RESUMEN
Background: Handwashing with soap can prevent the spread of fecal oral microbes in the home environment. Despite the lack of water and for a variety of reasons, soap-based handwashing is not practiced in developing countries after defecation. Objective: The objective of the study was to determine the environmental and behavioral factors associated with hand washing with soap after defecation of respondents with children under the age of 5 years in a rural setting. Methods: Data used were taken from 756 households with children under the age of 5 that participated in a cross-sectional study conducted from July 22 to August 9, 2018, in 2 selected districts in the Jimma Zone, Southwest Ethiopia. It included post-defecation hand washing with soap and other variables such as sociodemographic information, environmental and behavioral factors. Stata version 16 was used to analyze the data. We use binary logistic regression models. To declare statistical significance, a P-value of less than .05 with an adjusted odds ratio and a confidence interval of 95% was used. Results: The prevalence of soap-based post defecation hand washing practices among respondents was 64.4%. Hand washing practice after defecation with soap has a significant association with having more than 1 child under 5 years of age (AOR = 1.60; 95% CI: 1.05-2.45), households living with cattle (AOR = 2.00; 95% CI: 1.30-3.07), use of unimproved latrine (AOR = 0.55; 95%CI: 0.31-0.98), with the presence of feces in the compound of the households interviewed (AOR = 7.08; 95% CI: 4.07-12.35) and regular cleaning water containers before filling drinking water (AOR = 2.16; 95% CI: 1.13-4.15). Conclusions: Most of the study participants washed their hands with soap after defecation. The presence of feces in the compound, having more than 1 child, living with cattle, and cleaning water containers routinely before filling drinking water all enhanced post-defecation handwashing with soap. However, when using unimproved latrines, respondents' post-defecation handwashing behavior with soap may be significantly reduced.
RESUMEN
Condiciones de vida deficientes, contaminación fecal de agua, de alimentos y del suelo favorecen la transmisión de parásitos intestinales. Para establecer asociación entre pobreza e infestación parasitaria se evaluaron aspectos socio-sanitarios (composición familiar, estrato social, vivienda), ambientales (agua, excretas) y coproparasitológicos (examen directo y kato) en 257 sujetos (2 a 18 años), de Valencia Estado Carabobo. Se encontró: Predominio de escolares en estrato IV, de estructura monofamiliar y de 5 personas por grupo; 48,2 por ciento de infestación, alta prevalencia en escolares (mono (57,3 por ciento) y poliparasitismo (52,6 por ciento). Los protozoarios fueron más prevalentes en el estrato IV (63,9 por ciento) y los helmintos en el estrato V (64,3 por ciento). No se encontró asociación estadísticamente significativa entre estrato socioeconómico por el método de Graffar- Méndez Castellano y parasitosis, pero sí entre parasitosis y ausencia de cloacas, agua no tratada, baño intradomiciliario, ausencia de piso y número de personas por familia. Predominio de protozoarios en familias de hasta 5 personas (56,6 por ciento) y helmintos en familias con mas de de cinco personas (78,6 por ciento). Asociación significativa entre Blastocystis hominis, Entamoeba coli y Ascaris lumbricoides y familias de más de 5 personas. Hubo estrecha aociación entre parasitosis y condiciones socio-sanitarias, ambientales y conductuales, lo que favorece la morbilidad en este grupo poblacional, perpetuando el ciclo de pobreza e infestación parasitaria.
Poor living conditions, fecal contamination of food, water and soil are factors that contribute to intestinal parasites transmission. In order to stablish association between poverty and parasitary infectation, socio-sanitary (family structure, social stratum, housing), environmental (water and excreta disposition) and coproparasitological (direct and kato examination) aspects were evaluated, in 257 subjects (2-18 years old), from Valencia, Carabobo State. Findings were: High prevalence of school children, of stratum IV, of monofamiliar structure, with five persons per group. Parasite infestation was found in 48.2 percent of children, more prevalent in school children, with mono (53.7 percent) and poliparasitism (52.6 percent). Protozoa forms were more prevalent in stratum IV (63.9 percent) and helminthes forms in stratum V (64.3 percent). There was not statistically significant association between socioeconomic strata assessed by Graffar-Mndez Castellano method and parasitic infestation, but between parasitic infestation and sociosanitary conditions (absence of sewers, non-treated water, intradomiciliary bath, absence of floor and number of people by family), statistically significant association was present. Predominance of protozoa in subjects from small families groups (less than five persons) was 56.6 percent while in children from large families groups (higher than five persons), prevalence of helminthes was 78.6 percent. Significant association was found between Blastocystis hominis, Entamoeba coli and Ascaris lumbricoides and large families groups. It is concluded that a strong and significant association was found between parasite infestations and socio-sanitary, environmental and cultural conditions, situation that favours a high morbidity rate, which perpetuates the interactions cycle of poverty and parasite infestations.