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      Assessing the infection burden and associated risk factors in children under 5 across Jaipurs urban slums: A feasibility study using a One Health approach

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          Abstract

          Purpose: Infectious diseases are one of the leading causes of death among children under five (U5s) across both India & globally. This is worse in slum environments with poor access to water, sanitation & hygiene (WASH), good nutrition & a safe built environment.

          Globally, a One Health (e.g. human, animal & environment) approach is increasingly advocated by WHO, FAO & OIE to reduce infections & antimicrobial resistance. As U5s living in peri-urban slums are exposed to household and community owned companion & livestock animals and pests, the CHIP Consortium hypothesized that utilizing a One Health approach to co-produce behavior change & slum upgrading interventions may reduce this burden where other WASH & nutrition interventions have failed.

          This study aimed to assess the feasibility of utilising a One Health approach to assess U5 infection & risk factor prevalence in Jaipurs urban slums prior to undertaking prospective cohort studies involving culture and culture independent sampling of U5s and animals across our study sites in Jaipur, Jakarta & Antofagasta.

          Methods: We administered a Rapid Household Survey to 25 purposely selected households across six slums. The questionnaire evaluated infection prevalence, health seeking behaviors, the built environment, presence of animals & pests, and individual to household-level demographics. Associations were calculated using correlations among continuous variables to show strength of significance between continuous variables.

          Results: We found a high incidence of infections in children under five at 40%. This was most significantly correlated with accessibility of sanitary toilets (r = .62) and household expenditure. Vaccination coverage and child characteristics (such as size) were minimally correlated, while the presence of animals (pets or pests) was not correlated; the latter was likely due to the design of the survey.

          Conclusion: This study found a higher infection prevalence than previous studies. We also found higher correlations with infection incidence among household-level characteristics, indicating that effective interventions need to address both the built and socio-economic environments. A pilot prospective cohort study, which includes researcher observations for the presence of animals to account for inconsistencies in the survey, is now underway.

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          Author and article information

          Journal
          UCL Open: Environment Preprint
          UCL Press
          3 May 2020
          Affiliations
          [1 ] Department of Epidemiology and Public Health, UCL
          [2 ] Population, Policy and Practice Department, UCL
          [3 ] Jeevan Ashram Sanstha
          [4 ] Indonesia One Health University Network
          [5 ] Health and Wellbeing Department, Southwark Council
          [6 ] Bartlett School of Environmental Design and Engineering, UCL
          [7 ] Institute for Global Health, UCL
          [8 ] Jawaharlal Nehru University
          [9 ] Department of Geography, UCL
          Article
          10.14324/111.444/000032.v1

          This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

          The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

          Life sciences, Public health, Infectious disease & Microbiology

          One Health, Infectious Diseases, Children Under Five, Slum, India, Pollution and health

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