Effects of poor water, sanitation, and hygiene on child health in Godawari Municipality, Lalitpur, Nepal, with special reference to diarrheal disease and nutritional status: a cohort study 10.55131/jphd/2022/200313

Main Article Content

Marina Vaidya Shrestha
Bishnu Prasad Choulagai
Abhinav Vaidya
Shankar Khanal
Shiva Raj Adhikari
Bandana Pradhan

Abstract

Malnutrition is one of the global burdens of disease affecting children under-five in the developing world and has a bidirectional relation with diarrhea. This study aimed to determine the water, sanitation, and hygiene (WASH) effects on diarrhea and to assess its relationship with the nutritional status among exposed and non-exposed children under the age of five years. A prospective cohort of 434 children under-five was recruited and followed up for 12 months in Lalitpur. Socio-demographic, clinical, and anthropometric measurements of the participants were recorded using the World Health Organization (WHO) AnthroPlus. The observed incidence of diarrheal illness was 1.81 episodes per child/year (95% Confifence Interval (CI):1.75–1.87). Among poor WASH exposures, 63 (29.2%) children had diarrhea and among non-exposures, 59 (27.1%) had diarrhea. A total of 183 children (42.2%) had linear growth retardation (stunted), and 270 (62.2%) were malnourished. Hazards of diarrhea among exposed groups were 1.235 (95% CI: 0.785-1.943) times higher than in non-exposed groups. Based on the findings, it is recommended that the government and health organizations should plan Safe WASH activities or interventions for local communities. Moreover, they should encourage social support and promote behavioral change for adopting safe WASH practices.

Article Details

How to Cite
1.
Shrestha MV, Choulagai BP, Vaidya A, Khanal S, Adhikari SR, Pradhan B. Effects of poor water, sanitation, and hygiene on child health in Godawari Municipality, Lalitpur, Nepal, with special reference to diarrheal disease and nutritional status: a cohort study: 10.55131/jphd/2022/200313. J Public Hlth Dev [Internet]. 2022 Sep. 9 [cited 2024 Mar. 29];20(3):163-74. Available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/258512
Section
Original Articles
Author Biographies

Marina Vaidya Shrestha, Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Department of Community Medicine,Kathmanadu Medical College,Kathmandu University.

Bishnu Prasad Choulagai, Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Abhinav Vaidya, Department of Community Medicine,Kathmanadu Medical College,Kathmandu University, Nepal

Department of Community Medicine,Kathmanadu Medical College,Kathmandu University., Nepal 

Shankar Khanal, Central Department of Statistics. Tribhuvan University, Kathmandu, Nepal.

Central Department of Statistics. Tribhuvan University, Kathmandu, Nepal.

Shiva Raj Adhikari, Central Department of Economics, Tribhuvan University, Kirtipur, Kathmandu, Nepal.

Central Department of Economics, Tribhuvan University, Kirtipur, Kathmandu, Nepal.

Bandana Pradhan, Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Central Department of Public health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

References

World Health Organization. Double-duty actions. Policy brief. Geneva: World Health Organization [Internet]. 2017[cited 2022 Jan 24]. Available from: file:///D:/Drive%20C/Downloads/WHO-NMH-NHD-17.2-eng.pdf

Springmann M, Mozaffarian D, Rosenzweig C, Micha R. The burden of malnutrition. Global nutrition report; 2021.

Park K. Nutrition and Health. Park’s Text Book of Preventive and Social Medicine, 24th ed. Jabalpur: Banarsidas Bhanot, 2017.

World Health Organization. Malnutrition. Fact sheets. World Health Organization [Internet]. 2021[cited 2021 Sept 24]. Available from: https://www.who.int/health-topics/ malnutrition#tab = tab _ 1.

World Health Organization. Turning the tide of malnutrition responding for the challenge of 21st century. Nutrition for Health and development. World Health Organization [Internet]. 2020.[cited 2021 June 14]. Available from: https://apps.who.int/iris/handle/ 10665/66505.

Tiwari I, Acharya K, Paudel Y R et al. Planning of births and childhood undernutrition in Nepal: evidence from a 2016 national survey. BMC Public Health 2020; 20(1):1788. doi: 10.1186/s12889-020-09915-8.

Ministry of Health - MOH/Nepal, New ERA/Nepal, and ICF. Nepal demographic and health survey 2016. Kathmandu: MOH/Nepal, New ERA/Nepal, and ICF; 2017.

The Mother and Child Health and Education Trust. Facts for life – child development and early learning. [Internet]. [cited 2022 January 15]. Available from: http://factsforlife.org/ 03/messages.html

Singh A. Childhood malnutrition in India. Intechopen book series; 2020.

Singh A. Childhood malnutrition in India. Perspective of Recent Advances in Acute Diarrhea. London: Intech Open; 2020

Wasihun AG, Dejene TA, Teferi M, Marugán J, Negash L, Yemane D, McGuigan KG. Risk factors for diarrhoea and malnutrition among children under the age of 5 years in the Tigray Region of Northern Ethiopia. PLoS One 2018;13(11):e0207743. doi: 10.1371/journal.pone.0207743.

Brander RL, Pavlinac PB, Walson JL, John-Stewart GC, Weaver MR, Faruque ASG, et al. Determinants of linear growth faltering among children with moderate-to-severe diarrhea in the Global Enteric Multicenter Study. BMC Med 2019;17(1):214. doi: 10.1186/s12916-019-1441-3.

Soboksa NE, Gari SR, Hailu AB, Mengistie Alemu B. Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia. Environ Health Insights 2021;15: 1178630221999635. doi: 10.1177/1178630221999635.

Wierzba TF, El-Yazeed RA, Savarino SJ, Mourad AS, Rao M, Baddour M, et al. The interrelationship of malnutrition and diarrhea in a periurban area outside Alexandria, Egypt. J Pediatr Gastroenterol Nutr 2001;32(2):189-96. doi: 10.1097/00005176-200102000-00018.

Van Cooten MH, Bilal SM, Gebremedhin S, Spigt M. The association between acute malnutrition and water, sanitation, and hygiene among children aged 6-59 months in rural Ethiopia. Matern Child Nutr. 2019;15(1):e12631. doi: 10.1111/ mcn.12631.

Godawari municipality profile. Document. 2018.

Shrestha MV, Choulagain BP, Joshi TP, Adhikari SR, Pradhan B. Factors associated with Diarrheal disease among under five children in Godawari Municipality of Nepal: A cross sectional study. JHSS 2021;269-80. doi: 10.19204/2021/fctr12.

Sullivan KM, Soe MM. Documentation for Sample Size for a Cross-Sectional, Cohort, or Clinical Trial Studies; 2007.

World Health Organization. Reliability of anthropometric measurement in the WHO multicenter growth reference study. Acta Paediatrica Suppl. 2006; 450:38-46.

De Onis M. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.

World Health Organization. WHO child growth standards: methods and development: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. Geneva, Switzerland: World Health Organization [Internet]. 2006 [cited 2020 Sept 5]. Available from: https://www.who.int/publications/i/ item/ 924154693X

Iwashita H, Tokizawa A, Thiem VD, Takemura T, Nguyen TH, Doan HT, et al. Risk Factors Associated with Diarrheal Episodes in an Agricultural Community in Nam Dinh Province, Vietnam: A Prospective Cohort Study. Int J Environ Res Public Health. 2022;19(4):2456. doi: 10.3390/ijerph 19042456.

Lakshminarayanan S, Jayalakshmy R. Diarrheal diseases among children in India: Current scenario and future perspectives. J Nat Sc Biol Med 2015; 6(1):24-8. doi: 10.4103/0976-9668.149073.

World Health Organization. Nepal introduces Rota virus vaccine against diarrhoea in children: National Immunization Programme achieves new milestone. World Health Organization [Internet]. 2020 [cited 2020 Aug 15] Available from: https://www.who.int/nepal/news/detail/ 02-07-2020-nepal-introduces-rota-virus-vaccine-against-diarrhoea-in-children-national-immunization-programme-achieves-new-milestone

Aluisio AR, Maroof Z, Chandramohan D, Bruce J, Masher MI, Manaseki-Holland S, et al. Risk Factors Associated with Recurrent Diarrheal Illnesses among Children in Kabul, Afghanistan: A Prospective Cohort Study. PLoS ONE 2015;10(2): e0116342. doi: 10.1371/journal.pone. 0116342.

Chao DL, Roose A, Roh M, Kotloff KL, Proctor JL. The seasonality of diarrheal pathogens: A retrospective study of seven sites over three years. PLoS Negl Trop Dis 2019;13(8):e0007211. doi: 10.1371/journal.pntd.0007211

Rah JH, Cronin AA, Badgaiyan B, Aguayo VM, Coates S, Ahmed S. Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys. BMJ Open 2015;5(2):e005180. doi: 10.1136/ bmjopen-2014-005180.

Thurstans S, Opondo C, Seal A, Wells J, Khara T, Dolan C, et al. Boys are more likely to be undernourished than girls: a systematic review and meta-analysis of sex differences in undernutrition. BMJ Glob Health 2020; 5(12):e004030. doi: 10.1136/ bmjgh-2020-004030.

Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian SV. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol 2017;46(1):312-323. doi: 10.1093/ije/ dyw133.

Khattak UK, Iqbal SP, Ghazanfar H. The Role of Parents' Literacy in Malnutrition of Children Under the Age of Five Years in a Semi-Urban Community of Pakistan: A Case-Control Study. Cureus 2017;9(6): e1316. doi: 10.7759/cureus.1316.