Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3-9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya

Emily Davis; Oliver Cumming; Rose Evalyne Aseyo; Damaris Nelima Muganda; Kelly K Baker; Jane Mumma; Robert Dreibelbis

doi:10.3390/ijerph15020192

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Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3-9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya

Journal article

Open access

Peer reviewed

Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3-9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya

Emily Davis, Oliver Cumming, Rose Evalyne Aseyo, Damaris Nelima Muganda, Kelly K Baker, Jane Mumma and Robert Dreibelbis

International journal of environmental research and public health, Vol.15(2), p.192

01/24/2018

DOI: 10.3390/ijerph15020192

PMCID: PMC5857049

PMID: 29364184

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Abstract

Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result in diarrhea; however, there is a need for further evidence on specific exposure routes. This study describes the frequency and diversity of two important routes of enteric pathogen exposure among infants 3-9 months of age: infant oral contact behavior and caregiver handwashing behavior. Data were collected through structured observations of 25 index infants for the oral contact data and 25 households for the caregiver handwashing data in a peri-urban setting in Kisumu (Obunga), Kenya. Breast was the most common type of oral contact event with an average of 3.00 per observation period and 0.5 events per hour. This was followed by a range of physical objects with an average of 2.49 per observation and 0.4 events per hour. The "infant's own hands" was the third most common oral contact, with an average of 2.16 events per hour, and 0.4 oral contact events per hour. Food and liquids were the 4th and 5th most common oral contact events with an average of 1.64 food contacts and 0.52 liquid oral contact events per observation period. Feeding events, including breastfeeding, were the most commonly observed key juncture-71% of total junctures observed were caregivers feeding children. This was followed by child cleaning (23%), caregiver toilet uses at (4%), and lastly food preparation at 2%. HWWS was observed only once before a feeding event (1%), twice after cleaning a child (9%), and twice after caregiver toilet use (40%). The combined implication of data from observing oral contact behavior in children and hand hygiene of caregivers suggests that caregiver hand hygiene prior to feeding events and after cleaning a child are priority interventions.

Breast Feeding

Caregivers

Diarrhea, Infantile - prevention & control

Environmental Exposure - analysis

Environmental Exposure - prevention & control

Feces - microbiology

Female

Hand Disinfection

Hand Hygiene

Health Behavior

Humans

Infant

Kenya

Male

Mouth

Details

Title: Subtitle: Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3-9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya
Creators: Emily Davis - Johns Hopkins University
Oliver Cumming - University of London
Rose Evalyne Aseyo - Great Lakes University of Kisumu
Damaris Nelima Muganda - Great Lakes University of Kisumu
Kelly K Baker - University of Iowa
Jane Mumma - Great Lakes University of Kisumu
Robert Dreibelbis - University of London
Resource Type: Journal article
Publication Details: International journal of environmental research and public health, Vol.15(2), p.192
DOI: 10.3390/ijerph15020192
PMID: 29364184
PMCID: PMC5857049
NLM abbreviation: Int J Environ Res Public Health
ISSN: 1661-7827
eISSN: 1660-4601
Grant note: P30 ES005605 / NIEHS NIH HHS
Language: English
Date published: 01/24/2018
Academic Unit: Occupational and Environmental Health; Epidemiology
Record Identifier: 9984227057502771

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