Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India.
Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India.
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DOI：
10.1111/tmi.12915
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Moe C
中科院分区：
文献类型：
--
作者：
Berendes D;Leon J;Kirby A;Clennon J;Raj S;Yakubu H;Robb K;Kartikeyan A;Hemavathy P;Gunasekaran A;Roy S;Ghale BC;Kumar JS;Mohan VR;Kang G;Moe C
这项研究调查了低收入、人口密集的城市社区中0-2岁儿童的家庭卫生与肠道感染（包括腹泻特异性结局）之间的关系。作为MAL - ED研究的一部分，来自印度城市低收入社区的230名儿童在14-17个预定时间点和出生后2年腹泻期间提供了粪便标本，分析了细菌、寄生虫（原生动物和蠕虫）和病毒性病原体。通过对100个家庭的护理人员的访谈，通过混合效应泊松回归模型测试了家庭卫生设施的存在（和排放）与任何病原体特异性和腹泻特异性肠道感染之间的关系。很少有研究家庭（33%）报告有厕所，其中大多数（82%）排入露天排水沟。控制季节和家庭社会经济地位，家庭厕所的存在与肠道感染（RR: 0.91, 95% CI: 0.79-1.06）、细菌感染（RR: 0.87, 95% CI: 0.75-1.02）和原虫感染（RR: 0.64, 95% CI: 0.39-1.04）的较低风险相关，尽管没有统计学意义，但与腹泻（RR: 1.00, 95% CI: 0.68-1.45）或病毒感染（RR: 1.12, 95% CI: 0.79-1.60）无关。模型还表明，家庭厕所排水沟与肠道感染风险之间的关系可能因季节而异。家庭厕所的存在与细菌和原生动物肠道感染的风险较低有关，但与腹泻或病毒感染无关，这表明使用考虑病原的结果测量方法可能更准确地估计卫生设施对健康的影响。
This study examined associations between household sanitation and enteric infection – including diarrhoeal‐specific outcomes – in children 0–2 years of age in a low‐income, dense urban neighbourhood. As part of the MAL‐ED study, 230 children in a low‐income, urban, Indian neighbourhood provided stool specimens at 14–17 scheduled time points and during diarrhoeal episodes in the first 2 years of life that were analysed for bacterial, parasitic (protozoa and helminths) and viral pathogens. From interviews with caregivers in 100 households, the relationship between the presence (and discharge) of household sanitation facilities and any, pathogen‐specific, and diarrhoea‐specific enteric infection was tested through mixed‐effects Poisson regression models. Few study households (33%) reported having toilets, most of which (82%) discharged into open drains. Controlling for season and household socio‐economic status, the presence of a household toilet was associated with lower risks of enteric infection (RR: 0.91, 95% CI: 0.79–1.06), bacterial infection (RR: 0.87, 95% CI: 0.75–1.02) and protozoal infection (RR: 0.64, 95% CI: 0.39–1.04), although not statistically significant, but had no association with diarrhoea (RR: 1.00, 95% CI: 0.68–1.45) or viral infections (RR: 1.12, 95% CI: 0.79–1.60). Models also suggested that the relationship between household toilets discharging to drains and enteric infection risk may vary by season. The presence of a household toilet was associated with lower risk of bacterial and protozoal enteric infections, but not diarrhoea or viral infections, suggesting the health effects of sanitation may be more accurately estimated using outcome measures that account for aetiologic agents.
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