Spatial Distribution and Interaction between Diarrheal Disease and Food Insecurity in Haydom, Tanzania Open Access

Bowlen, Brenna (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/r494vm67x?locale=en
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Abstract

Background: Food insecurity and diarrheal disease in young children are inextricably linked. It is hypothesized that acute hunger and nutritional deficiencies propagated by periods of food insecurity prior to harvest in rural agricultural communities lead to increased diarrheal infectious disease prevalence.

 

Methods: We sought to quantify the relationship between food insecurity and symptomatic diarrheal disease prevalence during the hunger season in the Manyara Region of Tanzania. The sampling region was divided into 7 wards within a 20km radius from the Haydom Lutheran Hospital. 72,699 eligible quantitative survey responses from the Health and Demographic Surveillance Survey (HDSS) were analyzed. 11,412 observations were for children aged 12-59 months old. Diarrhea prevalence was reported as a dichotomous variable and food insecurity on a scale ranging from not enough to feed everyone in the household to more than enough to feed everyone in the household. Binary logistic regression methods were used to quantify the effect of food insecurity prior and post-harvest on diarrhea prevalence in children under 5, adjusted for age, sex, tribal affiliation, household size, and ward. All analyses were conducted in R version 4.3.1.

 

Results: Diarrhea period prevalence over the 7-day recall period was 1.68% for children under 5 years, increased from the overall 0.83% period prevalence estimate including adults and decreased from the infant (0-11 mo.) period prevalence estimate of 1.85%. Diarrhea period prevalence among children under 5 ranged from 1.05-1.89% between the 7 administrative wards. Food insecurity was more prevalent among the under 5 study population prior to harvest (22.1%) than afterwards (11.5%), as expected. Food insecurity prevalence varied by ward. The Maghang and Endimilay wards maintained the highest levels of food insecurity throughout the collection period. Adjusted ORs indicate food insecurity was associated with diarrheal disease prevalence prior to harvest (OR: 1.19; 95% CI: (0.84, 1.67)), but less so after harvest (OR: 0.99; 95% CI: (0.63, 1.55)).

 

Conclusions: Hunger seasons result in augmented food insecurity prevalence in the Manyara Region of Tanzania. We have reason to conclude there is an association between household food insecurity and diarrhea prevalence among children under 5, with a stronger association noted pre-harvest.

Table of Contents

Abstract

Background

Methods

Results

Discussion

Conclusions

References

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