Relationship between feeding practices and weanling diarrhoea in northeast Thailand.

Diarrhoea is a major public health problem in Thailand. During November 1998-January 1999, a cross-sectional survey and a nested qualitative study were conducted to understand the relationship between feeding practices and weanling diarrhoea, and to describe the related local beliefs and practices in a subdistrict of northeast Thailand. A cluster-sampling method was used for selecting 156 weanlings aged 3-24 months. A structured interview was conducted with the main caregivers of these weanlings. The questionnaire used for the interview included items about feeding practices and diarrhoea-history of the weanlings in 2 months prior to the interview. Seven focus-group discussions with an opportunistic sample of the caregivers were held in the villages. A series of vignettes and unstructured questions were used for eliciting the local beliefs about weanling diarrhoea and its causes. Thirty-six (23%) of the 156 weanlings had diarrhoea in 2 months prior to the interview. The factors that were significantly related to reported weanling diarrhoea included consumption of unboiled water by weanlings (OR = 10, p = 0.03), not covering perishable foods (OR = 3, p = 0.02), and washing feeding utensils of weanlings without dishwashing detergent (OR = 3.1, p = 0.02), 'Su' and 'tongsia'--two common local terms--were used for describing different types of weanling diarrhoea. Many caregivers considered 'su' a natural occurrence in a child's development. The results suggest that some poor feeding practices may contribute to the higher risk of weanling diarrhoea in northeast Thailand. Some local beliefs about weanling diarrhoea may mask the true causes, and mislead messages about its prevention.

Schistosomiasis control measures for small irrigation schemes in Zimbabwe : results from three years of monitoring at Mushandike Irrigation Scheme

A pilot study was initiated in 1984 on the 600 ha Mushandike Irrigation Project near Masvingo; Zimbabwe; with the objective of developing and field-testing practical guidelines to reduce the risk of schistosomiasis transmission for use by those involved in planning; designing; constructing and operating small-holder irrigation projects in Zimbabwe. Schistosomisasis is a parasitic disease which is particularly pravalent on irrigation land because of high levels of human contact with water and because colonisation by the aquatic snails; which act as its intermediate hosts; is generally favoured by the equatic enviornments created within irrigation and drainage systems. A number of important phases of the project are complete. These include formulating criteria for schistosomiasis control; implementing these criteria with the design and construction processes; establishing regular monitoring of the human and snail populations and introducing micro-computer assisted irrigation scheduling to reduce the likelihood of smail colonisation in parts of the system. Interim results form the monitoring exercise are now available which enable comparisons to be drawn between different zones of the project and with irrigated land nearby on which control measures have not been introduced. These results indicate that a combination of concrete lining; irrigation scheduling and using innovative control structures on the infield works has had a major impact on the snail hosts. Some disease transmission is; however; occuring in the pilot areas. This is apparently associated with some unsuitable village lacations; inadequate access to safe domestic water supplies and enhanced flows in some natural drainage channels; This report reviews the monitoring to date and discusses what further studies are needed to establish the effectiveness of the control measures