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This study examined the relationship between childhood diarrhea prevalence and caregiver knowledge of the causes and prevention of diarrhea in a prospective cohort of 952 children < 5 years of age in Cochabamba, Bolivia. The survey of caregiver knowledge found that more than 80% of caregivers were unaware that hand washing with soap could prevent childhood diarrhea. Furthermore, when asked how to keep food safe for children to eat only 17% of caregivers reported hand washing before cooking and feeding a child. Lack of caregiver awareness of the importance of practices related to hygiene and sanitation for diarrhea prevention were significant risk factors for diarrheal disease in this cohort. The knowledge findings from this study suggest that health promotion in these communities should put further emphasis on increasing knowledge of how water treatment, hand washing with soap, proper disposal of child feces, and food preparation relate to childhood diarrhea prevention.


George, C., et al. (2014). Risk Factors for Diarrhea in Children Under Five Years of Age Residing in Peri-Urban Communities in Cochabamba, Bolivia. American Journal of Tropical Medicine and Hygiene 91(6)1190-1196.

© 2014 American Society of Tropical Medicine and Hygiene. Original published version available at

Perin, J., Neiswender de Calani, K. J., Norman, W. R., Perry, H., George, C. M., Davis, T. P., & Lindquist, E. D. (2014). Risk factors for diarrhea in children under five years of age residing in peri-urban communities in cochabamba, bolivia. The American Journal of Tropical Medicine and Hygiene, 91(6), 1190–1196.

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