Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study

Abstract

BackgroundSustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP), in combination with rapid urbanization has strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum.MethodsIn this cross sectional study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan, was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings.ResultsTwo hundred participants, 100 from each setting, were enrolled. Knowledge, attitudes, and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Fewer than half of participants washed their hands with soap before eating or after eating: 31 % of slum dwellers washed before eating compared to 11 % of IDPs (P = 0.0050), and 25 % of slum dwellers washed after defecating compared to 4 % of IDPs (P = 0.0020). The IDPs were more likely to share a latrine (P = 0.0144) and less likely to disinfect their latrine than slum dwellers. Diarrhea in the household within the past 3 months was more common in the IDP camp (54 %) than the slum (20 %) (P = 0.0020).ConclusionsEven though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing, are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in both of these settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1789-3) contains supplementary material, which is available to authorized users.

Hygienic Behaviors and Risks for Ascariasis among College Students in Kabul, Afghanistan

“…15 As the population has rapidly expanded, the city has faced housing shortages and a decaying sanitary infrastructure. 16,17 Ascariasis was particularly high among those living in hostels, or group homes, and could be explained in part through differences in hygienic behaviors: for instance, students in hostels more commonly consumed well water and unwashed vegetables. Location characteristics have been previously identified as a strong predictors of ascariasis.…”

Sanitation practice and associated factors among slum dwellers residing in urban slums of Addis Ababa, Ethiopia: A community based cross-sectional study

“…This finding was closely related to a similar study from Addis Ababa which reported 43.89% of the households practice sanitation (Abdissa and Walelegn, 2016). Related finding from Kabul (Afghanistan) showed poor hygienic activities among urban slums (Mubarak et al, 2016). A study from slum of Lucknow, capital of Uttar Pradesh, also reported households had unsafe practices towards water storage and handling (Shukla et al, 2016).…”

“…Among the world's regions, Sub-Saharan Africa continue to have the lowest levels of sanitation facility coverage; 44% of the population uses either shared or unimproved facilities (WHO and UNICEF, 2012;WHO and UNICEF, 2013;WHO and UNICEF, 2014). This situation was worse among urban slum dwellers, mainly due to poor sanitation facilities and unhygienic conditions (Erik and Uno, 1994;WHO and UNICEF, 2013;Mubarak et al, 2016). Studies reported the slum environment to be high risk for diarrhoea; due to close proximity of sanitation facilities to homes, sharing of sanitation facilities, and poor hygiene of the sanitation facilities and housing compounds (Mubarak et al, 2016).…”

“…This situation was worse among urban slum dwellers, mainly due to poor sanitation facilities and unhygienic conditions (Erik and Uno, 1994;WHO and UNICEF, 2013;Mubarak et al, 2016). Studies reported the slum environment to be high risk for diarrhoea; due to close proximity of sanitation facilities to homes, sharing of sanitation facilities, and poor hygiene of the sanitation facilities and housing compounds (Mubarak et al, 2016). Overcrowding and poor sanitation in these areas also lead to high parasite transmission rates through closer proximity of the infected to larger vulnerable populations and infections thrives in these conditions (Brooker et al, Sahiledengle et al 371 2006).…”

“…According to the well-known F diagram, disease is transmitted first from feces to fluids, fields, flies, or fingers, and then directly to a new host or indirectly through food (US Agency for International Development, 2004). To discontinue these passageways, sanitation is the vanguard measure to prevent transmissions from faeces regardless of the area, either urban or rural settlements (Mubarak et al, 2016; US Agency for International Development, 2004).…”