Table 3.
Unadjusted random effect multinomial regression models of self-reported diarrhea and vomiting among students and risk factors at Monastic schools across Myanmar (N = 2,082)
| Factor | Diarrhea only (N = 244) | Vomiting only (N = 253) | Diarrhea and vomiting (N = 233) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| n (%) | RR (95% CI) | P value | n (%) | RR (95% CI) | P value | n (%) | RR (95% CI) | P value | |
| Student level | |||||||||
| Student characteristics | |||||||||
| Sex | |||||||||
| Male | 129 (12.3) | 1.14 (0.87–6–1.52) | 0.37 | 134 (12.7) | 1.14 (0.86–1.51) | 0.35 | 122 (11.6) | 1.11 (0.83–1.50) | 0.46 |
| Female | 115 (11.2) | Ref. | 119 (11.6) | Ref. | 111 (10.8) | Ref. | |||
| Grade | |||||||||
| 4 | 128 (12.4) | 1.41 (1.06–1.87) | 0.02 | 146 (14.1) | 1.74 (1.31–2.31) | < 0.01 | 125 (12.1) | 1.48 (1.11–1.98) | 0.01 |
| 5 | 116 (11.1) | Ref. | 107 (10.2) | Ref. | 108 (10.3) | Ref. | |||
| Hygiene behavior | |||||||||
| Poor handwashing before meals | |||||||||
| Yes | 53 (12.2) | 1.09 (0.77–1.56) | 0.62 | 70 (16.1) | 1.51 (1.08–2.10) | 0.02 | 64 (14.7) | 1.49 (1.06–2.10) | 0.02 |
| No | 191 (11.6) | Ref. | 183 (11.1) | Ref. | 169 (10.3) | Ref. | |||
| Poor handwashing after toilet use | |||||||||
| Yes | 52 (11.9) | 1.02 (0.71–1.45) | 0.93 | 61 (14.0) | 1.19 (0.85–1.68) | 0.31 | 59 (13.5) | 1.27 (0.90–1.80) | 0.18 |
| No | 192 (11.7) | Ref. | 192 (11.7) | Ref. | 174 (10.6) | Ref. | |||
| Inconsistent toilet use | |||||||||
| Yes | 115 (10.9) | 1.00 (0.74–1.37) | 0.98 | 139 (13.1) | 1.37 (1.01–1.86) | 0.04 | 133 (12.6) | 1.50 (1.10–2.05) | 0.01 |
| No | 129 (12.6) | Ref. | 114 (11.2) | Ref. | 100 (9.8) | Ref. | |||
| Poor hygiene education recall | |||||||||
| Yes | 32 (11.5) | 0.92 (0.60–1.41) | 0.71 | 31 (11.2) | 0.85 (0.55–1.31) | 0.47 | 38 (13.7) | 1.19 (0.79–1.78) | 0.40 |
| No | 212 (11.8) | Ref. | 222 (12.3) | Ref. | 195 (10.8) | Ref. | |||
| School level | |||||||||
| Type of toilet | |||||||||
| Pour flush | |||||||||
| Yes | 136 (11.4) | 0.86 (0.56–1.31) | 0.48 | 139 (11.6) | 0.83 (0.54–1.27) | 0.39 | 127 (10.6) | 0.81 (0.53–1.25) | 0.35 |
| No | 108 (12.2) | Ref. | 114 (12.9) | Ref. | 106 (12.0) | Ref. | |||
| Latrine | |||||||||
| Yes | 139 (11.7) | 1.09 (0.70–1.70) | 0.70 | 165 (13.8) | 1.55 (0.99–2.42) | 0.06 | 147 (12.3) | 1.41 (0.90–2.21) | 0.14 |
| No | 105 (11.8) | Ref. | 88 (9.9) | Ref. | 86 (9.7) | Ref. | |||
| Septic tank | |||||||||
| Yes | 101 (10.4) | 0.70 (0.46–1.07) | 0.77 | 110 (11.3) | 0.77 (0.50–1.16) | 0.87 | 88 (9.0) | 0.60 (0.39–0.93) | 0.39 |
| No | 143 (12.9) | Ref. | 143 (12.9) | Ref. | 145 (13.1) | Ref. | |||
| Unclean toilets | |||||||||
| Yes | 129 (11.2) | 0.85 (0.54–1.34) | 0.49 | 142 (12.3) | 0.97 (0.62–1.52) | 0.91 | 121 (10.5) | 0.82 (0.52–1.29) | 0.40 |
| No | 115 (12.4) | Ref. | 111 (11.9) | Ref. | 112 (12.0) | Ref. | |||
| Number of toilets for students* | |||||||||
| 1–2 | 73 (9.6) | 0.65 (0.38–1.10) | 0.11 | 109 (14.3) | 1.26 (0.75–2.12) | 0.39 | 90 (11.8) | 0.84 (0.50–1.41) | 0.51 |
| 3–5 | 74 (12.5) | 0.80 (0.48–1.34) | 0.40 | 69 (11.7) | 0.96 (0.57–1.64) | 0.90 | 50 (8.5) | 0.56 (0.33–0.97) | 0.04 |
| 6–20 | 97 (13.3) | Ref. | 75 (10.3) | Ref. | 93 (12.8) | Ref. | |||
| No separate toilets for girls | |||||||||
| Yes | 97 (10.1) | 0.69 (0.45–1.07) | 0.10 | 135 (14.0) | 1.20 (0.78–1.85) | 0.41 | 82 (8.5) | 0.57 (0.37–0.89) | 0.01 |
| No | 147 (13.1) | Ref. | 118 (10.5) | Ref. | 151 (13.5) | Ref. | |||
| Handwashing facilities | |||||||||
| Insufficient soap available | |||||||||
| Yes | 156 (10.5) | 0.62 (0.40–0.97) | 0.04 | 181 (12.2) | 0.88 (0.56–1.39) | 0.59 | 164 (11.0) | 0.84 (0.53–1.32) | 0.59 |
| No | 88 (14.8) | Ref. | 72 (12.1) | Ref. | 69 (11.6) | Ref. | |||
| Insufficient water available | |||||||||
| Yes | 42 (8.3) | 0.62 (0.36–1.06) | 0.08 | 56 (11.1) | 0.84 (0.50–1.43) | 0.52 | 72 (14.2) | 1.33 (0.79–2.22) | 0.28 |
| No | 202 (12.8) | Ref. | 197 (12.5) | Ref. | 161 (10.2) | Ref. | |||
| Number of handwash stations* | |||||||||
| 0–1 | 107 (12.3) | 1.24 (0.72–2.16) | 0.44 | 115 (13.2) | 1.62 (0.92–2.84) | 0.10 | 107 (12.3) | 1.22 (0.70–2.12) | 0.48 |
| 2–3 | 85 (11.5) | 1.04 (0.59–1.85) | 0.89 | 95 (12.9) | 1.40 (0.79–2.52) | 0.25 | 73 (9.9) | 0.88 (0.49–1.57) | 0.66 |
| 4–20 | 52 (11.0) | Ref. | 43 (9.1) | Ref. | . | 53 (11.2) | Ref. | ||
| Unimproved water storage | |||||||||
| Yes | 12 (14.8) | 1.57 (0.67–3.64) | 0.30 | 12 (14.8) | 1.35 (0.57–3.17) | 0.49 | 7 (8.6) | 0.84 (0.32–2.21) | 0.72 |
| No | 232 (11.6) | Ref. | 241 (12.0) | Ref. | 226 (11.3) | Ref. | |||
RR = risk ratio; CI = confidence interval.
*
Groups represent sample tertiles.