United Nations , 2015. Transforming Our World: The 2030 Agenda for Sustainable Development. Available at: https://sdgs.un.org/2030agenda.
World Health Organization/UNICEF , 2015. Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment. Available at: https://www.unicef.org/reports/progress-sanitation-and-drinking-water.
Freeman MC et al.2014. Systematic review: hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Health 19: 906–916.
Freeman MC et al.2013. Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration. PLoS Negl Trop Dis 7: e2439.
Dewey KG , Begum K , 2011. Long-term consequences of stunting in early life. Matern Child Nutr 7 (Suppl 3): 5–18.
Humphrey JH , 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet 374: 1032–1035.
Fenn B , Bulti AT , Nduna T , Duffield A , Watson F , 2012. An evaluation of an operations research project to reduce childhood stunting in a food-insecure area in Ethiopia. Public Health Nutr 15: 1746–1754.
Tofail F et al.2018. Effect of water quality, sanitation, hand washing, and nutritional interventions on child development in rural Bangladesh (WASH Benefits Bangladesh): a cluster-randomised controlled trial. Lancet Child Adolesc Health 2: 255.
UNICEF , 2010. Diarrhoea: Why Children Are Still Dying and What Can Be Done—UNICEF Data. Available at: https://data.unicef.org/resources/diarrhoea-why-children-are-still-dying-and-what-can-be-done/.
UNICEF , 2012. The State of the World’s Children 2012: Children in an Urban World. Available at: https://www.unicef.org/media/89226/file/The%20State%20of%20the%20World's%20Children%202012.pdf.
Wolf J et al.2014. Systematic review: assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression. Trop Med Int Health 19: 928–942.
Bangladesh Bureau of Statistics , 2018. National Hygiene Survey 2018. Available at: https://www.wateraid.org/bd/sites/g/files/jkxoof236/files/2021-01/National%20Hygiene%20Survey%202018_Bangladesh.pdf.
UNICEF , 2019. Progotir Pathey Bangladesh: Multiple Indicator Cluster Survey 2019. Available at: https://www.unicef.org/bangladesh/en/reports/progotir-pathey-bangladesh.
National Institute of Population Research and Training (NIPORT) and ICF , 2020. Bangladesh Demographic and Health Survey 2017–18. Dhaka, Bangladesh, and Rockville, MD: NIPORT and ICF.
Mahmud M , 2016. Water, Sanitation, Hygiene, and Nutrition in Bangladesh: A World Bank Study. Available at: http://hdl.handle.net/10986/22800.
Water Aid Bangladesh , 2021. Rural WASH Programme. Available at: https://www.wateraid.org/bd/rural-wash-programme.
Hsan K , Naher S , Griffiths MD , Shamol HH , Rahman MA , 2019. Factors Associated with the Practice of Water, Sanitation, and Hygiene (WASH) among the Rohingya Refugees in Bangladesh. London, United Kingdom: IWA Publishing.
Akter T , Ali AM , 2014. Factors influencing knowledge and practice of hygiene in Water, Sanitation and Hygiene (WASH) Programme areas of Bangladesh Rural Advancement Committee. Rural Remote Health 13: 2628.
National Institute of Population Research and Training, Ministry of Health and Family Welfare; Mitra and Associates; The DHS Program, ICF International , 2014. Bangladesh Demographic and Health Survey 2014. Available at: https://dhsprogram.com/pubs/pdf/FR311/FR311.pdf.
Ullah MB , Mridha MK , Arnold CD , Matias SL , Khan MSA , Siddiqui Z , Hossain M , Paul RR , Dewey KG , 2019. Factors associated with diarrhea and acute respiratory infection in children under two years of age in rural Bangladesh. BMC Pediatr 19: 386.
Hossain M , 2020. Ecological and Geomorphological Study of Saint Martin Island, Bangladesh.
Bangladesh Bureau of Statistics , 2015. Population Monograph: Age-Sex Composition of Bangladesh Population. Available at: http://188.8.131.52:8008/WebTestApplication/userfiles/Image/PopMonographs/Volume-9_Age-Sex.pdf.
ENA Software for SMART—SMART Methodology , 2020. Available at: https://smartmethodology.org/survey-planning-tools/smart-emergency-nutrition-assessment/?fbclid=IwAR1eHJI0ybDgavop4PrESAxzuBoYP9YKVnRP0BrmdZkUT1yXapZRkIM13X4.
Bostoen K , Chalabi Z , 2006. Optimization of household survey sampling without sample frames. Int J Epidemiol 35: 751–755.
UNICEF and WHO , 2018. Core Questions on Water, Sanitation and Hygiene for Household Surveys—2018 Update. Available at: https://washdata.org/sites/default/files/documents/reports/2019-03/JMP-2018-core-questions-for-household-surveys.pdf.
World Gastroenterology Organization , 2012. Acute Diarrhea in Adults and Children: A Global Perspective. Available at: https://www.worldgastroenterology.org/guidelines/acute-diarrhea/acute-diarrhea-english.
Mshida H et al.2020. Sanitation and hygiene practices in small towns in Tanzania: the case of Babati district, Manyara region. Am J Trop Med Hyg 103: 1726–1734.
Agbadi P , Darkwah E , Kenney PL , 2019. A multilevel analysis of regressors of access to improved drinking water and sanitation facilities in Ghana. J Environ Public Health 2019: 3983869.
Admasie A , Debebe A , 2016. Estimating access to drinking water supply, sanitation, and hygiene facilities in Wolaita Sodo Town, southern Ethiopia, in reference to national coverage. J Environ Public Health 2016: 8141658.
Andualem Z , Dagne H , Azene ZN , Taddese AA , Dagnew B , Fisseha R , Muluneh AG , Yeshaw Y , 2021. Households Access to Improved Drinking Water Sources and Toilet Facilities in Ethiopia: A Multilevel Analysis Based on 2016 Ethiopian Demographic and Health Survey. London, United Kingdom: BMJ Publishing Group.
Schmidt WP , Aunger R , Coombes Y , Maina PM , Matiko CN , Biran A , Curtis V , 2009. Determinants of handwashing practices in Kenya: the role of media exposure, poverty and infrastructure. Trop Med Int Health 14: 1534–1541.
Hjelm L , Mathiassen A , Miller D , Wadhwa A , 2017. Creation of a Wealth Index. World Food Programme. Available at: https://docs.wfp.org/api/documents/WFP-0000022418/download/.
Ballard TJ , Kepple AW , Cafiero C , 2013. The Food Insecurity Experience Scale. Development of a Global Standard for Monitoring Hunger Worldwide. Food and Agriculture Organization of the United Nations.
Smyth GK , 2003. Pearson’s goodness of fit statistic as a score test statistic. Statistics and Science: A Festschrift for Terry Speed. London, United Kingdom: Institute of Mathematical Statistics, 115–126.
Peat J , Barton B , 2014. Medical Statistics: A Guide to SPSS, Data Analysis and Critical Appraisal, 2nd edition. Malden, MA: Wiley Blackwell.
UNICEF and WHO , 2021. The WHO/UNICEF Joint Monitoring Program (JMP)-Bangladesh Country Profile. Available at: https://washdata.org/data/household#!/. Accessed December 5, 2021.
icddr,b and Water Aid, 2014. Bangladesh National Hygiene Baseline Survey Preliminary Report. Dhaka, Bangladesh: icddr,b.
Bangladesh Bureau of Statistics (BBS) and UNICEF Bangladesh , 2019. Progotir Pathey, Multiple Indicator Cluster Survey 2019, Survey Findings Report. Dhaka, Bangladesh: BBS.
World Health Organization , 2017. Diarrhoeal Disease. Geneva, Switzerland: WHO. Available at: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease. Accessed April 2, 2021.
UNICEF/WHO , 2018. Drinking Water, Sanitation and Hygiene in Schools: Global Baseline Report 2018. Available at: https://data.unicef.org/resources/wash-in-schools/. Accessed August 2, 2021.
Dey N , Parvez M , Mistry S , Levine D , 2019. Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: evidence from a repeated cross-sectional study (2007–2015) in rural Bangladesh. Int J Hyg Environ Health 222: 1098–1108.
Getahun W , Adane M , 2021. Prevalence of acute diarrhea and water, sanitation, and hygiene (WASH) associated factors among children under five in Woldia Town, Amhara Region, northeastern Ethiopia. BMC Pediatr 227: 21.
Natnael T , Lingerew M , Adane M , 2021. Prevalence of acute diarrhea and associated factors among children under five in semi-urban areas of northeastern Ethiopia. BMC Pediatr 21: 290.
Contzen N , de Pasquale S , Mosler H-J , 2015. Over-reporting in handwashing self-reports: potential explanatory factors and alternative measurements. PLoS One 10: e0136445.
Ram PK et al.2010. Is structured observation a valid technique to measure handwashing behavior? Use of acceleration sensors embedded in soap to assess reactivity to structured observation. Am J Trop Med Hyg 83: 1070–1076.
Markovitz AR , Goldstick JE , Levy K , Cevallos W , Mukherjee B , Trostle JA , Eisenberg JNS , 2012. Where science meets policy: comparing longitudinal and cross-sectional designs to address diarrhoeal disease burden in the developing world. Int J Epidemiol 41: 504–513.
Carlton EJ , Eisenberg JNS , Goldstick J , Cevallos W , Trostle J , Levy K , 2014. Heavy rainfall events and diarrhea incidence: the role of social and environmental factors. Am J Epidemiol 179: 344–352.
Mukabutera A , Thomson D , Murray M , Basinga P , Nyirazinyoye L , Atwood S , Savage KP , Ngirimana A , Hedt-Gauthier BL , 2016. Rainfall variation and child health: effect of rainfall on diarrhea among under 5 children in Rwanda, 2010. BMC Public Health 16: 731.
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Basic sanitation, safe drinking water, and proper hygiene practice may lessen the burden of waterborne illnesses and neglected tropical diseases. The current study sought, for the first time, to evaluate household water, sanitation, and hygiene (WASH) practices and acute diarrhea among children under 5 years of age and their associated factors on St. Martin’s Island. Two hundred one households with at least one child aged under 5 years were interviewed using a pretested semi-structured questionnaire designed according to UNICEF/WHO Joint Monitoring Program for Water Supply, Sanitation, and Hygiene 2019 and on-the-spot observations. Multiple logistic regression analyses investigated the association between potential sociodemographic characteristics, WASH components, and acute diarrhea. Almost all sampled households (99.5%) had improved drinking water facilities. More than one-third (36.5%) did not have an improved sanitation facility, and open defecation was reported by 12.4% of study subjects. Only one-third of respondents reported washing their hands with soap or detergent after defecation, and approximately 29% of respondents reported sharing their toilet with other family members. A handwashing station with soap and water was observed in only 14.4% of cases, whereas more than 22% had none. More than one-quarter (26.4%) of children aged under 5 years were reported to experience acute diarrhea. Access to WASH facilities and the occurrence of acute diarrhea were found to be associated with a set of demographic and socioeconomic characteristics. Sanitation facilities are limited and inappropriate WASH practices are prevalent in the studied population with linkage to diarrhea in children; therefore, urgent attention is needed to improve WASH facilities and encourage health-promoting WASH behavior in St. Martin’s Island population.
Disclosure: The datasets used and/or analyzed are kept confidential for future work and hence cannot be made public but are available from the corresponding author on reasonable request.
Authors’ addresses: Md. Hafizul Islam, Abira Nowar, and Saiful Islam, Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com.