1921
Volume 95, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Multiple factors contribute to undernutrition in Cambodian women. Our aim was to determine if type of household sanitation facility was associated with body mass index (BMI) and hemoglobin (Hb) concentration among pregnant women. Women ( = 544) from 75 villages in Kampong Chhnang Province had their height, weight, and Hb measured (HemoCue Hb 201) in the first trimester. Sociodemographic and household characteristics were collected. Multivariable linear and logistic regression models were used for analyses. Approximately 40% ( = 221) of women reported primarily using an ‘improved’ sanitation facility (closed pit latrine) and ∼60% ( = 323) used ‘non-improved’ facilities (open defecation). Mean ± standard deviation (SD) BMI was higher among women with improved versus non-improved facilities (19.9 ± 3.0 kg/m versus 19.4 ± 2.3 kg/m; = 0.01). Mean ± SD Hb concentration was also higher among women with improved versus non-improved facilities (118 ± 12 g/L versus 114 ± 14 g/L; = 0.001). Anemia prevalence (Hb < 110 g/L) was higher among women with non-improved facilities (34% versus 25%; = 0.04). An improved sanitation facility was a positive predictor of BMI (β = 0.57 kg/m; 95% confidence interval [CI] = 0.10, 1.04) and Hb concentration (β = 2.94 g/L; 95% CI = 0.53, 5.35), adjusting for age, parity, household size, village, gestation week, source of drinking water, and iron folic acid supplementation. Poor sanitation was associated with lower BMI and Hb concentration among pregnant Cambodian women. This warrants multisectoral approaches involving the health, nutrition, water, and sanitation sectors to effectively improve maternal health in Cambodia.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.16-0278
2016-11-02
2017-11-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/5/1211.html?itemId=/content/journals/10.4269/ajtmh.16-0278&mimeType=html&fmt=ahah

References

  1. World Health Organization, 2008. Safer Water, Better Health: Costs, Benefits, and Sustainability of Interventions to Protect and Promote Health. Geneva, Switzerland: World Health Organization.
  2. National Institute of Statistics, Directorate General for Health, ICF Macro, 2015. Cambodia Demographic and Health Survey 2014: Key Indicators Report. Phnom Penh, Cambodia: National Institute of Statistics, Directorate General for Health, and Calverton, MD: ICF Macro.
  3. Charles CV, Summerlee AJS, Dewey CE, , 2012. Anemia in Cambodia: prevalence, etiology and research needs. Asia Pac J Clin Nutr 21: 171181.
  4. Yong TS, Chai JY, Sohn WM, Eom KS, Jeoung HG, Hoang EH, Yoon CH, Jung BK, Lee SH, Sinuon M, Socheat D, , 2014. Prevalence of intestinal helminths among inhabitants of Cambodia (2006–2011). Korean J Parasitol 52: 661666.[Crossref]
  5. Inpankaew T, Schär F, Dalsgaard A, Khieu V, Chimnoi W, Chhoun C, Sok D, Marti H, Muth S, Odermatt P, Traub RJ, , 2014. High prevalence of Ancylostoma ceylanicum hookworm infections in humans, Cambodia, 2012. Emerg Infect Dis 20: 976982.[Crossref]
  6. National Nutrition Program, Cambodia, 2009. National Nutrition Training Curriculum: Minimum Package of Activities 10. Phnom Penh, Cambodia: Cambodia National Nutrition Program, Cambodia National Maternal and Child Health Center, and A2Z Project.
  7. Soukhathammavong PA, Sayasone S, Phongluxa K, Xayaseng V, Utzinger J, Vounatsou P, Hatz C, Akkhavong K, Keiser J, Odermatt P, , 2012. Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR. PLoS Negl Trop Dis 6: e1417.[Crossref]
  8. Janmohamed A, Karakochuk CD, Boungnasiri S, Chapman GE, Janssen PA, Brant R, Green TJ, McLean J, , 2016. Prenatal supplementation with Corn Soya Blend Plus reduces the risk of maternal anemia in late gestation and lowers the rate of preterm birth but does not significantly improve maternal weight gain and birth anthropometric measurements in rural Cambodian women: a randomized trial. Am J Clin Nutr 103: 559566.[Crossref]
  9. Coates J, Swindale A, Bilinsky P, , 2007. Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide (v. 3). Washington, DC: Food and Nutrition Technical Assistance Project and Academy for Educational Development.
  10. World Health Organization, 2001. Iron Deficiency Anaemia Assessment, Prevention, and Control: A Guide for Programme Managers. Geneva, Switzerland: World Health Organization.
  11. Karakochuk CD, Whitfield KC, Barr SI, Lamers Y, Devlin AM, Vercauteren SM, Kroeun H, Talukder A, McLean J, Green TJ, , 2015. Genetic hemoglobin disorders rather than iron deficiency are a major predictor of hemoglobin concentration in women of reproductive age in rural Prey Veng, Cambodia. J Nutr 145: 134142.[Crossref]
  12. Wieringa FT, Sophonneary P, Whitney S, Mao B, Berger J, Conkle J, Dijkhuizen MA, Laillou A, , 2016. Low prevalence of iron and vitamin A deficiency among Cambodian women of reproductive age. Nutrients 8: e197.[Crossref]
  13. Kov P, Smets S, Spears D, Vyas S, , 2013. Growing Taller among Toilets: Evidence from Changes in Sanitation and Child Height in Cambodia, 2005–2010. Amston, CT: Research Institute for Compassionate Economics Working Paper.
  14. Spears D, Ghosh A, Cumming O, , 2013. Open defecation and childhood stunting in India: an ecological analysis of new data from 112 districts. PLoS One 8: e73784.[Crossref]
  15. Pickering AJ, Djebbari H, Lopez C, Coulibaly M, Alzua ML, , 2015. Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial. Lancet Glob Health 3: e701e711.[Crossref]
  16. Spears D, , 2013. How Much International Variation in Child Height can Sanitation Explain? Policy Research Working Paper 6351. Washington, DC: World Bank.[Crossref]
  17. Clasen T, Boisson S, Routray P, Torondel B, Bell M, Cumming O, Ensink J, Freeman M, Jenkins M, Odagiri M, Ray S, Sinha A, Suar M, Schmidt WP, , 2014. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial. Lancet Glob Health 2: e645e653.[Crossref]
  18. Ziegelbauer K, Speich B, Mäusezahl D, Bos R, Keiser J, Utzinger J, , 2012. Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Med 9: e1001162.[Crossref]
  19. Korpe PS, Petri WA, Jr, 2012. Environmental enteropathy: critical implications of a poorly understood condition. Trends Mol Med 18: 328336.[Crossref]
  20. Humphrey JH, , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 10321035.[Crossref]
  21. Coffey D, Geruso M, , 2015. Sanitation, Disease, and Anemia: Evidence from Nepal. Amston, CT: Research Institute for Compassionate Economics Working Paper.
  22. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA, , 2008. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev 1: CD004265.
  23. UNICEF, World Health Organization, 2015. Progress on Sanitation and Drinking-Water: 2015 Update and MDG Assessment. New York, NY: UNICEF, and Geneva, Switzerland: World Health Organization.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0278
Loading
/content/journals/10.4269/ajtmh.16-0278
Loading

Data & Media loading...

  • Received : 09 Apr 2016
  • Accepted : 20 Jul 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error