Water and sanitation associated with improved child growth

  • A.T. M
  • C. J
  • A. K
 et al. 
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Abstract

Objective: To examine the relation between household water and sanitation, and the risk of stunting and reversal of stunting in Khartoum and Crezira regions Sudan. Design: Prospective cohort study. Setting: A total of 25 483 children aged 6-72 months from rural Sudan enrolled in an 18-month field trial in 1988 to study the effect of vitamin A supplementation on child health and survival. Results: The mean height-for-age z-scores at baseline and the end of study were -1.66 and -1.55, respectively, for the group with water and sanitation facilities, and -2.03 and -1.94 for the group without water and sanitation, after adjustment for age, region, gender, mother's literacy, intervention group (vitamin A vs placebo), family wealth, breastfeeding and cleanliness. Among children of normal height-for-age at baseline, the risk of stunting (< -2 height-for-age z-score) was lowest in the group that came from homes that had both water and sanitation compared to children from homes without these facilities (multivariate RR=0.79, 95% Cl 0.69-0.90). Among children stunted at baseline, those coming from homes with water and sanitation had a 17% greater chance of reversing stunting than those coming from homes without either facility (adjusted RR=1.17, 95% Cl 0.99-1.38). We did not detect a synergistic association between access to water and sanitation. Conclusions: Water and sanitation are independently associated with improved growth of children.

Author-supplied keywords

  • Sudan
  • article
  • body height
  • body weight
  • breast feeding
  • child growth
  • clinical trial
  • cohort analysis
  • confidence interval
  • controlled clinical trial
  • controlled study
  • dietary intake
  • environmental sanitation
  • female
  • growth disorder
  • human
  • incidence
  • infant
  • logistic regression analysis
  • male
  • nutritional status
  • population research
  • preschool child
  • prospective study
  • randomized controlled trial
  • retinol
  • risk assessment
  • risk factor
  • scoring system
  • social status
  • statistical analysis
  • survival rate
  • vitamin supplementation
  • water
  • water quality

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Authors

  • Merchant A.T.

  • Jones C.

  • Kiure A.

  • Kupka R.

  • Fitzmaurice G.

  • Herrera M.G.

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