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Illusive Havens Part 3


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Image 1: Gidan Bege Orphanage in Benue, Nigeria
Source: https://www.facebook.com/Gidanbegehomemakurdi/photos/pcb.260105698111607/260105628111614/?type=3&theater

Are orphanages the safe havens most people assume them to be?

According to Atu & et al., it may be the case that orphanages have higher disease prevalence rates for protozoan infections compared to the global averages calculated for resource poor countries (Minetti & et al., 2016, Atu & et al., 2016). As a whole, diarrheal diseases are the second leading causes of death in children under the age of five, beating out AIDS, malaria, and measles. Unfortunately, these statistics aren’t well known by the international community and consequently, malaria ends up at the forefront of public health initiatives.

 Children ages five and under are the most susceptible age demographic and when compounded with poor hygiene conditions and malnutrition, can lead to devastating results. The disease burden of diarrhea is incredibly high, killing an average of 2,195 children every single day and accounts for 1 of 9 child deaths globally (CDC, 2015).

 Across the four orphanages (Children of Mary Orphanage and Motherless Babies Home in Otukpo, Gidan Bege Orphanage Home in Makurdi, Mama Abayol Children’s Home in Makurdi, and Nongu u Kristu ui Serusha Tar (N.K.S.T) Orphanage Home in Mkar) sampled by Atu & et al., various socio-economic factors such as age, gender, and water sources were used as independent variables in the epidemiological survey (Atu & et al., 2016). All four orphanages were located in the Benue State of Nigeria, the same region highlighted in my previous blog post. If you’re curious about the transmission pathway of Giardia protozoans or about the ethnic conflict in Benue, refer back to Illusive Havens Part 2!

After obtaining the necessary consent from the children, the researchers analyzed prevalence rates of Cryptosporidium parvum and Giardia lamblia in stool samples. Of the 128 sampled children from the four orphanages, 43.8% tested positive for a protozoan infection. Prevalence rates were compared to the use of private wells vs. water tanks and it was observed that children using water tanks had the lowest prevalence rate (39.2%) compared to those that used private wells (52.4%) or boreholes (40%).




Image 3: An example of a water tank
It may be that the private wells used by the orphanages were not well protected and vulnerable to waste contamination. Children who “sometimes” practiced hand-washing yielded a prevalence rate of 36.5%, compared to those that did not utilize any hand-washing facilities (49.1%) after using the restroom. The inherent conditions of the four orphanages differed, from the availability of hand-washing facilities to their water sources. In addition, knowledge of hygiene practices differed between orphanages. Some children were practicing incorrect hand-washing techniques such as lathering insufficiently or even skipping the soap.

Figure 1: Table highlighting the relationship between the source of water and prevalence of protozoa in children’s fecal matter
Source: Atu & et al., 2016
Figure 2: Table highlighting the relationship between gender and disease prevalence.
Source: Atu & et al., 2016

The results definitely speak to the unbreakable link between socio-economic factors such as clean water/sanitation and disease prevalence rates. Additionally, these results underscore the conclusions drawn in the previous blogpost that children are the most susceptible individuals when it comes to water, sanitation, and health. However, I am not quite sure what to make of the difference in prevalence rates between male and female children. My best guess is that male children have a higher chance of exposure to contaminated water sources and food due to differences in daily activities. I believe that further investigation is required throughout different regions of sub-Saharan Africa to understand the disparities that arise in disease prevalence rates amongst different age groups, gender, and socioeconomic conditions. However, one thing is clear - orphanages are not immune to communicable diseases and may actually harbor conditions that exacerbate infection rates.


References:

Atu, B.O., & et al. (2016). Effects of Socio-Economic Factors and Hygiene Habits on Diarrhoeal Agents in Orphanages in Benue State, Nigeria. Nigerian Journal of Microbiology, Vol. 30 Issue 2, 3389 - 3394.

CDC. (2015). Global Diarrhea Burden. https://www.cdc.gov/healthywater/global/diarrhea-burden.html.

Comments

  1. Richard taylorNovember 26, 2018 at 8:05 AM

    Another fascinating post that uncovers an issue not commonly reported.

    ReplyDelete

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