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Environmental determinants of acute respiratory symptoms and diarrhoea in young coloured children living in urban and peri-urban areas of South Africa
Abstract
The impact of environmental risk factors associated with housing was examined in relation to diarrhoeal disease and acute respiratory symptoms in South African coloured children. A multistage cluster sample representative of all coloured people living in the major urban and peri-urban areas of South Africa was used for the study. Interviews were conducted with respondents from 1 227 households. Overall, 8,5% children under 5 years were reported to have had diarrhoea, while 29% had experienced coughing and breathing problems in a 2-week recall period. Individual risk factors identified using the odds ratios (ORs) for diarrhoea included not having an inside tap or a flush toilet in the homes (both yielded an OR of 3,3), not owning a refuse receptacle (OR = 2,5), not being connected to an electricity supply (OR = 2,5), low household income (OR = 1,8), more than 2 people per room (OR = 2,0) and less than Standard 5 maternal education (OR = 1,6). Absence of an inside toilet, not having a refuse receptacle and overcrowding all remained as independent risk factors after logistic regression analyses. Multiple logistic regression analyses revealed that not having a refuse receptacle and the absence of electricity for heating purposes were independently associated with respiratory symptoms. The overall preventive potentials for respiratory symptoms were significantly less than those for diarrhoea. Improving physical access to essential environmental health services in urban areas and improvements in the educational status of women are urgently needed if childhood infections are to be prevented.
