title: Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk.
abstract: Indonesia still faces several challenges in the areas of water, sanitation, and hygiene (WASH). Diarrhea remains a major killer of children and it is important to understand the local diarrhea transmission pathways to prioritise appropriate WASH interventions to reduce diarrhea burden. This study used a cross-sectional data set from a recent national household survey (the 2012 Indonesia Demographic and Health Survey) to examine the associations between diarrhea in children aged less than 24 months with WASH interventions and population characteristics. Unsafe disposal of child feces was strongly associated with an increased odds of child diarrhea (OR: 1.46; 95% CI: 1.18-1.82, p = 0.001). However, other WASH practices were not found to be associated. The findings underline the dangers of unsafe disposal of child feces and highlight the need for strengthening the related policies and program strategies and their implementation.
authors.affiliation: UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia. acronin@unicef.org.
authors.forename: Aidan A
authors.initials: AA
authors.lastname: Cronin
authors.affiliation: Faculty of Public Health, Universitas Airlangga, Banyuwangi Campus, Jalan Wijaya Kusuma No 113, Banyuwangi 68414, Indonesia. sksebayang@gmail.com.
authors.forename: Susy Katikana
authors.initials: SK
authors.lastname: Sebayang
authors.affiliation: UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia. htorlesse@unicef.org.
authors.forename: Harriet
authors.initials: H
authors.lastname: Torlesse
authors.affiliation: UNICEF Indonesia, World Trade Center 6, Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia. rnandy@unicef.org.
authors.forename: Robin
authors.initials: R
authors.lastname: Nandy
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005243:Feces; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D006920:Hygiene; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012037:Refuse Disposal / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors; D012449:Safety / Q000706:statistics & numerical data*
keywords: Indonesia; care practices; child feces disposal; diarrhea; hygiene; sanitation; water