The complementary effect of latrines and increased water usage on the growth of infants in rural Lesotho

Abstract

The effects of water quantity and sanitation, alone and in combination with each other, on infant weight gain and length gain were examined. Data on 119 infants were collected from 20 villages in rural Lesotho between July 1984 and January 1985. The interactions between sanitation and increased water usage for weight gain (p = 0.007) and length gain (p = 0.006) were significant after potential confounding was controlled. The biggest growth effects were dependent on families possessing a latrine and increasing their use of water during the warm, wet season. Infants gained 1.031 kg (95% confidence interval (CI) 0.420 to 1.642) and 2.028 cm (95% CI 0.523 to 3.533) more when both positive factors were present, as compared with only having a latrine. Increasing water usage compared with not increasing water usage resulted in only 0.105 kg (95% CI -0.175 to 0.385) more weight gain and -0.309 cm (95% CI -1.005 to 0.387) more length in the absence of a latrine. Similarly, infants gained 1.106 kg (95% CI 0.484 to 1.728) and 2.076 cm (95% CI 0.559 to 3.593) more if both factors were operating than did infants whose families only increased their water usage. In the nonincreased water group, the difference in growth between having and not having a latrine was 0.180 kg (95% CI -0.093 to 0.453) and -0.261 cm (95% CI -0.951 to 0.429). Water supply programs should emphasize use of more water for personal hygiene, and sanitation programs should install toilet facilities where water usage is high or has been increased because of an educational program.

PIP: Researchers analyzed data on 119 infants who lived in 20 villages in Lesotho from a 6 month period in 1984-1985 to evaluate the effect of latrines and increased water use on growth. 62% of the infants lived in families that did not have a latrine and did not increase water use between the 2 seasons. Only 3% increased water use and had a latrine. 19% had a latrine, but did not increase water use. 16% increased water use, but did not have a latrine. Infants from a family with a latrine which increased water use gained 1.031 kg more than those infants with a latrine but no increased water use (p=.0007). Among infants who did not have a latrine, the effect of not increasing water use was a meager 0.105 kg. Infants from a family with increased water use and a latrine gained 1.031 kg more than those who did not have a latrine (p=.0007). Among children whose families did not increase water use, the difference between having a latrine and not having a latrine was only 0.18 kg. Infants from a family which increased water use and had a latrine grew 2.076 cm more than those infants in a family which increased water use and did not have a latrine (p=.0007). Among infants who did not have a latrine, the effect of not increasing water use was a meager 0.261 cm. Infants from a family with a latrine and increased water use grew 2.2w028 cm more than infants with latrine but did not increase water use (p=.007). Among children whose families did not increase water use, the difference between having a latrine and not having a latrine was only 0.309 cm. These results demonstrated the complementary effect of latrines and increased water use which may have prevented pathogens from contaminating the environment and the quantity of pathogens ingested.