饮用水和环境卫生与五岁以下儿童腹泻的关联：来自埃塞俄比亚东部 Kersa 人口与健康监测点的证据。
Association of drinking water and environmental sanitation with diarrhea among under-five children: Evidence from Kersa demographic and health surveillance site, eastern Ethiopia.
机构信息
Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia.
出版信息
Front Public Health. 2022 Nov 14;10:962108. doi: 10.3389/fpubh.2022.962108. eCollection 2022.
BACKGROUND
Diarrhea remains one of the leading causes of mortality and morbidity, despite the global progression of eradicating the burden of diarrhea-related morbidity and mortality in the past two decades. In Sub-Saharan African (SSA) countries, there is inadequate supply and sanitation of safe water. However, there is a lack of literature that estimates the impact of drinking water and sanitation service on childhood diarrhea in Kersa Demographic and Health Surveillance. Therefore, the current study aimed to assess the prevalence and effect of water supply and environmental sanitation on diarrhea among under-five children from 2017 to 2021 in Kersa Demographic and Health Surveillance, Eastern Ethiopia.
METHOD
A prospective cohort study design was implemented among 6,261 children from the Kersa Health Demographic Surveillance System (HDSS), Eastern Ethiopia, from 1 January 2016 to 31 December 2021. STATA statistical software was used to extract data from the datasets. The binary logistic regression was used to identify the impact of water supply and environmental sanitation on diarrhea by controlling important confounders. The adjusted odds ratio (AOR) with a 95% confidence interval measures this association.
RESULT
The current study showed that among 6,261 under-five children, 41.75% of them had developed active diarrhea during the follow-up time. The final model depicted that having media exposure of 22% [AOR - 0.78 CI: (0.61, 0.98)], a protected tube well source of drinking water of 50% [AOR - 1.50, CI: (1.32, 1.71)], unprotected tube well source of drinking water of 66% [AOR - 1.66 CI: (1.27, 2.18)], having toilet facility of 13% [AOR - 0.87 CI: (0.78, 0.97)], and accessibility of source of water [AOR - 1.17 CI: (1.05, 1.30)] showed a significant association with diarrhea among under-five children.
CONCLUSION
The prevalence of diarrhea is found to be high in the Kersa District. The main predictors of diarrhea under five were a lack of latrines, an unimproved source of drinking water, and a distance from access to drinking water. The study setting should focus on increasing the adequacy of safe drinking water and sanitation.
背景
尽管在过去二十年中，全球在消除与腹泻相关的发病和死亡负担方面取得了进展，但腹泻仍然是导致发病和死亡的主要原因之一。在撒哈拉以南非洲（SSA）国家，安全用水的供应和卫生条件不足。然而，关于饮用水和环境卫生服务对 Kersa 人口与健康监测中 5 岁以下儿童腹泻影响的文献很少。因此，本研究旨在评估 2017 年至 2021 年期间，在埃塞俄比亚东部的 Kersa 人口与健康监测系统中，供水和环境卫生对 5 岁以下儿童腹泻的流行率和影响。
方法
本研究采用前瞻性队列设计，对来自 Kersa 健康人口监测系统（HDSS）的 6261 名儿童进行研究，研究时间为 2016 年 1 月 1 日至 2021 年 12 月 31 日。STATA 统计软件用于从数据集提取数据。采用二元逻辑回归控制重要混杂因素，以确定供水和环境卫生对腹泻的影响。调整后的优势比（AOR）及其 95%置信区间用于衡量这种关联。
结果
本研究表明，在 6261 名 5 岁以下儿童中，41.75%的儿童在随访期间出现腹泻。最终模型表明，有 22%的媒体暴露率[调整后比值比（AOR）-0.78，95%置信区间（CI）：（0.61，0.98）]、50%的有保护管井水源[AOR-1.50，CI：（1.32，1.71）]、66%的无保护管井水源[AOR-1.66，CI：（1.27，2.18）]、13%的厕所设施[AOR-0.87，CI：（0.78，0.97）]和水源获取情况[AOR-1.17，CI：（1.05，1.30）]与 5 岁以下儿童腹泻有显著关联。
结论
在 Kersa 区发现腹泻的流行率很高。导致五岁以下儿童腹泻的主要预测因素是缺乏厕所、未改善的饮用水源以及获取饮用水的距离。研究环境应侧重于增加安全饮用水和卫生设施的充足性。
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