Household faecal contamination and diarrhoea risk

Area of Science:

• Environmental Health
• Public Health
• Epidemiology

Background:

• Household faecal contamination (HFC) is a significant contributor to childhood diarrhoeal diseases, particularly in low socioeconomic settings.
• Identifying specific HFC sources is crucial for developing targeted interventions to reduce disease burden.

Purpose of the Study:

• To determine the primary sources of HFC in a low-ranking socioeconomic community in Yangon, Myanmar.
• To develop a valid Household Faecal Contamination Index (HFCI).
• To investigate the association between the HFCI and the incidence of diarrhoea in children.

Main Methods:

• Observational methods were used to gather data on HFC sources.
• A twice-weekly monitoring system tracked diarrhoea incidence in children.
• A HFCI was constructed based on three key indicators: lack of footwear, open defecation practices, and absence of latrines.

Main Results:

• A valid HFCI was developed, incorporating key HFC indicators.
• A significant increase in diarrhoea risk (4.21 to 8.66 per 1000 child-days) was observed as the HFCI score rose from 0 to 3 (P < 0.001).
• While adjusted rate ratios suggested an approximate doubling of risk across HFCI levels, statistical significance was not reached for these specific ratios.

Conclusions:

• The study successfully developed an HFCI and demonstrated a significant association with increased childhood diarrhoea incidence.
• Findings suggest that interventions addressing footwear, open defecation, and latrine availability could mitigate diarrhoea risk.
• Further research is recommended to validate these findings and explore the nuances of HFC and diarrhoea association.