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Water, sanitation and hygiene practices and its impact on infectious diseases and under-nutrition among children below five years of age in low income countries

Review Paper | March 1, 2018

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Hoyce Amini Mshida, Neema Kassim, Emmanuel Mpolya, Martin Epafras Kimanya

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J. Bio. Env. Sci.12( 3), 378-391, March 2018


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Under-nutrition among children aged below five years continuous to be a major public health threat despite numerous nutrition interventions taking place in low income countries. In 2016, about 23% of under-five children were stunted worldwide. Essentially, nutrition interventions have gained much attention although it can address only 20% of stunting in this age group. The awareness that the problem cannot solely be eliminated through optimization of diets has led to the theory that infectious diseases have potential impact to the problem and need attention as well. These diseases emanate from poor water, sanitation and hygiene practices and may affect the nutritional status of under-five children through different ways; may lead to malabsorption, poor villi function, leaking of mucosa, inflammation of the gut and even compromised immune system. Worms for example tend to compete for nutrients with the child. Furthermore, costs incurred for treating infections could affect food budget of the family. Also, when a child falls sick, whatever little food is taken is used for body recovery rather than growth. It is therefore, important to critically conceptualize the relationship between these risk factors for child mortality and morbidity and propose solutions through which such problems could be eliminated. This review paper therefore, suggests incooperating WASH interventions to nutrition and disease prevention interventions to address the problem of under-nutrition and infectious diseases among children below five years of age in developing countries and finally reduce child mortality.


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Water, sanitation and hygiene practices and its impact on infectious diseases and under-nutrition among children below five years of age in low income countries

Asudi AA. 2016. Effectiveness Of Water, Sanitation And Hygiene Interventions In Changing Mothers’ Behaviour And Improving Child Health: A Case Study Of Kamukunji Sub County, Nairobi County. University Of Nairobi.

Bado AR, Susuman AS, Nebie EI. 2016. Trends and risk factors for childhood diarrhea in sub-Saharan countries (1990–2013): assessing the neighborhood inequalities. Global health action 9.

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

Bloss E, Wainaina F, Bailey RC. 2004. Prevalence and predictors of underweight, stunting, and wasting among children aged 5 and under in western Kenya. Journal of tropical pediatrics 50, 260-270.

Bowen PA, Jessica Hillyard, Kari Hartwig, Sarah Langford and Mike Harvey, Susan James. 2010. The Whole Village Project Village Reports for Elerai, Eworendeke, Kimoukuwa, Tingatinga, Kiserian, Sinya, and Kitendeni in Longido District. Available: wholevillage.umn.edu/documents/Longido.pdf 2011.

Brown J, Cairncross S, Ensink JH. 2013. Water, sanitation, hygiene and enteric infections in children. Archives of disease in childhood, archdischild-2011-301528.

Burton MJ, Rajak SN, Hu VH, Ramadhani A, Habtamu E, Massae P, Tadesse Z, Callahan K, Emerson PM, Khaw PT. 2015. Pathogenesis of progressive scarring trachoma in Ethiopia and Tanzania and its implications for disease control: two cohort studies. PLoS Negl Trop Dis 9, e0003763.

Cairncross JBS. 2010a. Hygiene Sanitation and Water; Forgotten foundations of Health. PLoS Med 7.

Cairncross S, Hunt C, Boisson S, Bostoen K, Curtis V, Fung IC, Schmidt WP. 2010b. Water, sanitation and hygiene for the prevention of diarrhoea. International journal of Epidemiology 39, i193-i205.

Chambers R, Von Medeazza G. 2013. Sanitation and stunting in India. Economic & Political Weekly, 48, 15.

Chase C, Ngure F. 2016. Multisectoral Approaches to Improving Nutrition: Water, Sanitation, and Hygiene. Available at http://www.worldbank.org.

Checkley W, Buckley G, Gilman RH, Assis AM, Guerrant RL, Morris SS, Mølbak K, Valentiner-Branth P, Lanata CF, Black RE. 2008. Multi-country analysis of the effects of diarrhoea on childhood stunting. International journal of epidemiology 37, 816-830.

Checkley W, Gilman RH, Black RE, Epstein LD, Cabrera L, Sterling CR Moulton LH. 2004. Effect of water and sanitation on childhood health in a poor Peruvian peri-urban community. The Lancet 363, 112-118.

Chege PM, Kimiywe JO, Ndungu ZW. 2015. Influence of culture on dietary practices of children under five years among Maasai pastoralists in Kajiado, Kenya. International Journal of Behavioral Nutrition and Physical Activity 12, 1.

Chirande L, Charwe D, Mbwana H, Victor R, Kimboka S, Issaka AI, Baines SK, Dibley MJ, Agho KE. 2015. Determinants of stunting and severe stunting among under-fives in Tanzania: evidence from the 2010 cross-sectional household survey. BMC pediatrics 15, 1.

Conroy RM, Elmore-Meegan M, Joyce T, Mcguigan KG, Barnes J. 1996. Solar disinfection of drinking water and diarrhoea in Maasai children: a controlled field trial. The Lancet 348, 1695-1697.

Conroy RM, Meegan ME, Joyce T, Mcguigan K, Barnes J. 1999. Solar disinfection of water reduces diarrhoeal disease: an update. Archives of disease in childhood 81, 337-338.

Cravioto J, Delicardie ER. 1979. Nutrition, mental development and learning. Human growth. Springer.

Cumming O, Ensink J, Freeman M, Jenkins M. 201. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India.

Curtis V, Cairncross S. 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. The Lancet infectious diseases 3, 275-281.

Curtis VA, Danquah LO, Aunger RV. 2000. Planned, motivated and habitual hygiene behaviour: an eleven country review. Health education research 24, 655-673.

Dangour AD, Watson L, Cumming O, Boisson S, Che Y, Velleman Y, Cavill S, Allen E, Uauy R. 2013. Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children. The Cochrane Library.

Devoto F, Duflo E, Dupas P, Parienté W, Pons V. 2012. Happiness on tap: piped water adoption in urban Morocco. American Economic Journal: Economic Policy 4, 68-99.

Dewey KG, Mayers DR. 2011. Early child growth: how do nutrition and infection interact? Maternal & child nutrition 7, 129-142.

Diouf K, Tabatabai P, Rudolph J, Marx M. 2014. Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level. Global health action 7.

Doocy S, Burnham G. 2006. Point‐of‐use water treatment and diarrhoea reduction in the emergency context: an effectiveness trial in Liberia. Tropical medicine & international health 11, 1542-1552.

Esrey SA. 1996. Water, waste, and well-being: a multicountry study. American journal of epidemiology, 143, 608-623.

Fawzy A, Arpadi S, Kankasa C, Sinkala M, Mwiya M, Thea DM, Aldrovandi GM, Kuhn L. 2011. Early weaning increases diarrhea morbidity and mortality among uninfected children born to HIV-infected mothers in Zambia. Journal of Infectious Diseases 203, 1222-1230.

Feachem R, Mara DD, Bradley DJ. 1983. Sanitation and disease, John Wiley & Sons Washington DC, USA.

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 nutrition 15, 1746-1754.

Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM. 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. The Lancet infectious diseases 5, 42-52.

Freeman MC, Stocks ME, Cumming O, Jeandron A, Higgins J, Wolf J, PrüssUstün A, Bonjour S, Hunter PR, Fewtrell L. 2014. Systematic review: hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine & International Health 19, 906-916.

Gascon J, Vargas M, Schellenberg D, Urassa H, Casals C, Kahigwa E, Aponte J, Mshinda H, Vila J. 2000. Diarrhea in children under 5 years of age from Ifakara, Tanzania: a case-control study. Journal of clinical microbiology 38, 4459-4462.

Gautam OP. 2015. Food hygiene intervention to improve food hygiene behaviours, and reduce food contamination in Nepal: an exploratory trial. London School of Hygiene & Tropical Medicine.

Gautam OPS, Sandy Cairncross, Sue Cavill, and Valerie Curtis. 2017. Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal. American Journal of Tropical Medicine and Hygiene 96(6), 2017, pp. 1415-1426.

Gautam OPWPS, Sandy Cairncross, Sue Cavill, Valerie Curtis. 2017. Trial of a Novel Intervention to Improve Multiple Food Hygiene Behaviors in Nepal. American Journal of Tropical Medicine and Hygiene 96(6), 2017, pp. 1415-1426.

Gilman RH, Skillicorn P. 1985. Boiling of drinking-water: can a fuel-scarce community afford it? Bulletin of the World Health Organization 63, 157.

Hamisi MMEM, Robert M, Adiel KM, Michael AM, Mwifadhi M, Kesheni PS, Jonathan MM, Jenester U, Tenu VMP. 2012. Scaling up Mtumba report-Water Aid. Available at www.wateraid.org.

Hilonga O. 2015. Water Nano filters from Gongali Madel. Available at www.pinterest.com.

Hong R, Banta JE, Betancourt JA. 2006. Relationship between household wealth inequality and chronic childhood under-nutrition in Bangladesh. International Journal for Equity in Health 5, 1.

Hotz C, Gibson R. 2005. Participatory nutrition education and adoption of new feeding practices are associated with improved adequacy of complementary diets among rural Malawian children: a pilot study. European journal of clinical nutrition 59, 226-237.

Humphrey JH. 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet, 374, 1032-1035.

James Hodge HHC, Sophie B, Simon MCRP, Thomas C. 2016. Assessing the Association between Thermotolerant Coliforms in Drinking Water and Diarrhea: An Analysis of Individual Level Data from Multiple Studies. Environmental Health Perspectives DOI: 10.1289/EHP156.

Joshi PC, Kaushal S, Aribam BS, Khattri P, D’aoust O, Singh MM, Marx M, Guha-Sapir D. 2011. Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India. Global health action 4.

Karambu S, Matiru V, Kiptoo M, Oundo J. 2013. Characterization and factors associated with diarrhoeal diseases caused by enteric bacterial pathogens among children aged five years and below attending Igembe District Hospital, Kenya. Pan African Medical Journal 16.

Koyanagi A, Humphrey JH, Moulton LH, Ntozini R, Mutasa K, Iliff P, Black RE. 2009. Effect of early exclusive breastfeeding on morbidity among infants born to HIV-negative mothers in Zimbabwe. The American journal of clinical nutrition 89, 1375-1382.

Kulwa K, Kinabo JL, Modest B. 2006. Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. Food & Nutrition Bulletin 27, 236-244.

Kumi-Kyereme A, Amo-Adjei J. 2015. Household wealth, residential status and the incidence of diarrhoea among children under-five years in Ghana. Journal of epidemiology and global health.

Lemons A. 2009. Maji Salama: Implementing Ceramic Water Filtration Technology in Arusha, Tanzania. MPH Candidate Thesis.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Almazroa MA, Amann M, Anderson HR, Andrews KG. 2013. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet 380, 2224-2260.

Lin A, Arnold BF, Afreen S, Goto R, Huda TMN, Haque R, Raqib R, Unicomb L, Ahmed T, Colford JM. 2013. Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh. The American journal of tropical medicine and hygiene 89, 130-137.

Lomazzi M, Borisch B, Laaser U. 2014. The Millennium Development Goals: experiences, achievements and what’s next. Global health action 7.

Luby SP, Agboatwalla, M, Painter J, Altaf A, Billhimer W, Keswick B, Hoekstra RM. 2006. Combining drinking water treatment and hand washing for diarrhoea prevention, a cluster randomised controlled trial. Tropical medicine & international health 11, 479-489.

Lunn P, Northrop-Clewes C, Downes R. 1991. Intestinal permeability, mucosal injury, and growth faltering in Gambian infants. The Lancet 338, 907-910.

Lyimo B, Buza J, Smith W, Subbiah M, Call DR. 2016. Surface waters in northern Tanzania harbor fecal coliform and antibiotic resistant Salmonella spp. capable of horizontal gene transfer. African Journal of Microbiology Research 10, 348-356.

Lyimo C, Shayo R, Lyimo TJ. 2007. Community Awareness on Microbial Water Pollution and Its Effects on Health Development in Urban Tanzania: A Case Study of Tabata and Kiwalani Wards in Ilala District in Dar es Salaam Region. Tanzania Journal of Development Studies 7, 103-114.

Madise NJ, Matthews Z, Margetts B. 1999. Heterogeneity of child nutritional status between households: A comparison of six sub-Saharan African countries. Population studies 53, 331-343.

Mamulwar MS, Rathod HK, Jethani S, Dhone A, Bakshi T, Lanjewar B, Jadhav S, Bhawalkar JS. 2014. Nutritional status of under-five children in urban slums of Pune. International Journal of Medicine and Public Health 4, 247.

Martorell R. 2010. Physical growth and development of the malnourished child: contributions from 50 years of research at INCAP. Food and nutrition bulletin 31, 68-82.

Michaelsen KF, Weaver L, Branca F, Robertson A. 2000. Feeding and Nutrition of Infants and Young Children: Guidelines for the WHO European Region, with Emphasis on the Former Soviet Countries. WHO Regional Publications, European Series No. 87, ERIC.

Morris SS, Cousens SN, Lanata CF, Kirkwood BR. 1994. Diarrhea defining the episode. International Journal of Epidemiology 23, 617-623.

Moshy VH, Masenge TJ, Bryceson I. 2013. Undernutrition among under-five children in two fishing communities in Mafia Island Marine Park, Tanzania. Journal of Sustainable Development 6, p1.

Mshida HA, Kassim N, Kimanya ME, Mpolya E. 2017. Influence of Water, Sanitation, and Hygiene Practices on Common Infections among Under-Five Children in Longido and Monduli Districts of Arusha, Tanzania. Journal of Environmental and Public Health 2017.

Muhimbula HS, Issa-Zacharia A. 2010. Persistent child malnutrition in Tanzania: Risks associated with traditional complementary foods (A review). African Journal of Food Science 4, 679-692.

Nestel P, Geissler C. 1986. Potential deficiencies of a pastoral diet: A case study of the Maasai. Ecology of Food and Nutrition 19, 1-10.

Ngure FM, Humphrey JH, Mbuya MN, Majo F, Mutasa K, Govha M, Mazarur, E, Chasekwa B, Prendergast AJ, Curtis V. 2013. Formative research on hygiene behaviors and geophagy among infants and young children and implications of exposure to fecal bacteria. The American journal of tropical medicine and hygiene 89, 709-716.

Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ. 2014. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. Annals of the New York Academy of Sciences 1308, 118-128.

Nuhu S, Mpambije CJ. 2016. Water and Sanitation Services in Informal Urban Settlements and their Implications to Peoples Health in Tandale, Dar es Salaam Tanzania. International Journal 64.

Nyaruhucha C, Mamiro P, Kerengi A, Shayo N. 2006. Nutritional status of underfive children in a pastoral community in Simanjiro District, Tanzania. Tanzania Journal of Health Research 8, 32-36.

Oluwafemi F, Ibeh IN. 2011. Microbial contamination of seven major weaning foods in Nigeria. Journal of Health, Population and Nutrition 415-419.

Pelletie DL, Frongillo Jr, EA, Schroeder DG, Habicht JP. 1995. The effects of malnutrition on child mortality in developing countries. Bulletin of the World Health Organization 73, 443.

Pickering AJ, Davis J. 2012. Freshwater availability and water fetching distance affect child health in sub-Saharan Africa. Environmental science & technology 46, 2391-2397.

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. The Lancet Global Health 3, e701-e711.

PrüssUstün A, Bartram J, Clasen T, Colford JM, Cumming O, Curtis V, Bonjour S, Dangour AD, De France J, Fewtrell L. 2014. Burden of disease from inadequate water, sanitation and hygiene in low‐and middle‐income settings: a retrospective analysis of data from 145 countries. Tropical Medicine & International Health 19, 894-905.

Prüss-Üstün A, Bos R, Gore F, Bartram J. 2008. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health, World Health Organization.

Rutstein SO, Staveteig S. 2014. Making the Demographic and Health Surveys wealth index comparable. Rockville: ICF International.

Safari JG, Masanyiwa ZS, Lwelamira JE. 2015. Prevalence and Factors Associated with Child Malnutrition in Nzega District, Rural Tanzania. Current Research Journal of Social Sciences 7, 94-100.

Schmidt CW. 2014. Beyond malnutrition: the role of sanitation in stunted growth. Environmental health perspectives 122, A298.

SDGs. 2015. Sustainable Development Goals (SDG). Government of Nepal National Planning Commission 2015.

Sharifzadeh G, Mehrjoofard H, Raghebi S. 2010. Prevalence of malnutrition in under 6-year Olds in South Khorasan, Iran. Iranian journal of pediatrics 20, 435.

Sheth M, Dwivedi R. 2006. Complementary foods associated diarrhea. The Indian Journal of Pediatrics 73, 61-64.

Shetty P. 2000. Malnutrition and obesity. NFI Bulletin 21, 6-8.

Sinharoy SS, Schmidt WP, Cox K, Clemence Z, Mfura L, Wendt R, Boisson S, CrossettE, Grépin K A, Jack W. 2016. Child diarrhoea and nutritional status in rural Rwanda: a cross‐sectional study to explore contributing environmental and demographic factors. Tropical Medicine & International Health.

Spears D. 2013. How much international variation in child height can sanitation explain? World bank policy research working paper.

Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. 2014. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med 11, e1001620.

Sunguya BF, Poudel KC, Mlunde LB, Urassa DP, Yasuoka J, Jimba M. 2014. Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training.

TDHS. 2011. Tanzania Demographic and Health Survey, 2010, National Bureau of Statistics.

TDHS. 2015. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHCDGEC, MoH, NBS, OCGS, and ICF.

Teshale SA, Fikadu1 ALD. 2014. Factors associated with stunting among children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: a case-control study. BMC Public Health 14, 800.

Thomas J, Holbro N, Young D. 2013. A review of sanitation and hygiene in Tanzania. DFID, London.

Too-Kong T. 2014. The Millennium Development Goals Report 2014. United Nations, New York.

Touré O, Coulibaly S, Arby A, Maiga F, Cairncross S. 2013. Piloting an intervention to improve microbiological food safety in Peri-Urban Mali. International journal of hygiene and environmental health 216, 138-145.

UNICEF. 2009a. Diarrhoea: why children are still dying and what can be done. www. unicef. org/media/files/Final_Diarrhoea_Report_October_2009_final. pdf.

UNICEF. 2009b. State of the world’s children. Available at www.unicef. org/sowc09/docs/ SOWC09-FullReport-EN. pdf, 38.

UNICEF. 2014. Statistical snapshot: Child Mortality.

UNICEF. 2015. Progress on Sanitation and Drinking Water-2015 Update and MDGs Assessment.

UNICEF. WHO, World Bank. 2013. Joint child malnutrition estimates-Levels and trends. New York.

USAID. 2015. WASH & NUTRITION: Water and Development Strategy Implementation Brief. USAID report.

Waage J, Banerji R, Campbell O, Chirwa E, Collender G, Dieltiens V, Dorward A, Godfrey-Faussett P, Hanvoravongchai P, Kingdon G. 2010a. The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015. The Lancet 376, 991-1023.

Waage J, Banerji R, Campbell O, Chirwa E, Collender G, Dieltiens V, Dorward A, Godfrey-Faussett P, Hanvoravongchai P, Kingdon G. 2010b. The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015: Lancet and London International Development Centre Commission. The Lancet 376, 991-1023.

Waddington H, Snilstveit B, White H, Fewtrell L. 2009a. Water, sanitation and hygiene interventions to combat childhood diarrhoea in developing countries. New Delhi: International Initiative for Impact Evaluation.

Waddington H, Snilstveit B, White H, Fewtrell L. 2009b. Water, sanitation and hygiene interventions to combat childhood diarrhoea in developing countries, International Initiative for Impact Evaluation New Delhi.

Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O’brien KL, Campbell H, Black RE. 2013. Global burden of childhood pneumonia and diarrhoea. The Lancet 381, 1405-1416.

Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA, Group ICDS. 2007. Child development: risk factors for adverse outcomes in developing countries. The lancet 369, 145-157.

Wamani H, Åstrøm AN, Peterson S, Tumwine JK, Tylleskär T. 2007. Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC pediatrics 7, 17.

Wamani H, Åstrøm AN, Peterson S, Tylleskär T, Tumwine JK. 2005. Infant and young child feeding in western Uganda: knowledge, practices and socio-economic correlates. Journal of tropical pediatrics 51, 356-361.

Weiss Guenter and Lawrence TG. 2005. “Anemia of Chronic Disease.” New England Journal of Medicine 352, 1011-23. DOI: http://dx.doi.org/10.1056/NEJMra041809.

Welfare MOHS. 2014. Tanzania National Nutrtition Survey. Dar es Salaam: Tanzania Food and Nutrition Centre.

WHO and UNICEF. 2015. Progress on sanitation and drinking water–2015 update and MDG assessment, WHO.

WHO. 2005. Global database on child growth and malnutrition. Geneva: World Health Organization; 2004. Nutrition Landscape Information System. Country profile.

WHO. 2015. Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment. Geneva: World Health Organization.

Woldt M, Moy GG, Egan R. 2015. Improving Household Food Hygiene in a Development Context.

Wollo E. 2005. Risk factors for child under-nutrition with a human rights edge in rural villages of North Wollo, Ethiopia. East African medical journal 82.

Zeleke T, Zewdie A, Alemu A. 2014. Determinants of under-five childhood diarrhea in Kotebe Health Center, Yeka Sub City, Addis Ababa, Ethiopia: a case control study. Global Journal of Medical Research 14.

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.