The Association of Sanitation and Hygiene Practices With Intestinal Parasitic Infections Among Under-14 Children in Rural Dire Dawa, Eastern Ethiopia: A Community Based Cross-sectional Study

Abstract

Background: Intestinal parasitic infections (IPIs) are neglected tropical diseases. Sanitation and hygiene are vital components for achieving sustainable control of intestinal parasitic infections. Children are the most vulnerable to intestinal parasitic infections because of their immature immune systems and frequent exposure to unsanitary environments. The aim of this study was to assess the magnitude of IPIs and associated risk factors, including sanitation and hygiene practices, among under-14-year-old children in rural Dire Dawa, eastern Ethiopia. Methods: This community-based cross-sectional ’study included 778 subjects aged 1 to 14 years. Data were collected using questionnaires and stool examinations. The direct wet-mount method and formol-ether concentration techniques were performed to identify IPIs. Data Analysis: A descriptive statistic was used to show the prevalence of IPIs. Bi-variable and multivariable analysis using the logistic regression model was carried out. Results: The outputs are presented using an adjusted odds ratio (aOR) with 95% confidence intervals (CIs). The prevalence of 5 intestinal parasites was 33.7% (95% CI = 30.4%-37%). Giardia intestinalis (15.2%) and Hymenolepis nana (11.6%) had the highest prevalence. The odds of IPIs among children of illiterate mothers were 13.1 times higher when compared with children of mothers with secondary education (aOR = 13.1, P = .02), and the odds of IPIs among children from households that have unclean latrines were 1.8 times higher when compared with children from households that have clean latrines. (aOR = 1.8, P = .03). Children from households that discard solid waste in open fields had 1.7 times higher odds of having a positive result than children from households that burn their waste (aOR = 1.7, P = .03). However, children without a swimming habit (aOR = 0.4, P = .000) and asymptomatic children (aOR = 0.3, P = .000) were protective against IPIs. Conclusions: IPIs continue to be a public health problem in rural parts of Dire Dawa. The prevalence of Giardia intestinalis and H. nana could be of public health importance in this setting. Solid waste management, latrine cleanliness, mothers’ level of education, and child swimming habits in unclean accumulated water were significantly associated with IPIs. Therefore, efforts should be made to ensure intervention, considering such risks.