The relationship of mothers' perception of babies' faeces and other factors to childhood diarrhoea in an urban settlement of Papua New Guinea.

ABSTRACT

PIP: A 1-year prospective study on the etiology of infantile diarrhea, conducted in an urban settlement in Papua New Guinea, revealed a strong association between mothers' perceptions that feces are polluting and the number of diarrheal episodes. Children whose mothers did not recognize feces as a source of diarrhea were 7.4 times more likely to get diarrhea than those whose mothers were aware of this association. Similarly, those whose mothers did not link contaminated food to diarrhea were 6.8 times more likely to suffer from diarrhea than their counterparts who were knowledgeable about this relationship. There was no significant correlation between the number of diarrhea episodes and the other items--maternal perceptions of the etiologic significance of dirty clothes, food dropped on the ground, cow's milk, and breast milk in diarrhea--about which mothers were questioned. Even when the data were adjusted for the potentially confounding effects of maternal age, education, employment, and socioeconomic status, the associations between feces, contaminated food, and diarrheal incidence remained significant. The highest relative risk (11 times greater) of diarrhea was found among infants of mothers who failed to recognize the etiologic significance of both infants' feces and contaminated food. These findings suggest a need to educate mothers about the importance of handwashing after every contact with their child's feces. Education is also needed on the dangers of eating food that has been dropped on the ground. Of the 479 infants studied, 296 had no episodes of diarrhea during the 1-year study period, 144 had 1 episode, 21 had 2 episodes, 10 had 3 episodes, and 8 had 4 or more episodes.