Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Sci Rep. 2023 Feb 9;13(1):2294. doi: 10.1038/s41598-023-29556-2.
Infections with enteric pathogens have a high mortality and morbidity burden, as well as significant social and economic costs. Poor water, sanitation, and hygiene (WASH) conditions are the leading risk factors for enteric infections, and prevention in low-income countries is still primarily focused on initiatives to improve access to improved WASH facilities. Rural communities in developing countries, on the other hand, have limited access to improved WASH services, which may result in a high burden of enteric infections. Limited information also exists about the prevalence of enteric infections and management practices among rural communities. Accordingly, this study was conducted to assess enteric infections and management practices among communities in a rural setting of northwest Ethiopia. A community-based cross-sectional study was conducted among 1190 randomly selected households in a rural setting of northwest Ethiopia. Data were collected using structured and pretested interviewers-administered questionnaire and spot-check observations. We used self-reports and medication history audit to assess the occurrence of enteric infections among one or more of the family members in the rural households. Multivariable binary logistic regression model was used to identify factors associated with enteric infections. Statistically significant association was declared on the basis of adjusted odds ratio with 95% confidence interval and p value < 0.05. Out of a total of 1190 households, 17.4% (95% CI: 15.1, 19.7%) of the households reported that one or more of the family members acquired one or more enteric infections in 12 months period prior to the survey and 470 of 6089 (7.7%) surveyed individuals had one or more enteric infections. The common enteric infections reported at household-level were diarrhea (8.2%), amoebiasis (4.1%), and ascariasis (3.9%). Visiting healthcare facilities (71.7%), taking medications without prescriptions (21.1%), and herbal medicine (4.5%) are the common disease management practices among rural households in the studied region. The occurrence of one or more enteric infections among one or more of the family members in rural households in 12 months period prior to the survey was statistically associated with presence of livestock (AOR: 2.24, 95% CI:1.06, 4.75) and households headed by uneducated mothers (AOR: 1.62, 95% CI: (1.18, 2.23). About one-fifth of the rural households in the studied region reported that one or more of the family members had one or more enteric infections. Households in the study area might acquire enteric infections from different risk factors, mainly poor WASH conditions and insufficient separation of animals including their feces from human domestic environments. It is therefore important to implement community-level interventions such as utilization of improved latrine, protecting water sources from contamination, source-based water treatment, containment of domestic animals including their waste, community-driven sanitation, and community health champion.
肠道病原体感染具有较高的病死率和发病率负担,以及重大的社会和经济成本。较差的水、环境卫生和个人卫生(WASH)条件是肠道感染的主要危险因素,而低收入国家的预防措施仍然主要集中在改善获得改善的 WASH 设施的举措上。发展中国家的农村社区获得改善的 WASH 服务的机会有限,这可能导致肠道感染的负担很高。关于农村社区的肠道感染和管理做法的信息也很有限。因此,本研究旨在评估埃塞俄比亚西北部农村地区社区的肠道感染和管理做法。在埃塞俄比亚西北部农村地区,对 1190 户随机抽取的家庭进行了一项基于社区的横断面研究。使用结构化和预测试的访谈者管理问卷和现场检查观察收集数据。我们使用自我报告和药物史审计来评估农村家庭中一个或多个家庭成员是否发生了肠道感染。使用多变量二项逻辑回归模型来确定与肠道感染相关的因素。基于调整后的优势比、95%置信区间和 p 值 < 0.05,确定有统计学意义的关联。在总共 1190 户家庭中,17.4%(95%CI:15.1%,19.7%)的家庭报告在调查前 12 个月内,一个或多个家庭成员发生了一种或多种肠道感染,6089 名接受调查的个人中有 470 人发生了一种或多种肠道感染。家庭层面报告的常见肠道感染包括腹泻(8.2%)、阿米巴病(4.1%)和蛔虫病(3.9%)。在研究区域,农村家庭常见的疾病管理做法包括前往医疗机构就诊(71.7%)、未经处方服用药物(21.1%)和使用草药(4.5%)。在调查前 12 个月内,一个或多个家庭成员中发生一种或多种肠道感染与家庭中存在牲畜(优势比:2.24,95%CI:1.06,4.75)和由未受过教育的母亲担任户主(优势比:1.62,95%CI:(1.18,2.23))存在统计学关联。研究区域约五分之一的农村家庭报告称,一个或多个家庭成员发生了一种或多种肠道感染。研究地区的家庭可能会从不同的风险因素感染肠道感染,主要是较差的 WASH 条件和动物(包括其粪便)与人类家庭环境之间缺乏隔离。因此,实施社区层面的干预措施非常重要,例如使用改良的厕所、防止水源受到污染、基于源头的水处理、控制家庭动物及其废物、社区驱动的环境卫生和社区卫生卫士。