203169 Latrine access associated with improved health of rural Nepali children

Wednesday, November 11, 2009: 8:48 AM

Annette L. Fitzpatrick, PhD, MA , Departments of Epidemiology and Global Health, University of Washington, Seattle, WA
Dibya Kansakar, PhD , SaciWATERs, Andhra Pradesh, India
Meera Kansakar, MA , IMPRESS, Kathmandu, Nepal
Jason Soh, BS , Department of Epidemiology, University of Washington, Seattle, WA
Pamela Elardo, MS, PE , Living Earth Institute, Seattle, WA
Access to clean water and sanitation are crucial to assure the health of children in developing countries. When interventions to improve this access are provided, it is important that evaluations of their impact be conducted. We evaluated differences in health status of children living in households with and without access to a latrine in two low-caste villages of rural Nepal. Medical history and health status of family members were obtained from heads of households through personal interviews. Anthropometric measurements including height and weight were completed on children under the age of 12 and compared to 2000 CDC growth reference standards to obtain z-scores. Data were obtained on 579 children under age 12 living in 240 households. Younger children were more likely to be malnourished or stunted (p < .05) while gender was not associated with nutritional status. In households without access to latrines, 30.5% of children were severely malnourished compared 18.4% of those with access to latrines. Likewise, 24.2% of the children in households without latrines were severely stunted in contrast to 15.6% using latrines. Access to a household latrine, adjusted for gender, age, village, and household unit, reduced the risk of severe malnutrition by almost half (OR: 0.52, 95% CI: 0.31-0.87). Older parents were less likely to have children with severe stunting (OR: 0.97, 95% CI: 0.96-0.99) which may represent their greater experience or knowledge of healthy behaviors. Efforts to educate and improve access to sanitary conditions in rural Nepali communities are critically needed.

Learning Objectives:
At the end of this session, participants will be able to: 1. Describe the symptoms and diseases related to unclean water/sanitation problems that can be recognized by residents in rural Nepal. 2. Design a protocol for household interviews to evaluate morbidity, mortality, and nutritional deficiencies in developing countries. 3. Analyze data by using growth standards to calculate z-scores that may be used to estimate individual levels of malnutrition, stunting, and developmental problems in children residing in developing countires. 4. Discuss factors that may be related to reduced risk of malnutrition and stunting in efforts to provide clean water, sanitation, and education interventions to developing nations.

Keywords: Children's Health, Disease Management

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A

Qualified on the content I am responsible for because: I developed the grant proposal and received funding for this project; I am an epidemiologist working in evaluation of projects in developing countries.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.