Data for \"Factors associated with diarrheal disease among children aged 1-5 years in a cholera epidemic in rural Haiti\"

Diarrheal illness is a major cause of morbidity and mortality among children in Haiti, and the impact of diarrheal illness was compounded by a cholera outbreak between 2010 and 2019. Our understanding of risk factors for diarrhea among children during this outbreak is limited. We conducted a secondary analysis of data collected as part of a cholera vaccine effectiveness study to identify factors associated with medically attended diarrhea among children in central Haiti from October of 2012 through November of 2016. We identified 47 children aged one to five years old who presented to medical clinics with acute, watery diarrhea, and 166 matched controls who did not have diarrhea, and we performed conditional logistic regression to identify factors associated with diarrhea. Discontinuing exclusive breastfeeding within one month of birth was associated with increased risk of diarrhea (RR 6.9, 95% CI 1.46 – 32.64), and diarrhea was inversely associated with reported history of supplementation with vitamin A (RR 0.05, 95% CI 0.004 – 0.56) and zinc (reported among 0% of cases vs. 17% of controls). Because of the concordance in supplementation patterns, it was not possible to attribute the association to vitamin A or zinc independently. While having a respondent who correctly identified ≥3 means of avoiding cholera was associated with reduced risk of diarrhea (RR 0.43, 95% CI 0.19 - 1.01), reported household sanitation practices and knowledge of cholera were not consistently associated with risk of diarrhea. These findings support ongoing efforts to reduce barriers to breastfeeding and promote pediatric supplementation with vitamin A and zinc in Haiti. Given the reduced efficacy of current oral cholera vaccines (OCV) among children, the results reinforce the importance of breastfeeding and micronutrient supplementation in preventing all-cause pediatric diarrheal illness generally and during cholera outbreaks.腹泻性疾病是海地儿童发病与死亡的主要诱因之一，2010年至2019年间的霍乱疫情进一步加剧了其造成的公共卫生负担。目前学界对此次疫情期间儿童腹泻的危险因素认知仍较为有限。本研究针对2012年10月至2016年11月间海地中部地区因腹泻就医的儿童展开二次分析（Secondary Analysis），数据源自一项霍乱疫苗有效性研究的原始数据集。研究共纳入47名1至5岁的急性水样腹泻就诊儿童，以及166名匹配的非腹泻对照儿童，并采用条件logistic回归（Conditional Logistic Regression）分析腹泻相关危险因素。结果显示，出生后1个月内停止纯母乳喂养（Exclusive Breastfeeding）与腹泻风险升高显著相关（相对危险度（Relative Risk, RR）=6.9，95%置信区间（Confidence Interval, CI）：1.46~32.64）；而维生素A（Vitamin A）与锌（Zinc）的补充史与腹泻风险呈负相关，其中维生素A的相对危险度RR=0.05，95%置信区间CI：0.004~0.56，病例组锌补充报告率为0%，对照组为17%。由于两种营养素的补充模式高度一致，无法将该关联单独归因于维生素A或锌。若受访者能正确识别≥3种霍乱预防手段，则儿童腹泻风险可降低（RR=0.43，95%CI：0.19~1.01）；但报告的家庭卫生习惯与霍乱认知水平并未与腹泻风险呈现稳定关联。本研究结果为海地持续推进母乳喂养障碍消除工作、推广儿童维生素A与锌补充剂提供了循证依据。鉴于当前口服霍乱疫苗（Oral Cholera Vaccine, OCV）在儿童群体中的保护效力有所下降，本研究结果进一步强调了母乳喂养与微量营养素补充，在预防儿童全因腹泻性疾病及霍乱疫情期间腹泻的重要价值。