Fecal contamination on the household compound and in water sources are associated with subsequent diarrhea in young children in Urban Bangladesh (CHoBI7 Program)

Tahmina Parvin, Elizabeth D. Thomas, Md Sazzadul Islam Bhuyian, Ismat Minhaj Uddin, Md Tasdik Hasan, Zillur Rahman, Indrajeet Barman, Fatema Zohura, Jahed Masud, Marzia Sultana, Anne Westin, Fatema Tuz Johura, Shirajum Monira, Shwapon Kumar Biswas, David A. Sack, Jamie Perin, Munirul Alam, Christine Marie George

Research output: Contribution to journalArticlepeer-review

Abstract

We investigated the environmental and individual-level risk factors for diarrheal disease among young children in slum areas of Dhaka, Bangladesh. A prospective cohort study was conducted among 884 children under 5 years of age. Caregiver reports were collected on sociodemographic factors and hygiene behaviors. Diarrhea surveillance data was collected monthly based on caregiver-reported diarrhea for children in the past 2 weeks during the 12-month study period. Unannounced spot checks of the household compound were performed at 1, 3, 6, 9, and 12 months after enrollment to check for the presence of feces (animal or human) and the presence of animals in the child's sleeping space, to assess child and caregiver hands for the presence of dirt, and to collect samples of the household's source and stored drinking water. Children with feces found on the household compound during spot checks had a significantly higher odds of diarrhea (odds ratio: 1.71; 95% confidence interval: 1.23-2.38). Children residing in households with > 100 colony forming units/100 mL Escherichia coli in source drinking water had a significantly higher odds of diarrhea (OR: 1.43; 95% CI: 1.06-1.92). The presence of feces on the household compound and source drinking water with > 100 colony forming units/100 mL E. coli were significant risk factors for diarrheal disease for children < 5 years of age in slum areas of Dhaka, Bangladesh. These findings demonstrate the urgent need for comprehensive interventions to reduce fecal contamination on the household compound to protect the health of susceptible pediatric populations.

Original languageEnglish (US)
Pages (from-to)261-266
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume105
Issue number1
DOIs
StatePublished - Jul 2021

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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