果在家庭以外食用，比在家中食用更容易传播腹泻病。手抓饺子类食物“主食球”的来源与腹泻的发生有细微的关系。这些发现强调了在解决贫困城市住区弱势群体食物环境特殊需求方面要谨慎行事的必要性，以便在努力实现消除饥饿的全球发展目标的同时，获得减少腹泻发病率的共同效益。
