[Effect of hygiene measures, water sanitation and oral rehydration therapy on diarrhea in children less than five years old in the south of Ivory Coast]. / Effet de l'observance des mesures d'hygiène, d'approvisionnement en eau et de la thérapie par voie orale sur les diarrhées chez les enfants de moins de 5 ans dans le sud de la Côte d'Ivoire.

The purpose is to assess the impact of compliance with measures of hygiene and water supply and oral rehydration on the diarrhoea with under 5 years of age in four villages of southern Côte d'Ivoire. The method used is to compare morbidity and mortality of children, firstly between two groups of villages without such measures, secondly in two villages before and after implementing them. Initially, an exhaustive survey has determined the incidence rate of diarrhoea, the proportion of deaths resulting from such diarrhoea as well as the mortality rate 1988. Two similar survey were made in 1990 and 1992. The results show a 50% reduction of the incidence rate of diarrhoea and a 85% reduction of the proportion of deaths related to diarrhoea in the villages with intervention. The mortality rate to diarrhoea was likewise reduced by 85%. These results show the importance of the improvement and accessibility to drinkable water and hygiene in the prevention of diarrhoea in areas children.

[Impact of improved sanitary conditions and domestic hygiene on the incidence of ascaridiasis and ancylostomiasis in children two to four years old in the rural zones of Ivory Coast]. / Impact de l'assainissement et de l'hygiène domestique sur l'incidence de l'ascaridiose et de l'ankylostomose chez les enfants de 2 à 4 ans dans les zones rurales de Côte d'Ivoire.

The purpose of this study is to assess the impact of improvement measures for hygiene and water supply, installation of latrines and health education on the incidence of ascaridiasis and ankylostomiasis with 2 to 4 years old children in some villages of southern Côte d'Ivoire. The method used is the comparison of children carrying parasites before and after intervention. Initially in 1988, the stools of all children aged from 2 to 4 were collected and examined in order to look for the presence of parasites in the stools. Two identical inquiries were made in 1990 and 1992. The results show a reduction of the rate of incidence for ascaridiasis by 75% and ankylostomiasis by 82%. They demonstrate the importance of an appropriate evacuation of excreta, of an education of mothers and of domestic hygiene in the process of prevention of children parasitosis.

[Water supply, excrement disposal and diarrheal diseases in rural zones of Ivory Coast]. / Approvisionnement en eau, evacuation des excreta et maladies diarrhéiques dans les zones rurales de Côte d'Ivoire.

This study was designed to determine the incidence of diarrhea over a 15 day period in children below 4 years living in villages in a rural area of Côte d'Ivoire and to identify possible correlation with water supply and excrement disposal. In this exhaustive cross-sectional household survey, each person caring for a child between the ages of 0 and 4 years was interviewed at home using an open, pretested survey with questions concerning diarrhea, water supply, and excrement disposal. Responses were authenticated by on-site observations made by surveyors. The study population included 1151 care providers and 1260 children between 0 and 4 years of age. Diarrhea had occurred in 27.7% of children within the 15 days prior to questioning, i.e. an annual incidence rate of 3.1 episodes per child after seasonal correction. Age was a risk factor for diarrhea since the incidence of diarrhea was inversely proportional to age. The number of episodes increases up to 6 months, stabilizes at a maximum of 37 to 38% until 36 months, and then gradually decreases to 6% between 53 and 59 months. Diarrhea was more common in children whose care provider was illiterate, the relative risk being 1.22. There was also a correlation between occurrence of diarrhea and age of the care provider since older providers were more likely to be illiterate. Use of a technique to prevent water from splashing out during transport was correlated with diarrhea. Children whose care providers used leaves or plastic covers to prevent splashing during transport had more episodes of diarrhea (30%) than the those whose care providers did not use these techniques (23%). The place where stool pots were emptied was also related to diarrhea. Disposal behavior was strongly correlated with literacy of the care provider, with the site of disposal being relevant only if the provider was illiterate. In view of these findings, we conclude that educating women, teaching child care providers about healthy eating habits in children as young as 5 months, and informing families about proper water storage and excrement disposal would reduce the incidence of diarrheal disease in village children.