Household food sources and diarrhoea incidence in poor urban communities, Accra Ghana

Abstract

Diarrhoeal diseases remain a significant cause of morbidity and mortality, particularly in poor urban communities in the Global South. Studies on food access and safety have however not considered the sources of discrete food categories and their propensity to harbour and transmit diarrhoeal disease pathogens in poor urban settings. We sought to contribute to knowledge on urban food environment and enteric infections by interrogating the sources and categories of common foods and their tendency to transmit diarrhoea in low-income communities in Accra. We modelled the likelihood of diarrhoea transmission through specific food categories sourced from home or out of home after controlling for alternate transmission pathways and barriers. We used structured interviews where households that participated in the study were selected through a multi-stage systematic sampling approach. We utilized data on 506 households from 3 low-income settlements in Accra. These settlements have socio-economic characteristics mimicking typical low-income communities in the Global South. The results showed that the incidence of diarrhoea in a household is explained by type and source of food, source of drinking water, wealth and the presence of children below five years in the household. Rice-based staples which were consumed by 94.5% of respondents in the week preceding the survey had a higher likelihood of transmitting diarrhoeal diseases when consumed out of home than when eaten at home. Sources of hand-served dumpling-type foods categorized as “staple balls” had a nuanced relationship with incidence of diarrhoea. These findings reinforce the need for due diligence in addressing peculiar needs of people in vulnerable conditions of food environment in poor urban settlements in order to reap a co-benefit of reduced incidence of diarrhoea while striving to achieve the global development goal on ending hunger.

Diarrhea-Causing Bacteria and Their Antibiotic Resistance Patterns Among Diarrhea Patients From Ghana

“…Improper disposal of human waste is also another problem in the community. Open defecation into water bodies and bushes coupled with potable water scarcity could account for the high diarrhea cases ( Larbi et al, 2021 ). Practices such as handwashing, proper cooking of food, as well as proper disposal of human and household waste, are known to curb the spread of bacterial pathogens causing diarrhea.…”

“…In Sub-Saharan Africa, diarrhea is known to cause high fatality among children in rural and low-income communities as compared to the Americas and Europe. This is mainly because of unsanitary conditions such as defecation into rivers and streams which double as drinking water for livestock and humans, lack of potable drinking water, and improper handling of household food can lead to increased diarrhea cases ( Larbi et al, 2021 ; Takyi et al, 2021 ).…”

Hygienic disposal of stools and risk of diarrheal episodes among children aged under two years: Evidence from the Ghana Demographic Health Survey, 2003–2014

“…Children’s, as well as adult’s stools, must be disposed off safely, due to its association with diarrhea diseases, especially in poor urban communities [ 13 ]. Diarrheal diseases are among the top five common causes of death in children, accounting for over 525000 deaths among children [ 14 ].…”

“Working with little:” Access to market infrastructure and its effect on food handling and food safety among vegetable traders in an African city

“…Food security is influenced more by access than production in urban areas since about 80% of food products are acquired from the market (Middleton, 2016;Tuholske et al, 2020). The informal food market is primarily the nerve center of food distribution and access and contributes significantly to urban household food safety and security (Battersby et al, 2016;Tete Larbi et al, 2021). Therefore, a thorough understanding of urban food systems must include informal food vendors, the challenges of the sector, and their contribution to the food and nutrition needs of present and future generations (Balineau et al, 2021).…”

“…Limited access to waste disposal services has created a significant challenge to maintaining and sustaining hygiene within markets. The implications of such are food safety compromises and the spread of infectious diseases associated with such spaces and vendors (Rheinländer et al, 2008;Omari and Frempong, 2016;Tete Larbi et al, 2021).…”