Mothers' Personal and Domestic Hygiene and Diarrhoea Incidence in Young Children in Rural Bangladesh

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
International Journal of Epidemiology (Impact Factor: 9.18). 04/1989; 18(1):242-7. DOI: 10.1093/ije/18.1.242
Source: PubMed


This study examines the effect of maternal personal and domestic hygiene on the incidence of diarrhoea in children aged 6-23 months from rural areas around Teknaf, Bangladesh. The intervention area received augmented water supply through handpumps and health education while the control area received no project inputs. From July 1980 to June 1983, diarrhoea incidence was recorded weekly while mothers' personal and domestic hygiene was observed yearly. Annual incidence of diarrhoea in 314 children from the intervention area and 309 children from the control area was analysed in relation to maternal personal and domestic hygiene, controlling for education and occupation of household head and household size. Results show that, in both areas, use of handpump water for drinking and washing, removal of child's faeces from the yard, and maternal handwashing before handling food and after defaecation of self and child, observed together, decreased yearly diarrhoea incidence in children by more than 40% compared to children living in households where none or only one of these practices was observed.

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    • "Similarly, Shahid et al. (1996) and Luby et al. (2004) assessed the impact of a handwashing initiative consisting of the provision of soap along with regular surveillance and reinforcement of health messages of the benefits of handwashing. Additional multi-pronged interventions are assessed by Garrett et al. (2008); Aziz et al. (1990); Hoque et al. (1996); Rana (2009); Quick et al. (1999); Luby et al. (2006); Alam et al. (1989); and Lockwood et al. (2001). "
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    ABSTRACT: Preventable and treatable childhood diseases, notably acute respiratory infections and diarrhoeal diseases are the first and second leading causes of death and morbidity among young children in developing countries. The fact that a large proportion of child deaths are caused by these diseases is symptomatic of dysfunctional policy strategies and health systems in the developing world. Though clinical interventions against such diseases have been thoroughly studied, non-clinical interventions have received much less attention. This paper contributes to the existing literature on child wellbeing in two important respects: first, it presents a theory of change-based typology that emerges from a systematic review conducted on non-clinical interventions against preventable and treatable childhood diseases. Second, it pays particular attention to policies that have been tested in a developing country context, and which focus on children as the primary target population. Overall, we find that improved water supply and quality, sanitation and hygiene, as well as the provision of medical equipment that detect symptoms of childhood diseases, along with training and education for medical workers, are effective policy instruments to tackle diarrhoeal diseases and acute respiratory infections in developing countries.
    Full-text · Article · Sep 2013 · SSRN Electronic Journal
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    • "The effectiveness of hand washing with soap can reduce diarrheal risk up to 47% [10]. Many studies carried out in Bangladesh suggested that hand washing is one of the factors which decreases the incidence of diarrhea in intervention areas [11,12]. Studies also revealed that WASH intervention improve the water, sanitation and hygiene situation in Bangladesh; reduce diarrheal prevalence associated with lower number of fecal-colony forming bacteria on hands [13]. "
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    ABSTRACT: Background Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC’s water; sanitation and hygiene (WASH) programme areas over time. Methods This study is a cross-sectional comparative study between baseline (2006), midline (2009) and end-line (2011) surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i) 30 villages were selected from each sub-district by cluster sampling, and ii) 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey) for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene. Results A gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap. Conclusion Gap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.
    Full-text · Article · Jan 2013 · BMC Public Health
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    • "Only three of the 19 studies [40,45,54] reported measuring health and other indicators again after intervention activities had ceased. Time of follow-up after the intervention cessation ranged from six months to six years [40,45,54]. "
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    ABSTRACT: Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC) guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies). In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59). There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies), as well as the provision of water supply, sanitation and hygiene education (two studies) on reducing rates of diarrhoeal disease. The size of these effects is small and the quality of the studies generally poor. Research which measures the effectiveness of hygiene interventions is complex and difficult to implement. Multifaceted interventions (which target handwashing with soap and include water, sanitation and hygiene promotion) are likely to provide the greatest opportunity to improve child health outcomes in remote Indigenous communities.
    Full-text · Article · Feb 2008 · BMC Public Health
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