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Nutrition, Water quality, Sanitation and Hygiene Practices Associated with Children’s Health Status in Nepal. A Cross-sectional Study on Intestinal Parasitic Infections, Diarrhoea and Undernutrition
Akina Shrestha
Schweizerisches Tropen- und Public Health-Institut
Corresponding Author
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View the published version at BMC Public Health.
Background: Providing universal access to safe water, sanitation and hygiene (WASH) in remote Nepal remains challenging. Efforts to improve WASH access in these areas are impeded by a dearth of information on the status of WASH conditions and its association with health and nutritional status of children in Nepal. Methods: We investigated nutritional status, WASH practices, and their association with intestinal parasitic infections, diarrhoea, undernutrition and clinical signs of nutritional deficiencies (hereafter health outcomes) during March to May 2018. Data was collected through a cross-sectional survey of 1427 households, including questionnaires, observations, stool analysis, anthropometry, water quality measurements and assessment of clinical signs of nutritional deficiencies. Results: We found that 55.5% had undernutrition, 63.9% had clinical signs of nutritional deficiencies, 51.1% of children were suffering from intestinal parasitic infections, and 52.2% had waterborne illnesses. Multivariate mixed logistic regression analysis revealed statistically significant associations (p<0.05) between aforementioned health outcomes and a better socioeconomic status (adjusted odds ratio (AOR)=0.43, 95% confidence intervals (CI)=0.25-0.75), caregivers who can read (AOR=4.07, 95% CI=1.00-16.5), own food production of food (AOR=0.67, 95% CI=0.46-0.97), providing food supplements to the children (AOR=0.57, 95% CI=0.38-0.84), intermittent water supply (AOR=2.72, 95% CI=1.18-6.31), source water quality (AOR=10.44, 95% CI=1.61-67.4), washing hands when they look dirty (AOR=0.47, 95% CI=0.32-0.71), no toilet at home (AOR=6.12, 95% CI=1.08-14.25), cleanliness of the available toilet (AOR=0.68, 95% CI=0.47-0.98), handwashing after going to toilet (AOR=0.37, 95% CI=0.13-1.02), cleanliness of caregivers hand (AOR=0.61, 95% CI=0.41-0.89), presence of earthen floor (AOR=2.29, 95% CI=1.20-4.37), animals inside the house overnight (AOR=1.71, 95% CI=1.17-2.51) and regular deworming of the children (AOR=0.44, 95% CI=0.20-0.94). Conclusions: Findings suggest improvements in WASH services, along with household hygiene and nutritional interventions, may together reduce child morbidity and mortality in Nepal. Keywords: Drinking Water Quality, Sanitation and Hygiene, Child Health, Diarrhoea, Undernutrition, Intestinal Parasitic Infections, Nepal.
Keywords
Drinking Water Quality, Sanitation and Hygiene, Child Health, Diarrhoea, Undernutrition, Intestinal Parasitic Infections, Nepal.
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On 29 Nov, 2019
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Received 17 Nov, 2019
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Received 29 Oct, 2019
Reviewer #4 agreed
On 23 Oct, 2019
Reviewer #3 agreed
On 21 Oct, 2019
Reviewer #2 agreed
On 19 Oct, 2019
Reviewer #1 agreed
On 19 Oct, 2019
Reviewers invited
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Nutrition, Water quality, Sanitation and Hygiene Practices Associated with Children’s Health Status in Nepal. A Cross-sectional Study on Intestinal Parasitic Infections, Diarrhoea and Undernutrition
Akina Shrestha
Schweizerisches Tropen- und Public Health-Institut
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 08 Jan, 2020
Published
On 15 Aug, 2020
No community comments so far
Editor assigned
On 06 Jan, 2020
Submission checks complete
On 05 Jan, 2020
Editor invited
On 05 Jan, 2020
No comments provided
Editorial decision: Major revision
On 29 Nov, 2019
Review #3 received
Received 17 Nov, 2019
Review #2 received
Received 17 Nov, 2019
Review #1 received
Received 29 Oct, 2019
Reviewer #4 agreed
On 23 Oct, 2019
Reviewer #3 agreed
On 21 Oct, 2019
Reviewer #2 agreed
On 19 Oct, 2019
Reviewer #1 agreed
On 19 Oct, 2019
Reviewers invited
Invitations sent on 18 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 22 Sep, 2019
Editor invited
On 21 Sep, 2019
First submitted
On 20 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: Providing universal access to safe water, sanitation and hygiene (WASH) in remote Nepal remains challenging. Efforts to improve WASH access in these areas are impeded by a dearth of information on the status of WASH conditions and its association with health and nutritional status of children in Nepal. Methods: We investigated nutritional status, WASH practices, and their association with intestinal parasitic infections, diarrhoea, undernutrition and clinical signs of nutritional deficiencies (hereafter health outcomes) during March to May 2018. Data was collected through a cross-sectional survey of 1427 households, including questionnaires, observations, stool analysis, anthropometry, water quality measurements and assessment of clinical signs of nutritional deficiencies. Results: We found that 55.5% had undernutrition, 63.9% had clinical signs of nutritional deficiencies, 51.1% of children were suffering from intestinal parasitic infections, and 52.2% had waterborne illnesses. Multivariate mixed logistic regression analysis revealed statistically significant associations (p<0.05) between aforementioned health outcomes and a better socioeconomic status (adjusted odds ratio (AOR)=0.43, 95% confidence intervals (CI)=0.25-0.75), caregivers who can read (AOR=4.07, 95% CI=1.00-16.5), own food production of food (AOR=0.67, 95% CI=0.46-0.97), providing food supplements to the children (AOR=0.57, 95% CI=0.38-0.84), intermittent water supply (AOR=2.72, 95% CI=1.18-6.31), source water quality (AOR=10.44, 95% CI=1.61-67.4), washing hands when they look dirty (AOR=0.47, 95% CI=0.32-0.71), no toilet at home (AOR=6.12, 95% CI=1.08-14.25), cleanliness of the available toilet (AOR=0.68, 95% CI=0.47-0.98), handwashing after going to toilet (AOR=0.37, 95% CI=0.13-1.02), cleanliness of caregivers hand (AOR=0.61, 95% CI=0.41-0.89), presence of earthen floor (AOR=2.29, 95% CI=1.20-4.37), animals inside the house overnight (AOR=1.71, 95% CI=1.17-2.51) and regular deworming of the children (AOR=0.44, 95% CI=0.20-0.94). Conclusions: Findings suggest improvements in WASH services, along with household hygiene and nutritional interventions, may together reduce child morbidity and mortality in Nepal. Keywords: Drinking Water Quality, Sanitation and Hygiene, Child Health, Diarrhoea, Undernutrition, Intestinal Parasitic Infections, Nepal.