Diarrhoeal diseases in Soweto, South Africa, 2020: a community survey

Abstract

Background In South Africa, there are limited data on the burden of diarrhoea at a community level, specifically in older children and adults. This community survey estimated rates of and risk factors for diarrhoea across all ages and determined the proportion of cases presenting to healthcare facilities. Methods Randomly sampled households were enrolled from an existing urban health and demographic surveillance site. A household representative was interviewed to determine risk factors and occurrence of diarrhoea in the household, for all household members, in the past two weeks (including symptoms and health seeking behaviour). Diarrhoeal rate of any severity was calculated for <5 years, 5-15 years and >15 years age groups. Risk factors for diarrhoea and factors associated with health seeking behaviour were investigated using binomial logistic regression. Results Diarrhoeal rate among respondents (2.5 episodes/person-year (95%CI, 1.8-3.5)) was significantly higher than for other household members (1.0 episodes/person-year (95%CI, 0.8-1.4); IRR=2.4 (95%CI, 1.5-3.7) p<0.001). Diarrhoeal rate was not significantly different between age groups, however younger children (<5 years) were more likely to present to healthcare facilities (OR=5.86 (95%CI, 1.09-31.37), p=0.039). Having a child between 5-15 years in the household was associated with diarrhoea (OR=2.26 (95% CI, 1.32-3.86), p=0.003). While 26.4% of cases sought healthcare, only 4.6% of cases were hospitalised and only 3.4% of cases had a stool specimen collected. Conclusion Diarrhoeal rate was high across all age groups in this community; however, older children and adults were less likely to present to healthcare, and are therefore underrepresented through facility-based clinical surveillance.

“Our Home Is a Muddy Structure”: Perceptions of Housing and Health Risks Among Older Adults in Contrasting Neighborhoods in Ghana

“…Guided by the P-E hypothesis, this study identified factors influencing the health and well-being of older adults residing in two contrasting residential neighborhoods in Accra, Ghana. The reported susceptibility of older slum and non-slum dwellers to infectious and parasitic diseases is consistent with findings from previous studies with older urban populations in the region (49,50). However, in low-income urban communities such as slums, older adults' vulnerability to such inflictions is likely to be higher, given what may appear to be a mismatch between their personal competences and the environmental press presented by the residential settings in which they live (23).…”

A Descriptive Cross-Sectional Assessment of Caregivers’ Knowledge and Practices Regarding the Prevention and Management of Diarrhea among Children under the Age of Five in Thulamela B Clinics, South Africa

“…Several interventions have been in place to tackle diarrhea risk factors [ 12 ] including the use of rotavirus vaccine, support and promotion of exclusive breastfeeding at least in the first six months of a the child’s life, good community health literacy programs on how to manage and prevent diarrhea episodes and keep the children healthy through the use of oral rehydration solution (ORS) used to replace lost fluid as a result of dehydration, good hand washing with soap, use of safe drinking water and proper food and water storage containers [ 2 , 5 , 13 , 14 ]. According to the WHO/UNICEF [ 15 ], these proven interventions are yet to make progressive impacts to those at risk in the rural communities.…”