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Pham-Duc P, Nguyen-Viet H, Hattendorf J, Cam PD, Zurbrügg C, Zinsstag J, Odermatt P. Diarrhoeal diseases among adult population in an agricultural community Hanam province, Vietnam, with high wastewater and excreta re-use. BMC Public Health 2014; 14:978. [PMID: 25239151 PMCID: PMC4180152 DOI: 10.1186/1471-2458-14-978] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 09/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the potential health risks of wastewater and excreta use as fertiliser in agriculture, it is still widespread in Vietnam. However, the importance of diarrheal risk in adults' associated with the combined exposures to both excreta and wastewater use in agriculture is largely unknown. This study was carried out to determine diarrhoeal incidence and associated risk factors among the adult population exposed to wastewater and excreta used in agriculture in Hanam province, Vietnam. METHODS An open cohort of 867 adults, aged 16-65 years, was followed weekly for 12 months to determine the incidence of diarrhoea. A nested case-control study was used to assess the risk factors of diarrhoeal episodes. Two hundred and thirty-two pairs of cases and controls were identified and exposure information related to wastewater, human and animal excreta, personal hygiene practices, and food and water consumption was collected. RESULTS The incidence rate of reported diarrhoea was 0.28 episodes per person-years at risk. The risk factors for diarrhoeal diseases included direct contact with the Nhue River water (odds ratio [OR] = 2.4, attributable fraction [AF] 27%), local pond water (OR = 2.3, AF 14%), composting of human excreta for a duration less than 3 months (OR = 2.4, AF 51%), handling human excreta in field work (OR = 5.4, AF 7%), handling animal excreta in field work (OR = 3.3, AF 36%), lack of protective measures while working (OR = 6.9, AF 78%), never or rarely washing hands with soap (OR = 3.3, AF 51%), use of rainwater for drinking (OR = 5.4, AF 77%) and eating raw vegetables the day before (OR = 2.4, AF 12%). CONCLUSIONS Our study shows that professional exposure to wastewater and excreta during agricultural activities are significantly contributing to the risk of diarrhoea in adults. The highest attributable fractions were obtained for direct contact with Nhue River and local ponds, handling practices of human and animal excreta as fertilisers, lack of protective measures while working and poor personal hygiene practices, and unsafe food and water consumption were associated with the risk of diarrhoeal episodes in adults. Improve personal hygiene practices and use of relevant treated wastewater and excreta as the public health measures to reduce these exposures will be most effective and are urgently warranted.
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Affiliation(s)
- Phuc Pham-Duc
- />Center for Public Health and Ecosystem Research (CENPHER), Hanoi School of Public Health (HSPH), 138 Giang Vo, Hanoi, Vietnam
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- />University of Basel, P.O. Box, CH-4003, Basel, Switzerland
- />National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
- />Sandec - Department of Water and Sanitation in Developing Countries, Swiss Federal Institute of Aquatic Science and Technology, P. O. Box, CH-8600, Dübendorf, Switzerland
| | - Hung Nguyen-Viet
- />Center for Public Health and Ecosystem Research (CENPHER), Hanoi School of Public Health (HSPH), 138 Giang Vo, Hanoi, Vietnam
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- />Sandec - Department of Water and Sanitation in Developing Countries, Swiss Federal Institute of Aquatic Science and Technology, P. O. Box, CH-8600, Dübendorf, Switzerland
| | - Jan Hattendorf
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- />University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Phung Dac Cam
- />National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi, Vietnam
| | - Christian Zurbrügg
- />Sandec - Department of Water and Sanitation in Developing Countries, Swiss Federal Institute of Aquatic Science and Technology, P. O. Box, CH-8600, Dübendorf, Switzerland
| | - Jakob Zinsstag
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- />University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Peter Odermatt
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- />University of Basel, P.O. Box, CH-4003, Basel, Switzerland
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Gidudu J, Sack DA, Pina M, Hudson MJ, Kohl KS, Bishop P, Chatterjee A, Chiappini E, Compingbutra A, da Costa C, Fernandopulle R, Fischer TK, Haber P, Masana W, de Menezes MR, Kang G, Khuri-Bulos N, Killion LA, Nair C, Poerschke G, Rath B, Salazar-Lindo E, Setse R, Wenger P, Wong VCN, Zaman K. Diarrhea: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2010; 29:1053-71. [PMID: 21130754 DOI: 10.1016/j.vaccine.2010.11.065] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 11/18/2010] [Indexed: 01/12/2023]
Affiliation(s)
- J Gidudu
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Bani IA, Saeed AAW, Othman AAMA. Diarrhoea and child feeding practices in Saudi Arabia. Public Health Nutr 2002; 5:727-31. [PMID: 12570881 DOI: 10.1079/phn2002354] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the prevalence of diarrhoea in children less than two years old and study the relationship between diarrhoeal episodes and action taken for these episodes by their mothers. DESIGN The prevalence of diarrhoeal episodes among children and its associations with sociodemographic information and anthropometric measurements of the subjects was examined. Predictive factors for morbidity-associated diarrhoeal disease and actions taken for this were explored. SETTING Primary health care centres (PHCCs) in Riyadh, Kingdom of Saudi Arabia. SUBJECTS Children less than two years of age. RESULTS Nearly a quarter of the children contracted diarrhoea during the two weeks preceding the data collection point, giving about six episodes of diarrhoea per child per year. Diarrhoea was more common in children over 6 months of age, in children who had no vaccination or follow-up cards, and in those who were taken care of by friends and neighbours if their mothers were working outside the home. The mothers of the affected children were young, married before 25 years of age with 2-6 years of formal schooling. During diarrhoeal episodes, about 25% of mothers stopped or decreased breast-feeding, 11.3% reduced the volume of fluids given to their children, and 22.7% of children were fed less solid/semi-solid foods. Mothers used oral rehydration salt in more than 40% of diarrhoeal episodes and unprescribed antibiotics were used in 17% of cases. The mothers who were not taking appropriate action included young mothers with low education level and those working outside the home. CONCLUSION Diarrhoea is common in children less than two years old in Riyadh City, and intervention based in PHCCs needs to be undertaken to correct the faulty practices of mothers during diarrhoeal episodes in their children. Health education messages should emphasise feeding during diarrhoeal episodes.
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Affiliation(s)
- Ibrahim Ahmed Bani
- Department of Community Health Sciences, Applied Medical College, King Saud University, Riyadh, Saudi Arabia.
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Fuchs SC, Victora CG. Risk and prognostic factors for diarrheal disease in Brazilian infants: a special case-control design application. CAD SAUDE PUBLICA 2002; 18:773-82. [PMID: 12048603 DOI: 10.1590/s0102-311x2002000300021] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework. A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988. Three groups were investigated, with 192 children each. The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration. The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases. The third group consisted of controls without diarrhea. Mothers were interviewed by trained interviewers using a standardized questionnaire. Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression. Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea. Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea.
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Affiliation(s)
- Sandra Costa Fuchs
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90035-003, Brasil.
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