RELATIONSHIP BETWEEN HAND WASHING WITH SOAP AND STUNTING AMONG CHILDREN <2 YEARS FROM BANGLADESH | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013.
L. Unicomb1, C. Stewart2, A. Halder1, T. Huda3, P. Ghosh1, S. Luby4 1International Centre for Diarrhoeal Disease Research, Bangladesh 2Program in International and Community Nutrition, University of California, Davis, CA, USA 3Department of Disease Control, Faculty of Infectious and Tropical Diseases (ITD), London School of Hygiene and Tropical Medicine, London, UK 4Infectious Diseases and Geographic Medicine, Center for Innovation and Global Health StanfordUniversity, San Francisco, CA, USA
Background and objectives: Hand washing with soap has been shown to reduce diarrhea in low income settings. Frequent enteric infections impact on child growth in such settings,thus good hand washing practices, by reducing diarrhea may impact on child growth. We examine the relationship between hand washing and nutrition status.
Methods: Credible hand washing practice data were collected through 5 hour structured observations for 417 households with at least one child <2 years in rural Bangladesh in 2007. We measured their height and weight. We compared lengthfor-age z-scores (LAZ) with categorical hand washing variables ranging from no hand washing to washing both hands with soap. We controlled for wealth, parent education, child age and sex using a generalized estimated equation regression model and adjusted for households clustering.
Results: Among the 417 households, 169 of 432 (39%) children <2 were stunted. There were 8, 872 handwashing events observed. Of the 142 events recorded after latrine use, handwashing with soap was detected for 23(16%). Soap was used among 48 of 229 (21%) events of cleaning a childs anus, 5 of 783 (0.6%) during food preparation, 72 of 2, 821 (3%) before eating, and 14 of 1155 (1%) before feeding a child. Nutritional status, indicated by LAZ, was associated with wealth but not with washing both hands with water or soap when controlling for wealth, education, age and sex.
Conclusions: In this cross sectional study no association between nutrition status and hand washing during food-related or fecal-related events. Prospectively exploring an association of observed good hand washing practices on growth when dietary intake data are included is worthy of investigation.
