Diarrhoeal diseases in Soweto, South Africa, 2020: a cross-sectional community survey

BMC Public Health

Juno Thomas¹  Nicola A. Page²  Siobhan L. Johnstone³  Nellie Myburgh⁴  Portia Mutevedzi⁴  Carlos Herrera⁴  Shabir A. Madhi⁴  Michelle J. Groome⁴ 

[1]Center for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa

[2]Center for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa

[3]Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Private Bag X323, 0007, Arcadia, South Africa

[4]Center for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa

[5]School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

[6]South African Medical Research Council: Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

关键词: Diarrhoea;    Community;    Handwashing;    Adults;    Children;    ORS;   

DOI  :  10.1186/s12889-021-11470-9

来源: Springer

【 摘 要 】

BackgroundIn South Africa, there are limited data on the burden of diarrhoea at a community level, specifically in older children and adults. This community survey estimated rates of and factors associated with diarrhoea across all ages and determined the proportion of cases presenting to healthcare facilities.MethodsHouseholds were enrolled from an existing urban health and demographic surveillance site. A household representative was interviewed to determine associated factors and occurrence of diarrhoea in the household, for all household members, in the past 2 weeks (including symptoms and health seeking behaviour). Diarrhoeal rate of any severity was calculated for < 5 years, 5–15 years and > 15 years age groups. Factors associated with diarrhoea and health seeking behaviour were investigated using binomial logistic regression.ResultsDiarrhoeal rate among respondents (2.5 episodes/person-year (95% CI, 1.8–3.5)) was significantly higher than for other household members (1.0 episodes/person-year (95% CI, 0.8–1.4); IRR = 2.4 (95% CI, 1.5–3.7) p < 0.001). Diarrhoeal rates were similar between age groups, however younger children (< 5 years) were more likely to present to healthcare facilities than adults (OR = 5.9 (95% CI, 1.1–31.4), p = 0.039). Oral rehydration solution was used in 44.8% of cases. Having a child between 5 and 15 years in the household was associated with diarrhoea (OR = 2.3 (95% CI, 1.3–3.9), p = 0.003) and, while 26.4% of cases sought healthcare, only 4.6% were hospitalised and only 3.4% of cases had a stool specimen collected. While the majority of cases were mild, 13.8% of cases felt they required healthcare but were unable to access it.ConclusionDiarrhoeal rate was high across all age groups in this community; however, older children and adults were less likely to present to healthcare, and are therefore underrepresented through facility-based clinical surveillance. Current diarrhoeal surveillance represents a fraction of the overall cases occurring in the community.

【 授权许可】

CC BY