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
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Sampling
2.3. Data Collection
2.3.1. Oral Contact Events
2.3.2. Caregiver Handwashing
2.3.3. Expanded Field Notes and Daily Debriefing Session
2.4. Analysis
3. Results
3.1. Oral Contact Events
3.2. Caregiver Hand Hygiene
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Total Observation Time * | 142:33:00 (hh:mm:ss) |
Average Observation Time per Child | 05:42:07 (hh:mm:ss) |
Index Child Sex Distribution | 8 male, 17 female |
Index Child Age Distribution | 10 infants < 6 months 15 infants 6–9 months |
Total Observation Time * | 138:11:59 (hh:mm:ss) |
Average Observation Time per Caregiver | 05:31:37 (hh:mm:ss) |
Caregiver Sex Distribution | 27 female, 4 male |
Caregiver Age Distribution ** | Min: 9, Max: 50, Average: 21.8 |
Oral Contact Object | Average Number of Events per Observation Period | Average Number of Events per Hour |
---|---|---|
Breast | 3.00 | 0.5 |
Object | 2.49 | 0.4 |
Toy | 0.60 | 0.1 |
Clothing Items | 0.48 | 0.1 |
Dirt/Soil | 0.36 | 0.1 |
Phones | 0.2 | <0.1 |
Shoes/Sandals | 0.16 | <0.1 |
Pacifier | 0.16 | <0.1 |
Keys | 0.16 | <0.1 |
Furniture/Walls | 0.12 | <0.1 |
Bottle | 0.05 | <0.1 |
Remote Controller | 0.08 | <0.1 |
Cup/Bowl | 0.08 | <0.1 |
Spoon/Utensil | 0.04 | <0.1 |
Infant’s own hand | 2.16 | 0.4 |
Foods | 1.64 | 0.3 |
Cooked Food | 1.60 | 0.3 |
Uncooked Food | 0.04 | <0.1 |
Liquids | 0.52 | 0.1 |
Water | 0.44 | 0.1 |
Tea | 0.08 | <0.1 |
Other | 0.48 | <0.1 |
Wastewater | 0.04 | <0.1 |
Medicine | 0.12 | <0.1 |
Other | 0.32 | <0.1 |
Hands | 0.2 | <0.1 |
Caretaker Hand | 0.16 | <0.1 |
Other Child Hand | 0.04 | <0.1 |
Total | 10.56 | 1.76 |
Oral Contact Type | 3 to <6 Months (n = 10) | ≥6 to 9 Months (n = 15) | Total |
---|---|---|---|
Breast | 37 | 38 | 75 |
Percent of Observations | 49% | 51% | 28% |
Weighted Percent by Age | 39% | 61% | |
Objects | 49 | 15 | 64 |
Percent of Observations | 77% | 23% | 24% |
Weighted Percent by Age | 69% | 31% | |
Hands Own | 29 | 25 | 54 |
Percent of Observations | 54% | 46% | 20% |
Weighted Percent by age | 44% | 56% | |
Food | 30 | 11 | 41 |
Percent of Observations | 73% | 27% | 16% |
Weighted Percent by age | 65% | 35% | |
Liquids | 11 | 2 | 13 |
Percent of Observations | 85% | 15% | 5% |
Weighted Percent by age | 79% | 21% | |
Other | 9 | 3 | 12 |
Percent of Observations | 75% | 25% | 5% |
Weighted Percent by age | 67% | 33% | |
Hands Other | 2 | 3 | 5 |
Percent of Observations | 40% | 60% | 2% |
Weighted Percent by age | 31% | 69% | |
Total | 167 | 97 | 264 |
Percent of Observations | 63% | 38% | 100% |
Weighted Percent by age | 53% | 47% |
Juncture | Frequency | Percent |
---|---|---|
Feeding event | 71 | 70% |
Child cleaning | 23 | 23% |
Caregiver toilet use | 5 | 5% |
Preparing food | 2 | 2% |
Total | 101 | 100% |
Key Juncture | HWWS | Hand Rinsing | No HW | HWWS; Sequence Not Determined | Total |
---|---|---|---|---|---|
Before feeding | 1 (1%) | 0 (0%) | 65 (92%) | 5 (7%) | 71 |
After child cleaning | 2 (9%) | 0 (0%) | 18 (78%) | 3 (13%) | 23 |
After toilet use | 2 (40%) | 1 (20%) | 1 (20%) | 1 (20%) | 5 |
Before preparing food | 0 (0%) | 0 (0%) | 1 (50%) | 1 (50%) | 2 |
Total | 5 (5%) | 1 (1%) | 85 (84%) | 10 (10%) | 101 |
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Davis, E.; Cumming, O.; Aseyo, R.E.; Muganda, D.N.; Baker, K.K.; Mumma, J.; Dreibelbis, R. 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. Int. J. Environ. Res. Public Health 2018, 15, 192. https://doi.org/10.3390/ijerph15020192
Davis E, Cumming O, Aseyo RE, Muganda DN, Baker KK, Mumma J, Dreibelbis R. 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. International Journal of Environmental Research and Public Health. 2018; 15(2):192. https://doi.org/10.3390/ijerph15020192
Chicago/Turabian StyleDavis, Emily, Oliver Cumming, Rose Evalyne Aseyo, Damaris Nelima Muganda, Kelly K. Baker, Jane Mumma, and Robert Dreibelbis. 2018. "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" International Journal of Environmental Research and Public Health 15, no. 2: 192. https://doi.org/10.3390/ijerph15020192