Environmental, socio-cultural, and health factors associated with diarrhea in Santa Cruz Mixtepec, Juxtlahuaca, Oaxaca, Mexico

This study explored the role of the environment, socio-cultural beliefs and practices, and health status Indicators as factors causing diarrhea in the village of Santa Cruz Mixtepec, Juxtlahuaca, Oaxaca, Mexico. Several research techniques (microbiological, anthropometric. Interview, and observational) were utilized to document the possible Interrelationships of these factors. The total sample (n=177) consisted of Individuals who frequented the small health clinic in the village.

Microbiological analyses Indicated that every tested vector (food, feces, water and soil) contained agents that could cause diarrhea. The traditional clay water vessel was found through Its shape to reduce the surface area exposed to contamination. An environmental model which accounted for 16% of the total variation in diarrheal Incidence Included factors such as the number of rooms in the home, total number of animals owned by the participant's family, and the presence or absence of Entamoeba histolytica in the participant's fecal specimen.

None of the socio-cultural practices (hand-washing and food preparers' practices) were found to be associated with diarrheal Incidence. The lack of association may have been due to the Inability to quantify these practices. The villagers' delineation of types of diarrhea closely parallels that of modern medicine.

The health status of children (n=103) was assessed by comparison to NCHS growth curves and other Amerindian anthropometric studies. Although height stunting has occurred in approximately 50% of the children, all of these children are well within the 95th and 5th centile limits. Few individuals in this village are severely or even moderately malnourished. A health status indicator model which attempted to predict diarrheal incidence included factors such as height, head circumference, and total number of tortillas prepared in the household and accounted for ^~12% of total variance in diarrheal incidence.