Examining the relationship between socio-economic status, WASH practices and wasting

Raihan, Mohammad Jyoti; Farzana, Fahmida Dil; Sultana, Sabiha; Haque, Md. Ahshanul; Rahman, Ahmed Shafiqur; Waid, Jillian L.; McCormick, Benjamin; Choudhury, Nuzhat; Ahmed, Tahmeed

doi:10.1371/journal.pone.0172134

Cited by 38 publications

(36 citation statements)

References 39 publications

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“…We found a positive linear association where the z-score for WAZ increased consistently with increase in sanitation coverage. Our study failed to find an association between sanitation coverage and WHZ z-score, in contrast to earlier studies in Nepal [11] and Bangladesh [43] where positive associations were reported. It should be noted that in the supplementary analysis where we modelled childhood wasting (dichotomized version of WHZ zscore using the WHO reference population), cluster sanitation coverage was significantly associated with decreased likelihood of wasting (Supplementary Table 2).…”

Section: Discussioncontrasting

confidence: 99%

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

2020

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Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to understand the association between height-forage (HAZ), weight-for-height (WHZ) and weight-forage (WAZ) z-scores and WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children's WAZ, HAZ and WHZ scores were − 1.33 [1.1], − 1.52 [1.3] and − 0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12 to 0.48) for WAZ and 0.28 (95%CI: 0.001 to 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07 to 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04 to 0.25) in WAZ and 0.13 (95%CI: 0.01 to 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction = 0.02). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.

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Section: Discussioncontrasting

confidence: 99%

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

2020

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“…We found a positive linear association where the z-score for WAZ increased consistently with increase in sanitation coverage. Our study failed to find an association between sanitation coverage and WHZ z-score, in contrast to earlier studies in Nepal (11) and Bangladesh (43) where positive associations were reported. It should be noted that in the supplementary analysis where we modelled childhood wasting (dichotomized version of WHZ z-score using the WHO reference population), cluster sanitation coverage was significantly associated with decreased likelihood of wasting (Supplementary Table 1).…”

Section: Supplementary Analysiscontrasting

confidence: 99%

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores in Nepal.

Shrestha

Vicendese

Erbas

2020

Preprint

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Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to understand the association between height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores and WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children’s WAZ, HAZ and WHZ scores were -1.33 [1.1], -1.52 [1.3] and -0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12 to 0.48) for WAZ and 0.28 (95%CI: 0.001 to 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07 to 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04 to 0.25) in WAZ and 0.13 (95%CI: 0.01 to 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction=0.02). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.

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“…Diarrhoea and infections are widely reported to be significantly associated with wasting and underweight among children in various countries [21,29]. In comparison to this study, various studies in different countries proved that younger children are at more risk of wasting compared to older children like in Myanmar [30] and Bangladesh [19,31].…”

Section: Discussionsupporting

confidence: 40%

“…A large proportion of these diseases are related to diarrhea incidences which contribute to the mortality rate of about 1.9 million and new diarrhea cases estimated at 4 billion annually, especially among children under five years old [16]. Previous literature has shown considerable effects of inappropriate water sanitation and hygiene practices on children undernutrition including wasting in various countries [17][18][19]. However, very few and limited studies in Tanzania [7,20] have evaluated the WASH among sub-groups of population.…”

Section: Introductionmentioning

confidence: 99%

Inappropriate Household Water, Sanitation and Hygiene practices are associated with Wasting for children under 5 years in Rural Tanzania: Evidence from the 2015/2016 Survey

Khamis

Ntwenya

Senkoro³

2019

Preprint

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Introduction: Wasting is a serious problem which lead to various morbidity and mortality incidences among infants and young children in developing countries. More is needed to reveal the environmental factors affecting infant and young child health in various settings particularly rural areas. Objectives: The objective of this analysis was to examine the association between Water, Sanitation and Hygiene (WASH) factors with children acute malnutrition (wasting), and investigate weather rural and urban areas being prone to poor WASH practices in Tanzania. Methods: This is a secondary data analysis of the 2015 Tanzania Demographic and Health Survey (TDHS) which is a cross-sectional study. The data was retrieved and re-analysed according to the study objective. The study involved 8,937 children aged 0 to 5 years living in Rural and Urban areas of the United Republic of Tanzania. A child was considered to be wasted if weight-for-height Z-scores were below minus two standard deviations (-2 SD) from the median of the WHO reference. Adjusted for Rural and Urban, the WASH factors were entered in the binary logistic regression model for analysis. Multivariate logistic regression was used to control for confounders. Results: Overall, this analysis reveals that rural areas have relatively poor WASH practices compared to their urban counterparts. The result showed that three WASH factors were retained in the model in rural areas. After controling for potential confounders of wasting like diarhoea and fever. The backward selection procedures of the logistic regression showed that: inappropriate disposal of stool (AOR=1.28; 1-1.59 95% CI); more than 30 minutes spent to get water (AOR=0.74; 0.54-1.01 95% CI) and unavailable place for handwashing (AOR=1.23, 0.96-1.56 95% CI) were associated with wasting in rural areas. Only one factor of inappropriate disposal of stool (AOR=2.8; 1.59-4.89, 95% CI) was found to be significantly associated with wasting in urban areas. Both rural and urban areas, there was no association between availability of handwashing facilities, type of sanitation and access to improved water sources with childhood wasting. Conclusion: This study justifies the importance of interventions for WASH targeting on promotion of nutrition and disease prevention in Tanzania especially in rural areas.

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Examining the relationship between socio-economic status, WASH practices and wasting

Cited by 38 publications

References 39 publications

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores among under-five children in Nepal

Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores in Nepal.

Inappropriate Household Water, Sanitation and Hygiene practices are associated with Wasting for children under 5 years in Rural Tanzania: Evidence from the 2015/2016 Survey

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