Existing sanitation and hygiene conditions in Bangladeshi slums and their association with under-five child morbidity

ABSTRACT A cross-sectional survey was conducted using random sampling among five slum residents in Magura municipality. The study analyzed infrastructural factors (latrine conditions, types of houses) and behavioral factors (handwashing and cleaning practices for children and mothers). Water quality was assessed through biological (E. coli, fecal coliforms) and physicochemical (pH, total dissolved solids (TDS), and total suspended solids (TSS)) parameters. Associations with common morbidities such as diarrhea, typhoid, and dysentery were also analyzed. Over 40% of the latrines were kacha (unimproved), and 40% were semi-paka (semi-structured). Around 25% of latrines were unhygienic, while 80% of the houses were made of mud, tin, or a fence. Only 22–29% of households used soap and water for cleaning children, and 40–48% of mothers washed their hands with only water before feeding children. Most tube wells were 200–300 ft deep, and about half were located more than 30 ft from latrines. Over the past year, 52–60% of children suffered from diarrhea, and 20% from dysentery. Although diarrhea decreased over 5 years, dysentery cases increased. E. coli and fecal coliforms showed a significant negative correlation with diarrhea and dysentery (p < 0.05). TDS averaged 353.87 mg/L, and the pH was just above 7 (7.61 ± 0.21).