{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:56:09Z","timestamp":1788443769161,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T00:00:00Z","timestamp":1560729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009660","name":"London School of Hygiene and Tropical Medicine","doi-asserted-by":"publisher","award":["SHARE Research Project 2"],"award-info":[{"award-number":["SHARE Research Project 2"]}],"id":[{"id":"10.13039\/100009660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Diarrhoeal disease remains one of the leading causes of morbidity and mortality in the under-five population, particularly in low income settings such as sub-Saharan Africa. Despite significant progress in sanitation and water access, faecal-oral infections persist in these populations. Therefore, a better understanding of these transmission pathways, and how potential risk factors can be reduced within low income contexts is needed. This study, conducted in Southern Malawi from June to October 2017, used a mixed methods approach to collect data from household surveys (n = 323), checklists (n = 31), structured observations (n = 80), and microbiological food samples (n = 20). Results showed that food prepared for immediate consumption (primarily porridge for children) posed a low health risk. Poor hygiene practices increased the risk of contamination from shared family meals. Faecal and Staphylococcal bacteria were associated with poor hand hygiene and unhygienic eating conditions. Leftover food storage and inadequate pre-consumption heating increased the risk of contamination. Improvements in food hygiene and hand hygiene practices at critical points could reduce the risk of diarrhoeal disease for children under 2 years but must consider the contextual structural barriers to improved practice like access to handwashing facilities, soap, food and water storage.<\/jats:p>","DOI":"10.3390\/ijerph16122146","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T11:24:45Z","timestamp":1560770685000},"page":"2146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Risk Factors Associated with Feeding Children under 2 Years in Rural Malawi\u2014A Formative Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Kondwani","family":"Chidziwisano","sequence":"first","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"},{"name":"Department of Environmental Health, Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"},{"name":"Department of Civil and Environmental Engineering, University of Strathclyde, Level 5 James Weir Building, G1 1XQ, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2095-9724","authenticated-orcid":false,"given":"Elizabeth","family":"Tilley","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"},{"name":"EAWAG: Swiss Federal Institute of Aquatic Science and Technology, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossanie","family":"Malolo","sequence":"additional","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Save","family":"Kumwenda","sequence":"additional","affiliation":[{"name":"Centre for Water, Sanitation, Health and Appropriate Technology Development (WASHTED), Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"},{"name":"Department of Environmental Health, Polytechnic, University of Malawi, Private Bag 303, Chichiri, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janelisa","family":"Musaya","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, University of Malawi, P.O Box 360, Chichiri, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4185-9471","authenticated-orcid":false,"given":"Tracy","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, University of Strathclyde, Level 5 James Weir Building, G1 1XQ, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,6,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2019, May 10). 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