title: Animal livestock and the risk of hospitalized diarrhoea in children under 5 years in Vietnam.
abstract: OBJECTIVE
  To investigate the association between environmental exposure to livestock and incidence of diarrhoea among Vietnamese children.
  
  
  METHODS
  A population-based cohort of 353,525 individuals, living in 75,828 households in Khanh Hoa Province, Vietnam, with baseline data covering geo-referenced information on demography, socio-economic status and household animals was investigated. Geographic information system was applied to calculate the density of livestock. The data were linked to hospitalized diarrhoea cases of children under 5 years recorded at two hospitals treating patients from the area as inpatients in the study area.
  
  
  RESULTS
  Overall, 3116 children with diarrhoea were hospitalized during the study period. The incidence of diarrhoea hospitalization was 60.8/1000 child-years. Male gender, age <2 years, higher number of household members and lack of tap water were significantly associated with an increased risk of diarrhoea. There was no evidence that ownership of livestock increased the risk of diarrhoea. In spatial analysis, we found no evidence that a high density of any animals was associated with an increased risk of diarrhoea.
  
  
  CONCLUSIONS
  Exposure to animals near or in households does not seem to constitute a major risk for diarrhoea in children under the age of 5 in Vietnam. Public health interventions to reduce childhood diarrhoea burden should focus on well-recognized causes such as sanitation, personal hygiene, access to adequate clean water supply and vaccination.
authors.affiliation: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Vu Dinh
authors.initials: VD
authors.lastname: Thiem
authors.forename: Wolf-Peter
authors.initials: WP
authors.lastname: Schmidt
authors.forename: Motoi
authors.initials: M
authors.lastname: Suzuki
authors.forename: Le Huu
authors.initials: le H
authors.lastname: Tho
authors.forename: Hideki
authors.initials: H
authors.lastname: Yanai
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Dang Duc
authors.initials: DD
authors.lastname: Anh
authors.forename: Lay-Myint
authors.initials: LM
authors.lastname: Yoshida
mesh_terms: D017677:Age Distribution; D000818:Animals; D002675:Child, Preschool; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D058751:Livestock; D008297:Male; D012307:Risk Factors; D012499:Sanitation; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014744:Vietnam / Q000453:epidemiology