American Journal of Epidemiology Vol. 134, No. 8: 887-894
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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The Role of Home Environment in Infant Diarrhea in Rural Egypt
1University of Texas Health Science Center, Schools of Public Health and Medicine, University of Texas Houston, TX
2Epidemiology Study Center, Egyptian Ministry of Health Bilbets, Egypt
3Centers for Disease Control Atlanta, GA
Reprint requests to Dr. Herbert L. DuPont, Center for Infectious Diseases, University of Texas Health Science Center, 6431 Fannin, 1 729 JFB, Houston, TX 77030
In 1982 and 1983, a descriptive environmental survey was conducted in 317 households with newborn infants in rural Bilbeis, Egypt. The incidence of infant diarrhea in these households was ascertained by twice-weekly home visits for a 1-year period (1981–1982). Using univariate and multivanate analyses, the authors identified household factors that were statistically associated with infant diarrhea incidence, including number of children in the house under 4 years of age; number of persons per household; incidence of diarrhea in other family members; having a dirt (vs. concrete) dining room floor; having multiple living areas in the house; having a house or roof in need of repair, using well water rather than tap water for cooking or bathing; the absence of a sewer for waste bathwater; food being left out at room temperature between meals; and having many rodents in the house. Two practices involving interaction with the environment appeared to be protective: butchering of cattle by the family for home consumption, and protection of the infant from flies by a veil during napping. The combined household variables explained 25% of the variance in the total incidence of diarrhea. Categories of variables that accounted for most of the total variance explained by environmental factors are, in decreasing order: house structure (28%), water usage (24%); toilet and bathing area (12%); animal management (11%); food preparation area (10%); hygiene (8%); and wastewater management (6%). This approach may be useful in identifying environmental charactenstics whose change would reduce diarrheal illness among infants.
diarrhea; diarrhea; infantile; environment; housing; hygiene; sanitation
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