Formative research on hygiene behaviors and geophagy among infants and young children and implications of exposure to fecal bacteria

Francis M. Ngure, Jean H. Humphrey, Mduduzi N.N. Mbuya, Florence Majo, Kuda Mutasa, Margaret Govha, Exevia Mazarura, Bernard Chasekwa, Andrew J. Prendergast, Valerie Curtis, Kathyrn J. Boor, Rebecca J. Stoltzfus

Research output: Contribution to journalArticlepeer-review

Abstract

We conducted direct observation of 23 caregiver-infant pairs for 130 hours and recorded wash-related behaviors to identify pathways of fecal-oral transmission of bacteria among infants. In addition to testing fingers, food, and drinking water of infants, three infants actively ingested 11.3 ± 9.2 (mean ± SD) handfuls of soil and two ingested chicken feces 2 ± 1.4 times in 6 hours. Hand washing with soap was not common and drinking water was contaminated with Escherichia coli in half (12 of 22) of the households. A one-year-old infant ingesting 1 gram of chicken feces in a day and 20 grams of soil from a laundry area of the kitchen yard would consume 4,700,000-23,000,000 and 440-4,240 E. coli, respectively, from these sources. Besides standard wash and nutrition interventions, infants in low-income communities should be protected from exploratory ingestion of chicken feces, soil, and geophagia for optimal child health and growth.

Original languageEnglish (US)
Pages (from-to)709-716
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume89
Issue number4
DOIs
StatePublished - Oct 2013

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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