MATERNAL BEHAVIORAL RISK-FACTORS FOR SEVERE CHILDHOOD DIARRHEAL DISEASE IN KINSHASA, ZAIRE

This study examines the relationship between severe diarrhoeal disease and maternal knowledge and behaviours related to hygiene and sanitati on. Some 107 paediatric cases admitted to two hospitals in Kinshasa, Z aire in 1988 were matched on age and nearest-neighbour status to 107 c ontrols. Personal interviews and observational methods were used to as sess knowledge and behaviours related to hygiene and sanitation. Cases and controls had equivalent socioeconomic status, demographic profile s and access to water and sanitation facilities. However, cases genera lly exhibited lower levels of knowledge and less sanguine sanitary pra ctices than did controls. Of particular interest was the finding that very specific behavioural items distinguished cases from controls. The disposal of the child faeces and household garbage and mother's knowl edge that poor caretaker cleanliness was a cause of diarrhoea in child ren showed the strongest associations with risk of diarrhoea. There wa s an exponential relationship between the number of these items a moth er answered incorrectly and the odds of diarrhoeal disease. The risk a ttributable to these three variables was as high as 70%. These finding s provide further support for the view that focused educational interv entions may have a substantial impact on the occurrence of severe diar rhoeal disease in low-income countries.