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Household Flooring Associated with Reduced Infant Diarrheal Illness in Zimbabwe in Households with and without WASH interventions

Koyuncu, Aybuke, Kang Dufour, Mi-Suk, Watadzaushe, Constancia, Dirawo, Jeffrey, Mushavi, Angela, Padian, Nancy, Cowan, Frances ORCID: and McCoy, Sandra I (2020) 'Household Flooring Associated with Reduced Infant Diarrheal Illness in Zimbabwe in Households with and without WASH interventions'. Tropical Medicine & International Health, Vol 25, Issue 5, pp. 635-643.

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Diarrhoeal illness is a leading cause of childhood morbidity and mortality and has long‐term negative impacts on child development. Although flooring, water and sanitation have been identified as important routes of transmission of diarrhoeal pathogens, research examining variability in the association between flooring and diarrhoeal illness by water and sanitation is limited.
We utilised cross‐sectional data collected for the evaluation of Zimbabwe’s Prevention of Mother‐to‐Child HIV transmission programme in 2014 and 2017–18. Mothers of infants 9–18 months of age self‐reported the household's source of drinking water and type of sanitation facility, as well as infant diarrhoeal illness in the four weeks prior to the survey. Household flooring was assessed using interviewer observation, and households in which the main material of flooring was dirt/earthen were classified as having unimproved flooring, and those with solid flooring (e.g. cement) were classified as having improved flooring.
Mothers of infants living in households with improved flooring were less likely to report diarrhoeal illness in the last four weeks (PDa = −4.8%, 95% CI: −8.6, −1.0). The association between flooring and diarrhoeal illness did not vary by the presence of improved/unimproved water (pRERI = 0.91) or sanitation (pRERI = 0.76).
Our findings support the hypothesis that household flooring is an important pathway for the transmission of diarrhoeal pathogens, even in settings where other aspects of sanitation are sub‐optimal. Improvements to household flooring do not require behaviour change and may be an effective and expeditious strategy for reducing childhood diarrhoeal illness irrespective of household access to improved water and sanitation.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Housing. Buildings. Public Facilities > WA 795 Housing
WI Digestive System > WI 407 Diarrhea
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 312 Diarrheal disorders
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Tina Bowers
Date Deposited: 25 Mar 2020 14:50
Last Modified: 21 Feb 2021 02:02


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