Prediction of Child Health by Household Density and Asset-Based Indices in Impoverished Indigenous Villages in Rural Panamá

Carli M. Halpenny Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Panamá City, Panamá

Search for other papers by Carli M. Halpenny in
Current site
Google Scholar
PubMed
Close
,
Kristine G. Koski Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Panamá City, Panamá

Search for other papers by Kristine G. Koski in
Current site
Google Scholar
PubMed
Close
,
Victoria E. Valdés Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Panamá City, Panamá

Search for other papers by Victoria E. Valdés in
Current site
Google Scholar
PubMed
Close
, and
Marilyn E. Scott Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada; Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Panamá City, Panamá

Search for other papers by Marilyn E. Scott in
Current site
Google Scholar
PubMed
Close
Restricted access

Chronic infection over a 16-month period and stunting of preschool children were compared between more spatially dense versus dispersed households in rural Panamá. Chronic protozoan infection was associated with higher household density, lower household wealth index, poor household water quality, yard defecation, and the practice of not washing hands with soap before eating. Models for chronic diarrhea confirmed the importance of household wealth, water quality, sanitation, and hygiene practices. Furthermore, chronic protozoan infection was an important predictor for low height-for-age, along with low household wealth index scores, but not household density. Thus, despite better access to health related infrastructure in the more densely populated households, chronic protozoan infection was more common, and was associated with higher rates of child stunting, compared with more dispersed households.

Author Notes

*Address correspondence to Carli M. Halpenny, Institute of Parasitology and McGill School of Environment, Macdonald Campus of McGill University, 21,111 Lakeshore Road, Ste-Anne de Bellevue, Quebec H9X 3V9, Canada. E-mail: carli.halpenny@mail.mcgill.ca

Financial support: This study was supported by the Canadian International Development Research Centre, the Natural Science and Engineering Research Council of Canada, and the Secretaría Nacional de Ciencia, Tecnología e Innovación of Panamá. Research at the Institute of Parasitology is supported by a regroupement stratégique from the Fonds Québecois pour la Recherche sur la Nature et les Technologies.

Authors’ addresses: Carli M. Halpenny and Marilyn E. Scott, Institute of Parasitology and McGill School of Environment, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada, E-mails: carli.halpenny@mail.mcgill.ca and marilyn.scott@mcgill.ca. Kristine G. Koski, School of Dietetics and Human Nutrition, Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada, E-mail: kris.koski@mcgill.ca. Victoria E. Valdés, Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Panamá, City, Panamá, E-mail: victoriavalds@gmail.com.

  • 1.

    Nations United, 2009. Rethinking Poverty: Report on the World Social Situation 2010. Geneva: United Nations.

  • 2.

    Fiszbein A, Schady N, 2009. Conditional Cash Transfers: Reducing Present and Future Poverty. Washington, DC: World Bank.

  • 3.

    Khandker SR, Bakht Z, Koolwal GB, 2009. The poverty impact of rural roads: evidence from Bangladesh. Econ Dev Cult Change 57: 685722.

  • 4.

    Reardon T, Berdegué J, Escobar G, 2001. Rural nonfarm employment and incomes in Latin America: overview and policy implications. World Dev 29: 395409.

  • 5.

    Escobal J, Ponce C, 2004. The Benefits of Rural Roads: Enhancing Income Opportunities for the Rural Poor. Lima, Peru: Grupo de Análisis para el Desarrollo (GRADE).

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Brenneman A, Kerf M, 2002. Infrastructure and Poverty Linkages: A Literature Review. Washington, DC: The World Bank.

  • 7.

    Ombok M, Adazu K, Odhiambo F, Bayoh N, Kiriinya R, Slutsker L, Hamel MJ, Williamson J, Hightower A, Laserson KF, Feikin DR, 2010. Geospatial distribution and determinants of child mortality in rural western Kenya 2002–2005. Trop Med Int Health 15: 423433.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Denno D, 2011. Global child health. Pediatr Rev 32: e25e38.

  • 9.

    Agee MD, 2010. Reducing child malnutrition in Nigeria: combined effects of income growth and provision of information about mothers' access to health care services. Soc Sci Med 71: 19731980.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Bartram J, Cairncross S, 2010. Hygiene, sanitation, and water: forgotten foundations of health. PLoS Med 7: e1000367.

  • 11.

    Jenkins MW, Curtis V, 2005. Achieving the ‘good life’: why some people want latrines in rural Benin. Soc Sci Med 61: 24462459.

  • 12.

    Jenkins MW, Cairncross S, 2010. Modelling latrine diffusion in Benin: towards a community typology of demand for improved sanitation in developing countries. J Water Health 8: 166183.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hunter PR, MacDonald AM, Carter RC, 2010. Water supply and health. PLoS Med 7: e1000361.

  • 14.

    Luque Fernández MA, Mason PR, Gray H, Bauernfeind A, Fesselet JF, Maes P, 2010. Descriptive spatial analysis of the cholera epidemic 2008–2009 in Harare, Zimbabwe: a secondary data analysis. Trans R Soc Trop Med Hyg 105: 3845.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ferrari MJ, Djibo A, Grais RF, Bharti N, Grenfell BT, Bjornstad ON, 2010. Rural-urban gradient in seasonal forcing of measles transmission in Niger. Proc Biol Sci 277: 27752782.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Younas M, Shah S, Talaat A, 2008. Frequency of Giardia lamblia infection in children with recurrent abdominal pain. J Pak Med Assoc 58: 171174.

  • 17.

    Chacín-Bonilla L, Barrios F, Sanchez Y, 2008. Environmental risk factors for Cryptosporidium infection in an island from western Venezuela. Mem Inst Oswaldo Cruz 103: 4549.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Bates SJ, Trostle J, Cevallos WT, Hubbard A, Eisenberg JNS, 2007. Relating diarrheal disease to social networks and the geographic configuration of communities in rural Ecuador. Am J Epidemiol 166: 10881095.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Milroy CA, Borja PC, Barros FR, Barreto ML, 2001. Evaluating sanitary quality and classifying urban sectors according to environmental conditions. Environ Urban 13: 235255.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Garenne M, 2010. Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa. Arch Child Dis 95: 464468.

  • 21.

    Lutter CK, Chaparro CM, 2008. Malnutrition in Infants and Young Children in Latin America and the Caribbean: Achieving the Millenium Development Goals. Washington, DC: Pan American Health Organization.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Golden MH, 1996. Specific deficiencies versus growth failure: type I and type II. J Nutr Environ Med 6: 301.

  • 23.

    Falkingham J, Namazie C, 2002. Measuring Health and Poverty: A Review of Approaches to Identifying the Poor. London: United Kingdom Department for International Development.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data - or tears: an application to educational enrollments in states of India. Demography 38: 115132.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Rutstein S, Johnson K, 2004. The DHS Wealth Index. Calverton, MD: ORC Macro, MEASURE DHS+.

  • 26.

    Ministerio de Economía y Finanzas, 2003. Encuesta de Niveles de Vida 2003. Panama City, Panama: Ministerio de Economía y Finanzas.

  • 27.

    Payne L, Koski KG, Ortega-Barria E, Scott ME, 2007. Benefit of vitamin A supplementation on Ascaris re-infection is less evident in stunted children. J Nutr 137: 14551459.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Ministerio de Economía y Finanzas, 2010. La Distribución del Ingreso en Los Hogares de Panamá: Encuesta de Niveles de Vida 2008. Panama City, Panama: Ministerio de Economía y Finanzas.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    World Health Organization (WHO), 2006. WHO Child Growth Standards: Methods and Development: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age. Geneva: WHO Multicentre Growth Reference Study Group, World Health Organization.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Hamilton WP, Kim M, Thackston EL, 2005. Comparison of commercially available Escherichia coli enumeration tests: implications for attaining water quality standards. Water Res 39: 48694878.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    World Bank, 1999. Panama Poverty Assessment: Priorities and Strategies for Poverty Reduction. Washington, DC: Human Development Department, World Bank.

  • 32.

    UNICEF, 2008. The State of the World's Children 2009: Maternal and Newborn Health. New York: UNICEF.

  • 33.

    Victora CG, 1992. The association between wasting and stunting: an international perspective. J Nutr 122: 11051110.

  • 34.

    Fotso JC, Kuate-Defo B, 2005. Socioeconomic inequalities in early childhood malnutrition and morbidity: modification of the household-level effects by the community SES. Health Place 11: 205225.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    World Health Organization (WHO), 2008. Guidelines for Drinking Water Quality. Geneva: World Health Organization.

  • 36.

    Bateman OM, Smith S, 1991. A Comparison of the Health Effects of Water Supply and Sanitation in Urban and Rural Guatemala. Washington, DC: U.S. Agency for International Development.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Van De Poel E, Hosseinpoor AR, Speybroeck N, Van Ourti T, Vega J, 2008. Socioeconomic inequality in malnutrition in developing countries. Bull World Health Organ 86 282291.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Hong R, Mishra V, 2006. Effect of wealth inequality on chronic under-nutrition in Cambodian children. J Health Popul Nutr 24: 8999.

  • 39.

    Raso G, Utzinger J, Silué KD, Ouattara M, Yapi A, Toty A, Matthys B, Vounatsou P, Tanner M, N’Goran EK, 2005. Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d’Ivoire. Trop Med Int Health 10: 4257.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Nundy S, Gilman RH, Xiao L, Cabrera L, Cama R, Ortega YR, Kahn G, Cama VA, 2011. Wealth and its associations with enteric parasitic infections in a low-income community in Peru: use of principal component analysis. Am J Trop Med Hyg 84: 3842.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Gwatkin D, Wagstaff A, Yazbeck A, 2005. Reaching the Poor with Health Nutrition and Population Services: What Works, What Doesn't and Why. Washington, DC: World Bank.

  • 42.

    Adekanmbi VT, Kayode GA, Uthman OA, 2011. Individual and contextual factors associated with childhood stunting in Nigeria: a multilevel analysis. Matern Child Nutr doi: 10.1111/j.1740-8709.2011.00361.x.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera JMaternal and Child Undernutrition Study Group, 2008. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371: 243260.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Sackey ME, Weigel MM, Armijos RX, 2003. Predictors and nutritional consequences of intestinal parasitic infections in rural Ecuadorian children. J Trop Pediatr 49: 1723.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Boeke CE, Mora-Plazas M, Forero Y, Villamor E, 2010. Intestinal protozoan infections in relation to nutritional status and gastrointestinal morbidity in Colombian school children. J Trop Pediatr 56: 299306.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Simsek Z, Zeyrek FY, Kurcer MA, 2004. Effect of Giardia infection on growth and psychomotor development of children aged 0–5 years. J Trop Pediatr 50: 9093.

  • 47.

    Thapar N, Sanderson IR, 2004. Diarrhoea in children: an interface between developing and developed countries. Lancet 363: 641653.

  • 48.

    LeVine RA, Rowe ML, 2009. Maternal literacy and child health in less-developed countries: evidence, processes, and limitations. J Dev Behav Pediatr 30: 340349.

  • 49.

    Boyle MH, Racine Y, Georgiades K, Snelling D, Hong S, Omariba W, Hurley P, Rao-Melacini P, 2006. The influence of economic development level, household wealth and maternal education on child health in the developing world. Soc Sci Med 63: 22422254.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Haidar J, Kogi-Makau W, 2009. Gender differences in the household-headship and nutritional status of pre-school children. East Afr Med J 86 6973.

  • 51.

    McIntyre L, Rondeau K, Kirkpatrick S, Hatfield J, Islam KS, Huda SN, 2011. Food provisioning experiences of ultra poor female heads of household living in Bangladesh. Soc Sci Med 72: 969976.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Genser B, Strina A, Teles CA, Prado MS, Barreto ML, 2006. Risk factors for childhood diarrhea incidence: dynamic analysis of a longitudinal study. Epidemiology 17: 658667.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Silva RR, da Silva CAM, de Jesus Pereira CA, de Carvalho Nicolato RL, Negrão-Corrêa D, Lamounier JA, Carneiro M, 2009. Association between nutritional status, environmental and socio-economic factors and Giardia lamblia infections among children aged 6–71 months in Brazil. Trans R Soc Trop Med Hyg 103: 512519.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Teixeira JC, Heller L, Barreto ML, 2007. Giardia duodenalis infection: risk factors for children living in sub-standard settlements in Brazil. Cad Saude Publica 23: 14891493.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Lanata C, Huttly SRA, Yeager BAC, 1998. Diarrhea: whose feces matter? Reflections from studies in a Peruvian shanty town. Pediatr Infect Dis J 17: 79.

  • 56.

    Quihui L, Valencia ME, Crompton DW, Phillips S, Hagan P, Morales G, Diaz-Camacho SP, 2006. Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren. BMC Public Health 6: 225.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Mara D, Lane J, Scott B, Trouba D, 2010. Sanitation and health. PLoS Med 7: e1000363.

  • 58.

    Rinne S, Rodas EJ, Galer-Unti R, Glickman N, Glickman LT, 2005. Prevalence and risk factors for protozoan and nematode infections among children in an Ecuadorian highland community. Trans R Soc Trop Med Hyg 99: 585592.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 59.

    Hussein AS, 2011. Prevalence of intestinal parasites among school children in northern districts of West Bank-Palestine. Trop Med Int Health 16: 240244.

  • 60.

    Curtis V, Cairncross S, 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect Dis 3: 275281.

  • 61.

    Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM Jr, 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 4252.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 340 209 11
Full Text Views 1548 1 0
PDF Downloads 97 3 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save