Association of Water, Sanitation, Hygiene and Animal Ownership With Relapse to Acute Malnutrition Among Children Aged 6-59 Months in Mali, South Sudan and Somalia: A Multi-Site Prospective Cohort Study.

IF 2.6 2区医学 Q3 NUTRITION & DIETETICS

Maternal and Child Nutrition Pub Date : 2025-09-25 DOI:10.1111/mcn.70116

Lauren D'Mello-Guyett, Sarah King, Sherifath Mama Chabi, Feysal Absdisalan Mohamud, Nancy Grace Lamaka, John Agong, Malyun Mohamed, Karim Koné, Karin Gallandat, Mesfin Gose, Mohamed Sheikh Omar, Magloire Bunkembo, Indi Trehan, Anastasia Marshak, Khamisa Ayoub, Ahmed Hersi Olad, Bagayogo Aliou, Heather C Stobaugh, Oliver Cumming

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引用次数: 0

Abstract

Children successfully treated through community-based management of acute malnutrition (CMAM) frequently relapse to acute malnutrition (AM) following recovery and discharge. This prospective cohort study examined associations between relapse and household water, sanitation and hygiene (WASH) conditions, as well as animal ownership, in Mali, South Sudan and Somalia. Between April 2021 and June 2022, 1115 children were enrolled, with 964 children followed for 6 months, 242 in Mali, 488 in South Sudan and 234 in Somalia. Relapse to AM occurred in 32%, 63% and 21% of children in Mali, South Sudan and Somalia, respectively. In Mali, relapse risk was higher in households using multiple drinking water sources (aRR 1.71, 95% CI: 1.21-2.43, p = 0.003) or lacking soap (aRR 1.71, 95% CI: 1.03-2.82, p = 0.037). In South Sudan, inadequate drinking water sources, open defecation and the presence of animal faeces in the compound were associated with an increased risk of relapse (aRR 1.20, 95% CI: 1.04-1.38, p = 0.010; aRR 1.16, 95% CI: 1.03-1.30, p = 0.016; aRR 1.13, 95% CI: 1.02-1.26, p = 0.019, respectively). Sheep ownership in Mali (aRR 0.57, 95% CI: 0.40-0.81, p = 0.002) and cattle ownership in South Sudan (aRR 0.78, 95% CI: 0.71-0.85, p = < 0.001) were protective. No significant WASH or animal-related factors were associated with relapse in Somalia. As nearly all household drinking water samples were contaminated across settings and time points, no association could be detected between measured water quality and relapse. While many WASH indicators were not associated with relapse, some inadequate WASH conditions were identified as risk factors for relapse, although heterogeneous across contexts. These findings may help to identify at-risk children during treatment and inform strategies to reduce relapse post-recovery.

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马里、南苏丹和索马里6-59个月儿童中水、环境卫生、个人卫生和动物所有权与急性营养不良复发的关系：一项多地点前瞻性队列研究

通过社区急性营养不良管理（CMAM）成功治疗的儿童在康复出院后经常复发为急性营养不良（AM）。这项前瞻性队列研究调查了马里、南苏丹和索马里的复发与家庭用水、环境卫生和个人卫生（WASH）条件以及动物所有权之间的关系。在2021年4月至2022年6月期间，有1115名儿童登记，其中964名儿童随访6个月，其中马里242名，南苏丹488名，索马里234名。在马里、南苏丹和索马里，分别有32%、63%和21%的儿童复发急性呼吸道感染。在马里，使用多种饮用水源的家庭（aRR 1.71, 95% CI: 1.21-2.43, p = 0.003）或缺乏肥皂的家庭（aRR 1.71, 95% CI: 1.03-2.82, p = 0.037）的复发风险更高。在南苏丹，饮用水源不足、露天排就和化合物中存在动物粪便与复发风险增加相关（aRR 1.20, 95% CI: 1.04-1.38, p = 0.010; aRR 1.16, 95% CI: 1.03-1.30, p = 0.016; aRR 1.13, 95% CI: 1.02-1.26, p = 0.019）。马里的绵羊所有权（aRR 0.57, 95% CI: 0.40-0.81, p = 0.002）和南苏丹的牛所有权（aRR 0.78, 95% CI: 0.71-0.85, p = 0.002）

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来源期刊

Maternal and Child Nutrition 医学-小儿科

CiteScore

7.70

自引率

8.80%

发文量

144

审稿时长

6-12 weeks

期刊介绍： Maternal & Child Nutrition addresses fundamental aspects of nutrition and its outcomes in women and their children, both in early and later life, and keeps its audience fully informed about new initiatives, the latest research findings and innovative ways of responding to changes in public attitudes and policy. Drawing from global sources, the Journal provides an invaluable source of up to date information for health professionals, academics and service users with interests in maternal and child nutrition. Its scope includes pre-conception, antenatal and postnatal maternal nutrition, women''s nutrition throughout their reproductive years, and fetal, neonatal, infant, child and adolescent nutrition and their effects throughout life.