CHILD DEFECATION BEHAVIOR, STOOL DISPOSAL PRACTICES, AND CHILDHOOD DIARRHEA IN BURKINA-FASO - RESULTS FROM A CASE-CONTROL STUDY

Objective - To investigate the association between where young childre n defecate, where stools are disposed of, and the presence of human st ools on the ground in the compound and the rate of hospital admission with diarrhoea. Design - This was a case-control study with two contro l groups. Setting - The study took place in Bobo-Dioulasso, the second city of Burkina Faso in West Africa. Participants - Three groups of c hildren aged 36 months and under, and living in Bobo-Dioulasso were st udied. Cases were 757 children admitted to hospital with symptoms of d iarrhoea or dysentery. The First control group comprised 757 neighbour hood control children approximately matched on age and date of recruit ment, and the second, 631 children admitted to the same hospital witho ut symptoms of diarrhoea or dysentery. Main results - There was no evi dence of any association between where the child was reported to defec ate and hospital admission with diarrhoea or dysentery (odds ratio = 1 .10; 95% confidence interval (CI) 0.78, 1.57, cases v neighbourhood co ntrols; odds ratio = 0.84; 95% CI 0.60, 1.18, cases v hospital control s). There was evidence of an association between where the mother repo rted disposing of the child's stools and hospital admission with diarr hoea or dysentery (odds ratio = 1.50; 95% CI 1.09, 2.06, cases v neigh bourhood controls; odds ratio = 1.31; 95% CI 0.96, 1.79, cases v hospi tal controls). Human stools were more frequently observed in the yards of cases than controls (odds ratio = 1.38; 95% CI 0.98, 1.95, cases c ompared with neighbourhood controls; odds ratio = 1.33; 95% CI 0.96, 1 .84, cases compared with hospital controls). Conclusions - The finding s suggest that it is not where the child defecates that matters but ho w the mother then deals with the child's stools.