Assessing the Impact of Community-Led Sanitation Programs on Diarrheal Disease Incidence in Rural Punjab
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Childhood diarrhea remains associated with inadequate sanitation, unsafe feces disposal, and poor hygiene in rural Pakistan. Objective: To compare diarrheal incidence and related clinical outcomes among children younger than five years living in rural communities with and without active community-led sanitation programming. Methods: A longitudinal community-based cohort study enrolled 620 households, including 312 in sanitation-program communities and 308 in comparison communities. Baseline child, household, water, sanitation, and hygiene characteristics were recorded, and diarrheal episodes and healthcare outcomes were assessed during follow-up. Incidence was expressed per 100 child-months, and crude group comparisons were calculated from reported data. Results: Seventy-nine diarrheal episodes were recorded in sanitation-program communities and 141 in comparison communities. Reported incidence rates were 2.1 and 3.8 episodes per 100 child-months, respectively, corresponding to an approximate crude incidence-rate ratio of 0.55. Recurrent diarrhea occurred in 5.4% versus 12.7% of children, hospital visits in 7.1% versus 13.3%, intravenous fluid requirements in 3.5% versus 7.8%, and hospital admissions in 2.6% versus 5.5%. Conclusion: Community sanitation-program exposure was associated with lower recorded diarrheal incidence and reduced diarrhea-related healthcare utilization. The observational design and incomplete adjusted analysis precluded causal inference
DOI: 10.61919/bmkmb705
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204697282