Diarrheal morbidity and predisposing factors among children under 5 years of age in rural East Ethiopia

Abstract

Background: Diarrheal diseases remain a leading cause of preventable death among children under-five in lowand middle-income countries (LMICs). In Ethiopia, diarrhea is the major contributor to deaths for children under the age of 5 years. In order to develop prevention strategies for the alleviation of childhood diarrhea, it is necessary to identify the important predisposing factors. These predisposing factors have been observed to vary by location across Eastern Ethiopia. Moreover, the evidence on prevalence and determinants of diarrhea among children under 5 years of age in Dire Dawa and its suburbs is very limited and those available have been erratic. The objective of this study was to determine the prevalence and predisposing factors of diarrhea among children under the age of 5 years in rural Dire Dawa, East Ethiopia. Methods: A community-based cross-sectional study was conducted in rural Dire Dawa City Administration in May 2018. Multistage sampling technique was employed to recruit 1180 under-five children from the rural population of Dire Dawa City Administration. Data on socio-demographic, environmental, and child-and hygiene-related factors were collected by trained data collectors using a structured questionnaire. Logistic regression was used to identify independent risk factors for childhood diarrhea. Results: The 2-week prevalence of diarrhea among the under-five children was 23% (95% CI 20.8-25.7%). Maternal diarrhea (AOR = 2.22, 95% CI 1.10-4.47), handwashing after contact with child feces (AOR = 6.27, 95% CI 2.01-19.55), use of a dipper to draw water from containers (AOR = 2.88, 95% CI 1.41-5.89), and presence of a refuse disposal facility (AOR = 2.47, 95% CI 1.09-5.60) were the significant predisposing factors of diarrhea. Conclusion: Our study identified a high burden of childhood diarrheal disease in rural Dire Dawa City Administration in Eastern Ethiopia. The identified risk factors were maternal diarrhea, handwashing after contact with child feces, use of a dipper to draw water from containers, and presence of refuse disposal facility. To minimize the risk of diarrhea, health education programs focusing on good hygiene practice and sanitation as well as early treatment are recommended.

A Multilevel Analysis of Factors Associated with Childhood Diarrhea in Ethiopia

“…In this study, the odds of diarrhea were higher among children whose mothers had no formal education and lower educational status than children whose mothers had higher education. The study findings are consistent with earlier studies, which found higher odds of childhood diarrhea among children whose mothers were of lower educational status in Ethiopia, 5 , 7 , 11 , 42 , 43 Ghana, 44 and Uganda. 45 These observations may be due to well-educated mothers who are more likely to have better experience, education, attitude, and the necessary health information required for the appropriate diarrheal prevention.…”

“…In Ethiopia, diarrhea is the major contributor to the deaths of children under the age of 5 years. Key determinants of diarrhea among under 5 children in Ethiopia included lack of latrine, 5 , 6 maternal hand-washing practice after visiting a toilet, 5 , 7 , 8 child and maternal factors, 5 , 9 - 13 and socioeconomic factors. 13 According to the Ethiopian Demographic and Health Survey (EDHS) reports, the prevalence of diarrhea in 2000, 2005, 2011, and 2016 in under-5 Ethiopian children was 26%, 18%, 14%, and 12%, respectively.…”

“…Despite the available several epidemiological studies in different localities in Ethiopia, most studies did not account for the hierarchical nature and interrelationships among the multilevel determinants of childhood diarrhea 6 - 13 and in many cases, they are limited in scope and not representative at the national level. 6 - 13 , 18 , 19 Also, previous studies so far focus only on individual fixed effect factors that could ignore community-level variables, which may nullify or weaken the relation of the distal community-level factors. 6 , 7 , 11 , 12 , 19 Further, few studies have examined determinants of diarrhea among under-5 children at national level in Ethiopia.…”

“… 6 - 13 , 18 , 19 Also, previous studies so far focus only on individual fixed effect factors that could ignore community-level variables, which may nullify or weaken the relation of the distal community-level factors. 6 , 7 , 11 , 12 , 19 Further, few studies have examined determinants of diarrhea among under-5 children at national level in Ethiopia. For example, 2 studies by Messelu et al 20 and Nigatu et al 21 were survey-specific, while the others focused on geographical disparities of childhood diarrhea.…”

Mothers’ Self-Efficacy for Preventing Diarrhea in Children Under 5 Years

“…Were consistent with the findings of the current study in titled (diarrheal morbidity and predisposing factors among children under 5 years of age in rural East Ethiopia). They mentioned that the majority of mother housewife and accounted for (73.6) [10] .…”