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pubmed:otherAbstract |
PIP: This study had 2 objectives: 1) to determine whether a case-control approach is an effective measure for assessing the effect of improved sanitation on bacterial diarrhea, and 2) to assess the effects of environmental sanitation on diarrheal disease in Cebu. The study took place during the warm, rainy months (July-September) of 1985. The study population consisted of 281 children under 2 who were treated at 1 of 16 clinics for diarrhea due to Escherichia coli, salmonella, shigella, and Vibrio cholerae. The controls were 384 children under 2 who were brought to the clinics for respiratory ailments and did not have diarrhea. Environmental sanitation was classed as "good" if the bacterial count in the water supply was low (i.e., water was obtained from the municipal water supply or bore holes) and if excreta disposal was adequate (i.e., there were flush toilets, sealed latrines, or pit latrines). Water quantity was measured by the number of times the child was bathed. The effects of the exposure variables on the study children were determined by logistic regression analyses adjusted for confounding variables, which included sex, educational level of the household, breast feeding, attendance at well-baby clinics, number of children under 5 in the household, and frequency of bathing the child. The results of the study showed that improved sanitation reduced the episodes of bacterial diarrhea by 40%, and that case-control studies with sample sizes of about of about 500 cases and 500 controls are adequate to detect disease reductions of 33% or more.
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