Exposure-response relationship of neighbourhood sanitation and children's diarrhoea
| Autor: | Yu-Ling Cheng, Youngmee Tiffany Jung, Wendy Lou |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Diarrhea Male medicine.medical_specialty Asia Adolescent Sanitation 030231 tropical medicine Population Developing country Logistic regression Young Adult 03 medical and health sciences 0302 clinical medicine Residence Characteristics Environmental health medicine Humans 030212 general & internal medicine Improved sanitation education Africa South of the Sahara education.field_of_study business.industry Public health Incidence (epidemiology) Public Health Environmental and Occupational Health Infant Middle Aged Infectious Diseases Socioeconomic Factors Child Preschool Female Parasitology medicine.symptom business |
| Zdroj: | Tropical Medicine & International Health. 22:857-865 |
| ISSN: | 1360-2276 |
| Popis: | Objectives To assess the association of neighborhood sanitation coverage with under-five childrens diarrheal morbidity and to evaluate its exposure-response relationship. Methods We used the Demographic and Health Surveys (DHS) of 29 developing countries in sub-Saharan Africa and South Asia conducted between 2010 and 2014. The primary outcome was 2-week incidence of diarrhea in children under 5 years of age (N=300426). We conducted three-level logistic regression analyses and applied cubic splines to assess the trend between neighborhood-level coverage of improved household sanitation and diarrheal morbidity. Results Asignificant association between neighborhood-level coverage of improved household sanitation and diarrheal morbidity (OR[95%CI] = 0.68[0.62-0.76]) was found. Exposure-relationship analyses results showed improved sanitation coverage threshold at 0.6. We found marginal degree of association (OR[95%CI]=0.82[0.77-0.87]) below the threshold which beyond the threshold sharply increased to OR of 0.44 (95%CI:0.29-0.67) at sanitation coverage of 1 (i.e. neighborhood-wide use of improved household sanitation). Similar exposure-response trends were identified for urban and rural subgroups. Conclusions Our findings suggest that neighborhood sanitation plays a key role in reducing diarrheal diseases and that increase in sanitation coverage may only have minimal impact on diarrheal illness unless sufficiently high coverage is achieved. |
| Databáze: | OpenAIRE |
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