| Popis: |
Gut damage, resulting in maldigestion or malabsorption of food and stimulation of the immune system, has been linked to growth faltering in young children in the developing world. Gut damage occurs along a spectrum, with only the more severe damage resulting in visible symptoms such as diarrhoea; most gut damage in young children is sub-clinical but chronic, and over time it can have a significant impact on a child’s growth rate. Hand-washing with soap has been found to reduce the risk of diarrhoea by 42-47%. Would this simple intervention also reduce the sub-clinical yet chronic form of gut damage associated with childhood growth faltering? Framed within the bio-cultural research paradigm, and theoretically informed by insights from Critical Medical Anthropology, this study used a mixed-method, longitudinal approach in order to investigate this question. Eighty-eight children aged 3-12 months were recruited from eight slum communities in Kathmandu, Nepal. Each community was allocated to a control or intervention group (n=43 and 45 children, respectively). In intervention areas, a community-based hand-washing with soap programme was devised and implemented for six months; in control areas, mothers continued their normal practices. The intervention was evaluated by comparing five outcomes: rates of maternal hand-washing, levels of child morbidity, gut damage, immune stimulation and growth faltering in the two groups. Hand-washing rates increased amongst intervention mothers: by the end of the intervention, mothers living in hand-washing areas were more likely to report hand-washing with soap after cleaning the baby’s bottom and before cooking, eating or feeding the child (for all, P |
