Child soil ingestion in rural Ghana – frequency, caregiver perceptions, relationship with household floor material and associations with child diarrhoea

Bauza, Valerie; Byrne, Diana M.; Trimmer, John T.; Lardizabal, Amanda; Atiim, Philip; Asigbee, Mawuli A. K.; Guest, Jeremy S.

doi:10.1111/tmi.13050

Cited by 33 publications

(25 citation statements)

References 23 publications

(47 reference statements)

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“…During rapid observation at least one child was observed to play at 54% of public residential sites and engaged in behaviors such as hand contact with soil and surface water, hand-to-mouth contact, and geophagy, validating that observed behaviors in Kisumu neighborhoods are consistent with extant literature (25–27, 32, 33, 35, 36) and are relevant pathways for pathogen exposure. Of all public sites where children <5 yrs were observed in Kisumu, 93% of these sites were residential areas with mostly permeable or unpaved surfaces, versus non-residential sites.…”

Section: Methodssupporting

confidence: 78%

“…For example, eating soil from the ground may be more hazardous than ingestion of household drinking water because humans or animals may defecate directly on the ground whereas water is more likely to be protected and treated for safety. (12, 25, 26) Some exposure differences may be related to child behavior. Young children typically have high rates of contact with soil and objects,(27–31) and occasionally surface water,(32, 33) and frequently place their hands in their mouth with no handwashing in between.…”

Section: Introductionmentioning

confidence: 99%

“…(33, 34) This results in frequent indirect ingestion of trace amounts of soil, and perhaps surface water. Geophagia (direct ingestion of handfuls of soil) among young children(25, 26, 33, 35) and drinking from surface water also occur, (33) albeit less frequently than hand-to-mouth behaviors. Yet, the greater volume of material ingested by these infrequent behaviors could result in greater pathogen doses than what is ingested via hand-to-mouth behaviors.…”

Section: Introductionmentioning

confidence: 99%

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The Landscape of Enteric Pathogen Exposure of Young Children in Public Domains of Low-Income, Urban Kenya: The Influence of Exposure Pathway and Spatial Range of Play on Multi-Pathogen Exposure Risks

Medgyesi

Sewell

Senesac

et al. 2018

Preprint

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Section: Methodssupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Landscape of Enteric Pathogen Exposure of Young Children in Public Domains of Low-Income, Urban Kenya: The Influence of Exposure Pathway and Spatial Range of Play on Multi-Pathogen Exposure Risks

Medgyesi

Sewell

Senesac

et al. 2018

Preprint

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“…Greater amounts of time spent playing in public areas might increase young children’s exposure to enteric pathogens and other contaminants via more total hand and mouth contacts with objects. Contact with soil and trash was common compared to other measured behaviors and could result in repeat oral ingestion of fecal pathogens [47,48,49,50]. Hand contact with latrines, drains, animals and animal feces were infrequent, yet these items may transmit high amounts of feces or waste contaminants.…”

Section: Discussionmentioning

confidence: 99%

Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

Medgyesi

Brogan

Sewell

et al. 2018

IJERPH

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Globally, gastrointestinal (GI) infections by enteric pathogens are the second-leading cause of morbidity and mortality in children under five years of age (≤5 years). While GI pathogen exposure in households has been rigorously examined, there is little data about young children’s exposure in public domains. Moreover, public areas in low-income settings are often used for other waste disposal practices in addition to human feces, such as trash dumping in areas near households. If young children play in public domains, they might be exposed to interrelated and highly concentrated microbial, chemical, and physical hazards. This study performed structured observations at 36 public areas in an internally displaced persons community that has transitioned into a formal settlement in Haiti. We documented how often young children played in public areas and quantified behaviors that might lead to illness and injury. Children ≤5 years played at all public sites, which included infants who played at 47% of sites. Children touched and mouthed plastic, metal and glass trash, food and other objects from the ground, ate soil (geophagia) and drank surface water. They also touched latrines, animals, animal feces and open drainage canals. Hand-to-mouth contact was one of the most common behaviors observed and the rate of contact significantly differed among developmental stages (infants: 18/h, toddlers: 11/h and young children: 9/h), providing evidence that children could ingest trace amounts of animal/human feces on hands that may contain GI pathogens. These findings demonstrate that water, sanitation and hygiene interventions could be more effective if they consider exposure risks to feces in public domains. Furthermore, this research highlights the need for waste-related interventions to address the broader set of civil conditions that create unsafe, toxic and contaminated public environments where young children play.

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“…Similarly, the unsafe child excreta disposal was higher in households with children aged 1-2 years. Infant or todlers have higher exposure to feces and dirt due to their frequent habit of putting objects, soil, and hands into their mouth [30].…”

Section: Discussionmentioning

confidence: 99%

Unimproved water, sanitation, and hygiene (WASH) and common childhood illness in Myanmar: evidence from a nationally representative survey

Naz

Ghimire²

2020

Preprint

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Background Inadequate Water, Hygiene and Sanitation (WASH) is one of the major risk factors of common childhood illness - namely, diarrhea, cough, fever, and acute respiratory infection, in many Southeast Asian countries. This study aims to analyze the relationship between WASH-related indicators and common childhood illnesses; cough, fever and diarrhea among under-five children in Myanmar. Methods The data of 4,815 under-fives was extracted from the first Myanmar Demographic and Health Survey 2015-16. Chi-square test was used to determine association between WASH and sociodemographic variables and each common childhood illness. The bivariate logistic regression was used to obtain the unadjusted odds of cough, fever, and diarrhea for each wash indicator, i.e., Unimproved toilet, access to unsafe water, and unsafe feces disposal. Further multivariate regression was employed and adjusted odd ratios were obtained of each common childhood illness after accounting for all wash indicators. Results Among under-five children, 16.2% suffered from cough, 16% suffered from fever, and 10.4% from diarrhea. Unimproved toilet facility was associated with cough (Adjusted Odds Ratio (AOR) 1.15, 95% CI:0.86, 1.22), and fever (AOR 1.03, 95% CI:0.86,1.23) among children. Children from households practicing unimproved child feces disposal had 21%, 18%, and 52% higher odds of experiencing cough (95% CI:1.12, 1.31), fever (95% CI: 0.99,1.29), and diarrhea (95% CI:1.21, 1.68), respectively. A combination of unimproved water, toilet and child feces disposal facilities was associated with cough (AOR 1.34, 95% CI:1.03, 1.73), fever (AOR 1.12, 95% CI:0.86, 1.19) and diarrhea (AOR 1.18, 95% CI:0.95, 1.29). Conclusion Inadequate improved WASH significantly contributed to common childhood illnesses among children in Myanmar. Findings suggest that WASH interventions should be targeted to the poor and rural areas where the prevalence of both childhood illnesses and unimproved WASH facilities were reportedly high.

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Child soil ingestion in rural Ghana – frequency, caregiver perceptions, relationship with household floor material and associations with child diarrhoea

Abstract: Our results suggest direct soil ingestion is associated with diarrhoea independent of household floor material, and separate interventions may be necessary to prevent exploratory soil ingestion.

Cited by 33 publications

References 23 publications

The Landscape of Enteric Pathogen Exposure of Young Children in Public Domains of Low-Income, Urban Kenya: The Influence of Exposure Pathway and Spatial Range of Play on Multi-Pathogen Exposure Risks

The Landscape of Enteric Pathogen Exposure of Young Children in Public Domains of Low-Income, Urban Kenya: The Influence of Exposure Pathway and Spatial Range of Play on Multi-Pathogen Exposure Risks

Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

Unimproved water, sanitation, and hygiene (WASH) and common childhood illness in Myanmar: evidence from a nationally representative survey

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