Enteric health of children in coastal Bangladesh: A cross-sectional study

Objective: To investigate the environmental factors associated with enteric diseases among children in coastal Bangladesh. Methods: A cross-sectional descriptive study was conducted between July 2018 and November 2018, enrolling 59 preschool children from Nabipur village in Bhola district and Paikgacha village in Khulna district. Keraniganj in Dhaka district was selected as a control village for comparison. A self-administered semi-structured questionnaire was used to collect data, including health information (height, weight, food habits, and hygiene practices), age and history of medication. Food, water and stool samples were also collected from the participants. Results: Children in coastal zones experience an average of 6 episodes per year as compared to 3 diarrhea episodes in Dhaka. The salinity of drinking water varied significantly across the study sites (480±30 ppm in Bhola, 450±36 ppm Khulna, 180±17 ppm in Dhaka). The coastal children had higher fecal calprotectin levels (67±2.7 ng/mg and 77±12 ng/mg in Khulna and Bhola, respectively) compared to those living in Dhaka (25±1.5 ng/mg). The levels of fecal calprotectin and fecal s100A12 were both positively correlated with the salinity of drinking water in Bhola (r=0.66 for calprotectin; r=0.51 for s100A12) and Khulna (r=0.77 for calprotectin; r=0.54 for s100A12). Conclusions: The study revealed a positive correlation between the salinity levels in drinking water and the elevated levels of fecal calprotectin and fecal s100A12 in children living in coastal villages of Khulna and Bhola in Bangladesh, whereas no such association was found among children living in central Bangladeshi locality of Keraniganj, Dhaka.