Research Article
Hygiene and Sanitation Practices and the Risk of Morbidity
among Children 6–23 Months of Age in Kumbungu District,
Ghana
Fusta Azupogo,
1
Fadilatu Abdul-Rahaman,
1
Beatrice Gyanteh,
1
and Ambrose Atosona
2
1
Department of Family and Consumer Sciences, Faculty of Agriculture, University for Development Studies, Tamale, Ghana
2
Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
Correspondence should be addressed to Ambrose Atosona; aatosona@yahoo.com
Received 11 August 2019; Accepted 19 October 2019; Published 12 December 2019
Academic Editor: Jennifer L. Freeman
Copyright © 2019 Fusta Azupogo et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Poor hygiene and sanitation (WASH) practices are characterised by the manifestation of disease and infections, notably
diarrhoea and respiratory tract infections (RTIs) among children. is study aimed to assess the influence of WASH practices on
the occurrence of diarrhoea and RTIs among children 6–23 months of age. Methods. An analytical cross-sectional study design was
conducted in June 2017. Systematic random sampling technique was used to select 300 mothers/caregivers with children aged 6–23
months from 9 communities in the Kumbungu District. We assessed the WASH practices, socio-demographic characteristics of
the households and the occurrence of diarrhoea and RTIs among the children with a semi-structured questionnaire. e Hygiene
Improvement Framework observational guide was adapted for household sanitation. Backward binary multiple logistic regression
was used to determine the WASH practices that significantly predicted morbidity. Results. About 53% and 55.3% of the children
reportedly experienced diarrhoea and RTIs, respectively, two weeks before the survey. Caregiver handwashing with soap aſter
defecation [OR = 0.32 (95% C.I: 0.19, 0.52)] and before feeding [OR = 0.50 (95% C.I: 0.30, 0.84)] as well as washing the child’s hands
with or without soap before feeding [OR = 0.21 (95% C.I: 0.04, 1.01)] were associated with lower odds of diarrhoea morbidity. e
main determinants of RTI morbidity included caregiver handwashing with or without soap aſter defecation [OR = 0.29 (95% C.I:
0.10, 0.81)] and washing of the child’s hands with soap before feeding [OR = 0.60 (95% C.I: 0.37, 0.99)] However, we found no
association between household sanitation and diarrhoea as well as RTI among the children. Conclusion. About a half each of the
children had diarrhoea and RTI 2 weeks before the survey. e results emphasise the need for urgent targeting of handwashing and
waste disposal programmes to avert the high burden of diarrhoea and RTIs among children.
1. Introduction
Globally, diseases such as diarrhoea and respiratory tract
infections (RTIs) have been identified as major threats to child
survival. Diarrhoea, defined as the passage of three or more
loose/liquid stools per day, is one of the leading causes of mor-
bidity and mortality in children under five years [1–3].
According to the WHO [3], an estimated 1.7 billion cases of
diarrhoea disease occur annually worldwide, with approxi-
mately 525 000 children dying from the disease. Diarrhoea is
currently the second most important cause of child morbidity
and mortality aſter malaria.
Similarly, acute respiratory tract infections are a significant
cause of death among children under five years of age [4].
Upper Respiratory Tract Infections (URTIs) refers to infec-
tions in the respiratory tract down to the larynx and include
common cold, pharyngitis, tonsillitis, otitis media and exter-
nal, sinusitis, stomatitis etc. [5]. Lower Respiratory Tract
Infections (LRTIs) refer to infections below the larynx and
include pneumonia, bronchitis, bronchiolitis, empyema, lung
abscess etc. [5]. ese conditions are responsible for between
1.9 million and 2.2 million childhood deaths [4]. According
to Williams et al. [4], it is further documented that 42% of
RTIs associated deaths occur in Africa [4]. In most cases, RTIs
can also be as a result of diarrhoea over an extended period
[6].
Underlying reasons for the spread of these diseases are
found in poor hygiene and sanitation, limited access to safe
Hindawi
Advances in Public Health
Volume 2019, Article ID 4313759, 12 pages
https://doi.org/10.1155/2019/4313759