{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:31:59Z","timestamp":1790695919992,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"UNICEF Lao People\u2019s Democratic Republic","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,9,11]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We assessed whether Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF), either alone or combined, were associated with malnutrition among Lao People\u2019s Democratic Republic (Lao PDR) children aged 6 to &lt;24 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a secondary analysis of the 2017 Lao Social Indicator Survey II (LSIS II), which used multistage probability proportional to size sampling. Logistic regression analyses were conducted with OR and its corresponding 95% CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The LSIS II was conducted a nationwide household-based survey covering all 18 provinces in Lao PDR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We had a total of 3375 children (weighted sample 3345) and 357 households with data on drinking water.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The outcomes of this study were stunting and wasting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of stunting and wasting was 28.9% and 10.1%, respectively. Even though households with access to a basic or improved water source were high (82.5%), over 83% of drinking water was contaminated with\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      . Access to improved sanitation, basic hygiene and adequate IYCF gave a significant lower risk of becoming stunted. The combined effect of these practices on stunting was (adjusted OR (AOR)=0.54; 95% CI=0.41\u2009to 0.73) greater than each practice alone (improved sanitation: AOR=0.75; 95% CI=0.61\u2009to 0.93; basic hygiene: AOR=0.69; 95% CI=0.57\u2009to 0.83; adequate IYCF: AOR=0.79; 95% CI=0.64\u2009to 0.98). Access to improved sanitation and adequate IYCF was associated with a significant lower risk for being wasted, and again the combined effect of these practices was (AOR=0.64; 95% CI=0.44\u2009to 0.92) greater than each practice alone (improved sanitation: AOR=0.68; 95% CI=0.49\u2009to 0.93 and adequate IYCF: AOR=0.66; 95% CI=0.47\u2009to 0.92).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the strong associations with both stunting and wasting, and the added benefits when combining WASH and IYCF, there is a need of multisectoral interventions to reduce early childhood malnutrition in Lao PDR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-073974","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T10:37:51Z","timestamp":1697193471000},"page":"e073974","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association of both Water, Sanitation and Hygiene (WASH) and Infant and Young Child Feeding (IYCF) practices with childhood malnutrition in Lao PDR: a cross-sectional study of the 2017 Lao Social Indicator Survey II"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3336-3652","authenticated-orcid":false,"given":"Somphos Vicheth","family":"Som","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank T","family":"Wieringa","sequence":"additional","affiliation":[{"name":"UMR QualiSud, French National Research Institute for Sustainable Development, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maiza","family":"Campos Ponce","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Polman","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prosper","family":"Dakurah","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Emergency Fund Lao PDR, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Duncan","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Emergency Fund Lao PDR, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"Blomberg","sequence":"additional","affiliation":[{"name":"United Nations Children\u2019s Emergency Fund Lao PDR, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sitthorot","family":"Rasphone","sequence":"additional","affiliation":[{"name":"The Ministry of Planning and Investment\u2019s National Economic Research Institute, Vientiane, Lao People\u2019s Democratic Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0566-6592","authenticated-orcid":false,"given":"Marinka van der","family":"Hoeven","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"2025121601064338000_13.10.e073974.1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(22)00367-9"},{"key":"2025121601064338000_13.10.e073974.2","unstructured":"UNICEF, WHO, WORLD BANK . Levels and trends in child malnutrition UNICEF \/ WHO \/ World Bank group joint child malnutrition estimates key findings of the 2021 edition. World Heal Organ 2021:1\u201332."},{"key":"2025121601064338000_13.10.e073974.3","unstructured":"Bl\u00f6ssner M , Onis MD , World Health Organization . Malnutrition, Quantifying the health impact at national and local levels. 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Global nutrition report. 2021."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-073974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:07:04Z","timestamp":1765876024000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-073974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":38,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,13]]},"published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1136\/bmjopen-2023-073974"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-073974","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}