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Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis

Author

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  • Paul H. McClelland

    (Department of Surgery, NewYork-Presbyterian Brooklyn Methodist Hospital, New York, NY 11215, USA
    These authors contributed equally to this work.)

  • Claire T. Kenney

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
    These authors contributed equally to this work.)

  • Federico Palacardo

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
    These authors contributed equally to this work.)

  • Nicholas L. S. Roberts

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
    These authors contributed equally to this work.)

  • Nicholas Luhende

    (ASMK Foundation, Shinyanga P.O. Box 350, Tanzania)

  • Jason Chua

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Jennifer Huang

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Priyanka Patel

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Leonardo Albertini Sanchez

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Won J. Kim

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • John Kwon

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Paul J. Christos

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

  • Madelon L. Finkel

    (Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA)

Abstract

Diarrhea remains a significant cause of morbidity and mortality among children in developing countries. Water, sanitation, and hygiene practices (WASH) have demonstrated improved diarrhea-related outcomes but may have limited implementation in certain communities. This study analyzes the adoption and effect of WASH-based practices on diarrhea in children under age five in the rural Busiya chiefdom in northwestern Tanzania. In a cross-sectional analysis spanning July-September 2019, 779 households representing 1338 under-five children were surveyed. Among households, 250 (32.1%) reported at least one child with diarrhea over a two-week interval. Diarrhea prevalence in under-five children was 25.6%. In per-household and per-child analyses, the strongest protective factors against childhood diarrhea included dedicated drinking water storage (OR 0.25, 95% CI 0.18–0.36; p < 0.001), improved waste management (OR 0.37, 95% CI 0.27–0.51; p < 0.001), and separation of drinking water (OR 0.38, 95% CI 0.24–0.59; p < 0.001). Improved water sources were associated with decreased risk of childhood diarrhea in per-household analysis (OR 0.72, 95% CI 0.52–0.99, p = 0.04), but not per-child analysis (OR 0.83, 95% CI 0.65–1.05, p = 0.13). Diarrhea was widely treated (87.5%), mostly with antibiotics (44.0%) and oral rehydration solution (27.3%). Targeting water transportation, storage, and sanitation is key to reducing diarrhea in rural populations with limited water access.

Suggested Citation

  • Paul H. McClelland & Claire T. Kenney & Federico Palacardo & Nicholas L. S. Roberts & Nicholas Luhende & Jason Chua & Jennifer Huang & Priyanka Patel & Leonardo Albertini Sanchez & Won J. Kim & John K, 2022. "Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis," IJERPH, MDPI, vol. 19(7), pages 1-18, April.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4218-:d:785441
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    References listed on IDEAS

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    1. Frédéric Anderson Konkobo & Mamounata Diao & Paul Windinpsidi Savadogo & Roger Dakuyo & Noëlle Edwige Roamba & Sandrine Zongo & Mamoudou Hama Dicko, 2024. "Reduction of Malnutrition Related to Unsafe Water Consumption in Developing Countries: Potabilization of Surface Water and Traditional Well Water, with Plant Extracts," IJERPH, MDPI, vol. 21(5), pages 1-21, April.

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