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Child defecation behaviour, stool disposal practices, and childhood diarrhoea in Burkina Faso: results from a
E Traoré1, S Cousens, V Curtis
1Ministère de la Santé, de l'Action Sociale et de la Famille, Bobo-Dioulasso, Burkina Faso.
Insights
Childhood diarrhea hospitalizations are linked to stool disposal practices, not defecation location. Proper stool management by mothers is crucial for preventing diarrheal diseases in young children.
Area of Science:
- Public Health
- Environmental Health
- Pediatrics
Background:
- Diarrheal diseases remain a significant cause of mortality in young children globally.
- Understanding environmental risk factors associated with childhood diarrhea is critical for effective prevention strategies.
Purpose of the Study:
- To investigate the association between children's defecation habits, stool disposal methods, and the presence of feces in the environment with the incidence of hospital admissions for diarrhea.
Main Methods:
- A case-control study was conducted in Bobo-Dioulasso, Burkina Faso.
- 757 children hospitalized with diarrhea (cases) were compared with 757 neighborhood controls and 631 hospital controls without diarrhea.
- Data collected included where children defecated, how stools were disposed of, and observed stool presence in compounds.
Main Results:
- No significant association was found between where children defecated and diarrhea hospital admissions.
- A notable association was observed between maternal stool disposal practices and diarrhea hospitalizations.
- Human stools were more frequently present in the yards of children admitted with diarrhea compared to controls.
Conclusions:
- The study highlights that maternal management of children's stools is a more critical factor in preventing childhood diarrhea than the location of defecation.
- Improved sanitation and hygiene practices, particularly regarding stool disposal, are essential for reducing diarrheal disease burden in young children.
Objective:
To investigate the association between where young children defecate, where stools are disposed of, and the presence of human stools on the ground in the compound and the rate of hospital admission with diarrhoea.
Design:
This was a case-control study with two control groups.
Setting:
The study took place in Bobo-Dioulasso, the second city of Burkina Faso in West Africa.
Participants:
Three groups of children aged 36 months and under, and living in Bobo-Dioulasso were studied. Cases were 757 children admitted to hospital with symptoms of diarrhoea or dysentery. The first control group comprised 757 neighbourhood control children approximately matched on age and date of recruitment, and the second, 631 children admitted to the same hospital without symptoms of diarrhoea or dysentery.
Main Results:
There was no evidence of any association between where the child was reported to defecate and hospital admission with diarrhoea or dysentery (odds ratio = 1.10; 95% confidence interval (CI) 0.78, 1.57, cases v neighbourhood controls; odds ratio = 0.84; 95% CI 0.60, 1.18, cases v hospital controls). There was evidence of an association between where the mother reported disposing of the child's stools and hospital admission with diarrhoea or dysentery (odds ratio = 1.50; 95% CI 1.09, 2.06, cases v neighbourhood controls; odds ratio = 1.31; 95% CI 0.96, 1.79, cases v hospital controls). Human stools were more frequently observed in the yards of cases than controls (odds ratio = 1.38; 95% CI 0.98, 1.95, cases compared with neighbourhood controls; odds ratio = 1.33; 95% CI 0.96, 1.84, cases compared with hospital controls).
Conclusions:
The findings suggest that it is not where the child defecates that matters but how the mother then deals with the child's stools.