水、环境卫生和个人卫生与食物做法对印度北部儿科队列人群中肠热病的关联。

Association of water, sanitation, hygiene and food practices with enteric fever in a paediatric cohort in North India.

机构信息

Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.

Clinical and Research Laboratories, Society for Applied Studies, New Delhi, India.

出版信息

BMJ Paediatr Open. 2022 Apr;6(1). doi: 10.1136/bmjpo-2021-001352.

DOI:10.1136/bmjpo-2021-001352

PMID:36053585

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9045109/

Abstract

BACKGROUND

Our aim was to assess the association of water, sanitation and hygiene (WASH) and food practices with culture-confirmed enteric fever in children <15 years of age.

METHODS

We followed a cohort of 6000 children from an urban low socioeconomic neighbourhood in South Delhi for 2 years to estimate burden of culture-confirmed enteric fever. Risk ratios (RRs) were estimated to study the association between WASH practices and enteric fever. We assessed the microbiological quality of drinking water and conducted geospatial analysis to evaluate the distribution of enteric fever cases around households with contaminated drinking water.

RESULTS

A total of 5916 children in 3123 households completed survey. Piped water (82%) was the major source of household drinking water. One-third (32%) of the households treated water before consumption. Almost all households had sanitary toilets (99.9%) and 16% used shared toilets. Consumption of food from street vendors and unnamed ice creams more than once a week was observed in children from 12.7% and 38.4% households, respectively. Eighty culture-confirmed enteric fever cases were reported. The risk of enteric fever was 71% higher in children belonging to households having food from outside once a week or more (RR 1.71, 95% CI 1.00 to 2.94). The RR for enteric fever in children living in households with availability of safe drinking water was 0.75 (95% CI 0.45 to 1.26). We found that 14.8% of the households had presence of coliforms or in their household drinking water. The odds of having a case of enteric fever within a 5 and 25 m buffer zone around households with contaminated drinking water were 4.07 (95% CI 0.81 to 20.5) and 1.44 (95% CI 0.69 to 3.00), respectively.

CONCLUSION

In addition to WASH practices, optimal food hygiene may have a role in urban low socioeconomic population to control enteric fever.

TRIAL REGISTRATION NUMBER

CTRI2017/09/009719.

摘要

背景

我们旨在评估水、环境卫生和个人卫生（WASH）以及食物实践与 15 岁以下儿童确诊肠热病之间的关联。

方法

我们对德里南部一个城市低收入社区的 6000 名儿童进行了为期 2 年的队列研究，以估计确诊肠热病的负担。风险比（RR）用于研究 WASH 实践与肠热病之间的关联。我们评估了饮用水的微生物质量，并进行了地理空间分析，以评估家庭周围受污染饮用水与肠热病病例的分布情况。

结果

共有 3123 户家庭的 5916 名儿童完成了调查。家庭饮用水的主要来源是管道水（82%）。三分之一（32%）的家庭在饮用前对水进行处理。几乎所有家庭都有卫生厕所（99.9%），16%的家庭使用共用厕所。12.7%和 38.4%的家庭中，分别有 12.7%和 38.4%的儿童每周至少一次食用街头摊贩和不知名冰淇淋。报告了 80 例确诊肠热病病例。每周食用一次或以上外来食物的儿童患肠热病的风险增加了 71%（RR 1.71，95%CI 1.00 至 2.94）。家中有安全饮用水的儿童患肠热病的风险为 0.75（95%CI 0.45 至 1.26）。我们发现，14.8%的家庭饮用水中存在大肠菌群或。家庭饮用水受污染的家庭周围 5 和 25 米缓冲区出现肠热病病例的几率分别为 4.07（95%CI 0.81 至 20.5）和 1.44（95%CI 0.69 至 3.00）。