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Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa

SAJCH : the South African journal of child health, 2022-09, Vol.16 (3), p.158 [Peer Reviewed Journal]

COPYRIGHT 2022 Health & Medical Publishing Group ;ISSN: 1994-3032 ;EISSN: 1999-7671 ;DOI: 10.7196/SAJCH.2022.v16.13.1876

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  • Title:
    Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa
  • Author: Hendricks, M.K ; Sambo, M ; Laubscher, R ; Pendlebury, S ; Bourne, L
  • Subjects: Analysis ; Children ; Diseases ; Health aspects ; Medical research ; Medicine, Experimental ; Sanitation
  • Is Part Of: SAJCH : the South African journal of child health, 2022-09, Vol.16 (3), p.158
  • Description: Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings. Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age. Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization's child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was [greater than or equal to] 25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02-3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06-3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13-5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28-4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21-4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative. Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children's growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.
  • Publisher: Health & Medical Publishing Group
  • Language: English
  • Identifier: ISSN: 1994-3032
    EISSN: 1999-7671
    DOI: 10.7196/SAJCH.2022.v16.13.1876
  • Source: Open Access: African Journals Online
    DOAJ Directory of Open Access Journals
    Geneva Foundation Free Medical Journals at publisher websites
    Alma/SFX Local Collection
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