Mohammad Yousuf Mubarak
Kabul Medical University, Afghanistan
University of Michigan, USA
Title: Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: A cross sectional study
Biography
Biography: Mohammad Yousuf Mubarak
Abstract
Background: Sustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP) in combination with rapid urbanization has severely strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum.
Methods: In this cross sectional study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings and associations between preventive factors and household diarrhea in the past three months was evaluated using logistic regression.
Results: Two hundred participants, 100 from each setting were enrolled. Knowledge, attitudes and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Slum dwellers were more likely to wash their hands with soap before eating (P=0.006) or after defecating (P=0.0022), compared to those in the IDP camp, though fewer than half did so in either setting. Diarrhea in the household within the past 3 months was more common in the IDP camp (54%) than the slum (20%) (P=0.0022). In the fully adjusted model, only setting was significantly associated with diarrheal illness (IDP camp vs. slum OR: 5.39, 95% CI: 2.45, 11.86).
Conclusions: Even though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the high absolute burden of diarrhea and lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in both of these settings.