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Risk factors for the development of persistent diarrhoea and malnutrition in Burmese children
1Department of Medical Research, Ministry of Health, Yangon (Rangoon), Myanmar, Burma.
Insights
Socioeconomic and behavioral factors significantly increase the risk of persistent diarrhea and malnutrition in children. Addressing poverty, maternal education, and hygiene practices is crucial for prevention.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Persistent diarrhea and malnutrition are critical health issues in children.
- Identifying associated risk factors is essential for effective intervention strategies.
Purpose of the Study:
- To identify socioeconomic and behavioral risk factors for persistent diarrhea and malnutrition in children in Burma.
Main Methods:
- A case-control study involving 67 children (1-59 months) hospitalized for persistent diarrhea and severe malnutrition.
- Age- and sex-matched healthy controls from the same neighborhood were selected.
- Interviews and direct observation of household child-care practices were conducted.
Main Results:
- Key risk factors included low family income, low maternal education, poor sanitation (unhygienic latrines, flies), inadequate hygiene practices (handwashing, child's appearance), child defecating on the floor, and consuming food from the floor.
- Maternal knowledge deficits regarding diarrhea causes and malnutrition prevention, demand breastfeeding, and lack of appropriate weaning foods were also significant.
- Relative risk and etiologic fractions were calculated for identified risk factors.
Conclusions:
- Persistent diarrhea and malnutrition in this population result from a complex interplay of socioeconomic factors, poor hygiene, specific feeding practices, and low maternal education.
- Interventions should address poverty, enhance maternal education, improve sanitation and hygiene, and promote appropriate infant feeding practices.
Abstract:
To identify socioeconomic and behavioural risk factors for development of persistent diarrhoea and malnutrition in children, a case-control study was carried out in Burma. Cases were 67 children 1-59 months old hospitalized for diarrhoea lasting > 14 days and complicated by severe malnutrition; for each case, a healthy control child was selected who was age- and sex-matched from the same neighbourhood. Homes of cases and controls were visited for interviews and for direct observation of household child-care practices. Risk factors were catalogued and calculations made for relative risk and etiologic fractions. Risk factors that were associated with persistent diarrhoea and malnutrition included low family income, low education of mothers, unhygienic latrines, flies in the house and on the child, dirty appearance of child and mother, mother not using soap and water when washing child's hands, defaecation of child on floor, breastfeeding on demand, child eating food from floor, not feeding recommended weaning foods, and lack of knowledge by mother about causes of diarrhoea and about foods that prevent malnutrition. These results indicated that persistent diarrhoea and malnutrition in Burma is caused by a complex of several interrelated socioeconomic factors, unsanitary behaviour pertaining to personal hygiene, the practice of demand breastfeeding and lack of certain weaning foods, and low education of mothers who showed less knowledge about causes of diarrhoea and prevention of malnutrition.