Risk factors for the transmission of diarrhoea in children: a case-control study in rural Malaysia
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S M Knight1, W Toodayan, W C Caique
1Department of Community Medicine, Universiti Sains Malaysia, Kota, Bharu.
Insights
Diarrhoea transmission in young children is linked to unboiled water, food storage, and bottle feeding. Animals inside homes and lack of latrine washing water also increase risk.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- Diarrhoea presents a significant health concern in children under five.
- Tumpat District, Malaysia, has observed a rise in diarrhoea cases.
- Identifying modifiable risk factors is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate modifiable risk factors associated with diarrhoea transmission.
- To analyze risk factors in children aged 4-59 months in Tumpat District.
- To inform targeted public health interventions for diarrhoea control.
Main Methods:
- A matched case-control study design was employed.
- Ninety-eight pairs of children (matched on age and sex) were recruited.
- Data on exposure status were collected through blinded home visits and conditional logistic regression.
Main Results:
- Drinking unboiled water, storing cooked food, and bottle feeding were identified as significant risk factors.
- Presence of animals indoors and lack of washing water in latrines were also associated with increased diarrhoea risk.
- No significant association was found with water quality, drinking water source, or handwashing practices.
Conclusions:
- Modifiable factors like water preparation, food hygiene, and sanitation practices significantly influence diarrhoea transmission.
- Interventions targeting these specific risk factors are recommended for diarrhoea prevention in the study area.
- Further research may explore the complex interplay of environmental and behavioral factors in childhood diarrhoea.
Abstract:
In response to a recorded increasing incidence of diarrhoea in Tumpat District, Malaysia, a case-control study was performed to identify modifiable risk factors for the transmission of diarrhoea, in children aged 4-59 months. Ninety-eight pairs of children, matched on age and sex, were recruited prospectively from health centres. Exposure status was determined during a home visit. Interviewers were 'blinded' as to the disease status of each child. Odds ratios were measured through matched pair analysis and conditional logistic regression. Risk factors for diarrhoea identified were: reported--drinking of unboiled water, storage of cooked food before consumption and bottle feeding; and observations--animals inside the house and absence of washing water in latrines. Water quality, source of drinking water, reported hand washing behaviour, indiscriminate defecation by children, cup use and the absence of a functional latrine were not associated with diarrhoea. Nonsignificant associations were found for: accessibility of washing water source, type of water storage container and use of fly covers for food.