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Environmental and behavioural exposure pathways associated with diarrhoea and enteric pathogen detection in

Kelly K Baker1, Jane Awiti Odhiambo Mumma2, Sheillah Simiyu3

  • 1Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa, USA kelly-k-baker@uiowa.edu.

BMJ Open
|October 31, 2022
PubMed

Insights

Improving household hygiene, including handwashing and sanitation, significantly reduces infant diarrhea and pathogen exposure in Kenya. Proper hygiene practices are crucial for preventing enteric infections in young children.

Area of Science:

  • Environmental health
  • Infectious disease epidemiology
  • Pediatric public health

Background:

  • Diarrheal diseases and enteric pathogen infections pose a significant threat to infant health globally, particularly in low-resource settings.
  • Household environmental hygiene and behavioral factors are known to influence the transmission of enteric pathogens.

Purpose of the Study:

  • To investigate how household environmental hygiene and behavioral conditions moderate the association between diarrhea and enteric pathogen detection in infants.
  • To identify specific pathogen sources and risk factors in the household environment.

Main Methods:

  • A cross-sectional study utilizing enrollment survey data from 898 caregivers and their 5-month-old infants in Kisumu, Kenya.
  • Data collected included caregiver-reported diarrhea prevalence and laboratory analysis of enteric pathogens in infant stool.
  • Key exposures and effect modifiers such as sanitation access, animal cohabitation, and handwashing practices were assessed.

Main Results:

  • Handwashing after handling animals and before eating were strongly associated with a lower risk of reported diarrhea.
  • Cohabitation with domestic animals and specific flooring types were associated with increased pathogen co-detection in infants.
  • Caregiver handwashing after defecation moderated the protective effect of private latrine access against infant pathogen exposure.

Conclusions:

  • Eliminating animal cohabitation, improving flooring, and promoting consistent handwashing are critical interventions to prevent enteric pathogen exposure in young infants.
  • The effectiveness of sanitation interventions, such as private latrines, is contingent on proper caregiver hand hygiene practices.
Abstract

Keywords:
epidemiologygastrointestinal infectionsinfection controlpublic health

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