Risk factors for the transmission of diarrhoea in children: a case-control study in rural Malaysia
Knight, S.M.; Toodayan, W.; Caique, W.C.; Kyi, W.; Barnes, A.; Desmarchelier, P.
International Journal of Epidemiology 21(4): 812-818
1992
ISSN/ISBN: 0300-5771 PMID: 1521988 DOI: 10.1093/ije/21.4.812Document Number: 321434
In February-March 1989, during home visits, health investigators collected data on 98 pairs of 4-59 month old children recruited from 5 government health centers in rural Tumpat District in Malaysia to identify the risk factors for transmission of diarrhea. The controls had acute respiratory infections. Households not boiling drinking water and children drinking that water were leading risk factors of diarrhea transmission (adds ration [OR]=15, p=.02 and OR=3.13, p.001, respectively). 80.3% of reported boiled drinking water samples did not have any fecal coliforms. Storage of cooked food for 2 hours before consumption was a risk factor OR of conditional logistic regression=3 for 2 hours, p=.02; 2.44 for 2 hours=1/2 day, p=.03; and 9.82 for 1.2 day, p=.03). Another risk factor was animals (cats and chickens) living inside the dwelling (OR=2.41, p=.06). Socioeconomic status could not account for these 2 risk factors. Even though having no latrine in the house was not associated with diarrhea (OR=1.7, p=5), no water available with which to wash the anus and hand in latrines located in those houses which had latrines was significantly associated with diarrhea (OR=2.8, p=.05). This may have reflected overall poor hygienic standards. Even though breast feeding did not have a strong protective effect against diarrhea, bottle feeding was significantly associated with diarrhea (OR=8.07, p=.06). The lack of negative association between breast feeding and diarrhea may have been due to the controls' had respiratory infections, and breast feeding does have a protective effect against them. These results can help health officials to develop intervention strategies to reduce the incidence of diarrhea in rural children in Malaysia.