| 摘要: | Background: Haiti is the only country in the western hemisphere with a death rate from diarrhea among children under five years old that is comparable to countries located in high diarrheal burden areas like sub-Saharan Africa and South Asia, and low coverage of improved water and sanitation. Previous studies have revealed the association between inadequate WASH system and diarrhea among children under five years old but in Haiti, no similar study had been conducted, thus this study aims to analyze the impact of access to water, sanitation, and hygiene on the prevalence of diarrhea among children under five years old in Haiti.
Methods: Data from the Demographic Health Survey on Haiti were used for this study. Data from four surveys, 2000,2005,2012,2016 were collected and analyzed separately. The variable outcome was if the child had diarrhea during the two weeks preceding the survey. Independent variables were WASH-related factors such as having access to an improved source of water, adequate sanitation, handwashing facility with water and soap, and sociodemographic variables like children sex and age, mother’s age, education level, and working status, wealth index, region and place of residence. Descriptive statistics, logistic regression with both crude and adjusted OR, and calculation of both 90 and 95 confidence intervals were used to run the analysis.
Result: There was a decline in the prevalence of diarrhea through the surveys. Diarrhea prevalence decreased from 26% in 2000 to 21% in 2016. The multivariate analysis, adjusted for sociodemographic factors found children age between 12 and 23 months, living in the Centre department and toilet facility shared as having higher odds for diarrhea across all the surveys except in 2005 for toilet facility shared and 2000 for the region of residence.
Improved water and sanitation played a little role and having handwashing with water and soap were found to not be associated with diarrhea among children under five years old.
Conclusion: This study’s findings showed that living in the Centre region, children aged between 12 and 23 months were associated with a higher risk for diarrhea and toilet facility shared as a persistent risk factor for diarrhea among children under five. Improvement of the WASH conditions, especially for individual toilet facilities and programs focus on hygiene behavior emphasizing on the importance of cleanliness should be prioritized to better protect the children's health. |
