Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis

Paul H. McClelland, Claire T. Kenney, Federico Palacardo, Nicholas L. S. Roberts, Nicholas Luhende, Jason Chua, Jennifer Huang, Priyanka Patel, Leonardo Albertini Sanchez, Won J. Kim, John Kwon, Paul J. Christos and Madelon L. Finkel
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Paul H. McClelland: Department of Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, New York, NY 11215, USA
Claire T. Kenney: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Federico Palacardo: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Nicholas L. S. Roberts: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Nicholas Luhende: ASMK Foundation, Shinyanga P.O. Box 350, Tanzania
Jason Chua: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Jennifer Huang: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Priyanka Patel: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Leonardo Albertini Sanchez: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Won J. Kim: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
John Kwon: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Paul J. Christos: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
Madelon L. Finkel: Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA

IJERPH, 2022, vol. 19, issue 7, 1-18

Abstract: Diarrhea remains a significant cause of morbidity and mortality among children in developing countries. Water, sanitation, and hygiene practices (WASH) have demonstrated improved diarrhea-related outcomes but may have limited implementation in certain communities. This study analyzes the adoption and effect of WASH-based practices on diarrhea in children under age five in the rural Busiya chiefdom in northwestern Tanzania. In a cross-sectional analysis spanning July-September 2019, 779 households representing 1338 under-five children were surveyed. Among households, 250 (32.1%) reported at least one child with diarrhea over a two-week interval. Diarrhea prevalence in under-five children was 25.6%. In per-household and per-child analyses, the strongest protective factors against childhood diarrhea included dedicated drinking water storage (OR 0.25, 95% CI 0.18–0.36; p < 0.001), improved waste management (OR 0.37, 95% CI 0.27–0.51; p < 0.001), and separation of drinking water (OR 0.38, 95% CI 0.24–0.59; p < 0.001). Improved water sources were associated with decreased risk of childhood diarrhea in per-household analysis (OR 0.72, 95% CI 0.52–0.99, p = 0.04), but not per-child analysis (OR 0.83, 95% CI 0.65–1.05, p = 0.13). Diarrhea was widely treated (87.5%), mostly with antibiotics (44.0%) and oral rehydration solution (27.3%). Targeting water transportation, storage, and sanitation is key to reducing diarrhea in rural populations with limited water access.

Keywords: WASH; drinking water; diarrhea; children under five; prevention; hygiene; sanitation; rural; Tanzania; Sub-Saharan Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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