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      Determinants of disposal of child faeces in latrines in urban slums of Odisha, India: a cross-sectional study

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          Abstract

          Background

          Even among households that have access to improved sanitation, children’s faeces often do not end up in a latrine, the international criterion for safe disposal of child faeces.

          Methods

          We collected data on possible determinants of safe child faeces disposal in a cross-sectional study of 851 children <5 y of age from 694 households in 42 slums in two cities in Odisha, India. Caregivers were asked about defecation and faeces disposal practices for all the children <5 y of age in the household.

          Results

          Only a quarter (25.5%) of the 851 children’s faeces were reported to be disposed of in a latrine. Even fewer (22.3%) of the 694 households reported that the faeces of all children <5 y of age in the home ended up in the latrine the last time the child defecated. In multivariate analysis, factors associated with being a safe disposal household were education and religion of the primary caregiver, number of children <5 y of age in the household, wealth, type and location of the latrine used by the household, household members >5 y of age using the latrine for defecation and mobility of children <5 y of age in the household.

          Conclusions

          Few households reported disposing of all of their children’s faeces in a latrine. Improving latrine access and specific behaviour change interventions may improve this practice.

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          Most cited references23

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          Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data

          Background Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Methods Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010–11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Results Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. Conclusions This study provides support for the ecological relationship between alcohol-related mortality and alcohol consumption. The synthesis of knowledge from a combination of sales, survey and mortality data, as well as primary research studies, is key to ensuring that regional alcohol consumption, and its relationship with alcohol-related harms, is better understood.
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            Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review

            Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify cohort studies that sought to quantify diarrhea incidence among any age group of children 0-59 mo of age. Methods We used the Expectation-Maximization algorithm as a part of a two-stage regression model to handle diverse age data and overall incidence rate variation by study to generate country specific incidence rates for low- and middle-income countries for 1990 and 2010. We then calculated regional incidence rates and uncertainty ranges using the bootstrap method, and estimated the total number of episodes for children 0-59 mo of age in 1990 and 2010. Results We estimate that incidence has declined from 3.4 episodes/child year in 1990 to 2.9 episodes/child year in 2010. As was the case previously, incidence rates are highest among infants 6-11 mo of age; 4.5 episodes/child year in 2010. Among these 139 countries there were nearly 1.9 billion episodes of childhood diarrhea in 1990 and nearly 1.7 billion episodes in 2010. Conclusions Although our results indicate that diarrhea incidence rates may be declining slightly, the total burden on the health of each child due to multiple episodes per year is tremendous and additional funds are needed to improve both prevention and treatment practices in low- and middle-income countries.
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              Optimization of household survey sampling without sample frames.

              There are a few sampling methods available to survey households in situations where sample frames are either unavailable or are unreliable. The most popular of these methods is the expanded programme of immunization (EPI) sampling method, which has been used in low-income countries. The purpose of this paper is to explain how mathematical programming can be used to optimize EPI and other household survey sampling methods in these situations.
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                Author and article information

                Journal
                Trans R Soc Trop Med Hyg
                Trans. R. Soc. Trop. Med. Hyg
                trstmh
                Transactions of the Royal Society of Tropical Medicine and Hygiene
                Oxford University Press
                0035-9203
                1878-3503
                May 2019
                21 January 2019
                21 January 2019
                : 113
                : 5
                : 263-272
                Affiliations
                [1 ]Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
                [2 ]OHSU/PSU School of Public Health, Oregon Health and Science University, Portland, OR, USA
                [3 ]Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
                Author notes
                Corresponding author: Tel: +447455498616; E-mail: fiona.majorin@ 123456lshtm.ac.uk
                Article
                try142
                10.1093/trstmh/try142
                6515899
                30668852
                3c0708d1-8f99-48bd-be21-d15b9918097f
                © The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 November 2018
                : 19 December 2018
                Page count
                Pages: 10
                Funding
                Funded by: Bill & Melinda Gates Foundation 10.13039/100000865
                Award ID: OPP1008048
                Categories
                Original Articles

                Medicine
                child faeces,cross-sectional study,india,sanitation,wash
                Medicine
                child faeces, cross-sectional study, india, sanitation, wash

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