title: Drinking water quality, feeding practices, and diarrhea among children under 2 years of HIV-positive mothers in peri-urban Zambia.
abstract: In low-income settings, human immunodeficiency virus (HIV)-positive mothers must choose between breastfeeding their infants and risking transmission of HIV or replacement feeding their infants and risking diarrheal disease from contaminated water. We conducted a cross-sectional study of children < 2 years of age of 254 HIV-positive mothers in peri-urban Zambia to assess their exposure to waterborne fecal contamination. Fecal indicators were found in 70% of household drinking water samples. In a multivariable analysis, factors associated with diarrhea prevalence in children < 2 years were mother having diarrhea (adjusted odds ratio [aOR] = 5.18, 95% confidence interval [CI] = 1.65-16.28), child given water in the past 2 days (aOR = 4.08, 95% CI = 1.07-15.52), child never being breastfed (aOR = 2.67, 95% CI = 1.06-6.72), and rainy (versus dry) season (aOR = 4.60, 95% CI = 1.29-16.42). Children born to HIV-positive mothers were exposed to contaminated water through direct intake of drinking water, indicating the need for interventions to ensure microbiological water quality.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK. rachel.peletz@lshtm.ac.uk
authors.forename: Rachel
authors.initials: R
authors.lastname: Peletz
authors.forename: Michelo
authors.initials: M
authors.lastname: Simuyandi
authors.forename: Kelvin
authors.initials: K
authors.lastname: Sarenje
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
authors.forename: Suzanne
authors.initials: S
authors.lastname: Filteau
authors.forename: Thomas
authors.initials: T
authors.lastname: Clasen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014871:Water Microbiology / Q000592:standards*; D014881:Water Supply / Q000592:standards*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology