Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001-2011

Overview

Journal Am J Trop Med Hyg

Specialty Tropical Medicine

Date 2014 May 29

PMID 24865679

Citations 39

Authors

James A Fuller

Thomas Clasen

Marieke Heijnen

Joseph N S Eisenberg

Affiliations

Soon will be listed here.

Abstract

Shared sanitation is defined as unimproved because of concerns that it creates unsanitary conditions; this policy is being reconsidered. We assessed whether sharing a toilet facility was associated with an increased prevalence of diarrhea among children < 5 years of age. We use data from Demographic and Health Surveys conducted in 51 countries. Crude and adjusted prevalence ratios (PRs) for diarrhea, comparing children from households that used a shared facility with children from households that used a non-shared facility, were estimated for each country and pooled across countries. Unadjusted PRs varied across countries, ranging from 2.15 to 0.65. The pooled PR was 1.09; differences in socioeconomic status explained approximately half of this increased prevalence (adjusted PR = 1.05). Shared sanitation appears to be a risk factor for diarrhea although differences in socioeconomic status are important. The heterogeneity across countries, however, suggests that the social and economic context is an important factor.

Citing Articles

ATP-based assessments of recent cleaning and disinfection for high-touch surfaces in low-resource shared toilets.

Prentice-Mott G, Maru L, Kossik A, Mugambi E, Ombok C, Odinoh R NPJ Clean Water. 2024; 7(1).

PMID: 39569317 PMC: 11578106. DOI: 10.1038/s41545-024-00380-z.

Identification of Enteric Pathogen Reservoirs and Transmission Pathways Associated with Short Childhood Stature in the Kolkata Indian Site of the Global Enteric Multicenter Study.

Long K, Gunanti I, Stride C, Sanchez J, Sur D, Manna B Nutrients. 2024; 16(16).

PMID: 39203869 PMC: 11357064. DOI: 10.3390/nu16162733.

Associations between Shared Sanitation, Stunting and Diarrhoea in Low-Income, High Density Urban Neighbourhoods of Maputo, Mozambique - a Cross-Sectional Study.

Braun L, MacDougall A, Sumner T, Adriano Z, Viegas E, Nala R Matern Child Health J. 2024; 28(4):775-784.

PMID: 38427278 PMC: 10963538. DOI: 10.1007/s10995-024-03924-4.

Prevalence and risk factors of childhood diarrhea among wastewater irrigating urban farming households in Addis Ababa.

Ali A, Gari S, Goodson M, Walsh C, Dessie B, Ambelu A PLoS One. 2023; 18(11):e0288425.

PMID: 37939075 PMC: 10631672. DOI: 10.1371/journal.pone.0288425.

Prevalence and risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, Eastern Ethiopia; Robust Poisson Regression Analysis.

Solomon E, Gari S, Alemu B Afr Health Sci. 2023; 22(4):653-663.

PMID: 37092051 PMC: 10117517. DOI: 10.4314/ahs.v22i4.71.

References

Chakraborty A, Das J . Comparative study of incidence of diarrhea among children in two different environmental situations in Calcutta. Indian Pediatr. 1983; 20(12):907-13. View

Sobel J, Gomes T, Ramos R, Hoekstra M, Rodrigue D, Rassi V . Pathogen-specific risk factors and protective factors for acute diarrheal illness in children aged 12-59 months in São Paulo, Brazil. Clin Infect Dis. 2004; 38(11):1545-51. DOI: 10.1086/420822. View

Blakely T, Hales S, Kieft C, Wilson N, Woodward A . The global distribution of risk factors by poverty level. Bull World Health Organ. 2005; 83(2):118-26. PMC: 2623808. DOI: /S0042-96862005000200012. View

Arnold B, Galiani S, Ram P, Hubbard A, Briceno B, Gertler P . Optimal recall period for caregiver-reported illness in risk factor and intervention studies: a multicountry study. Am J Epidemiol. 2013; 177(4):361-70. DOI: 10.1093/aje/kws281. View

Isunju J, Schwartz K, Schouten M, Johnson W, van Dijk M . Socio-economic aspects of improved sanitation in slums: a review. Public Health. 2011; 125(6):368-76. DOI: 10.1016/j.puhe.2011.03.008. View

Heijnen M, Cumming O, Peletz R, Chan G, Brown J, Baker K . Shared sanitation versus individual household latrines: a systematic review of health outcomes. PLoS One. 2014; 9(4):e93300. PMC: 3990518. DOI: 10.1371/journal.pone.0093300. View

Zafar S, Luby S, Mendoza C . Recall errors in a weekly survey of diarrhoea in Guatemala: determining the optimal length of recall. Epidemiol Infect. 2009; 138(2):264-9. DOI: 10.1017/S0950268809990422. View

Ghosh S, Sengupta P, Mandal S, Manna B, Sikder S, Sirkar B . Maternal behaviour and feeding practices as determinants of childhood diarrhoea: some observations amongst rural Bengalee mothers. Indian J Public Health. 1994; 38(2):77-80. View

Brooks J, Shapiro R, Kumar L, Wells J, Phillips-Howard P, Shi Y . Epidemiology of sporadic bloody diarrhea in rural Western Kenya. Am J Trop Med Hyg. 2003; 68(6):671-7. View

10.

Ramakrishnan R, Venkatarao T, Koya P, Kamaraj P . Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamilnadu. Indian J Public Health. 2001; 43(4):136-9. View

11.

Black R, Cousens S, Johnson H, Lawn J, Rudan I, Bassani D . Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375(9730):1969-87. DOI: 10.1016/S0140-6736(10)60549-1. View

12.

Shultz A, Omollo J, Burke H, Qassim M, Ochieng J, Weinberg M . Cholera outbreak in Kenyan refugee camp: risk factors for illness and importance of sanitation. Am J Trop Med Hyg. 2009; 80(4):640-5. View

13.

Katukiza A, Ronteltap M, Oleja A, Niwagaba C, Kansiime F, Lens P . Selection of sustainable sanitation technologies for urban slums--a case of Bwaise III in Kampala, Uganda. Sci Total Environ. 2010; 409(1):52-62. DOI: 10.1016/j.scitotenv.2010.09.032. View

14.

Khan M . Limitation of communal latrines in changing the prevalence of parasites and diarrhoeal attack rate in Dhaka Peri-urban slums. Environ Pollut. 1987; 47(3):187-94. DOI: 10.1016/0269-7491(87)90209-0. View

15.

Feikin D, Audi A, Olack B, Bigogo G, Polyak C, Burke H . Evaluation of the optimal recall period for disease symptoms in home-based morbidity surveillance in rural and urban Kenya. Int J Epidemiol. 2010; 39(2):450-8. PMC: 2846445. DOI: 10.1093/ije/dyp374. View

16.

Tuttle J, Ries A, Chimba R, Perera C, Bean N, Griffin P . Antimicrobial-resistant epidemic Shigella dysenteriae type 1 in Zambia: modes of transmission. J Infect Dis. 1995; 171(2):371-5. DOI: 10.1093/infdis/171.2.371. View

17.

Kulabako R, Nalubega M, Wozei E, Thunvik R . Environmental health practices, constraints and possible interventions in peri-urban settlements in developing countries--a review of Kampala, Uganda. Int J Environ Health Res. 2010; 20(4):231-57. DOI: 10.1080/09603120903545745. View