Geographical disparities and determinants of childhood diarrheal illness in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

Abstract

Background: Childhood diarrheal illness is the second leading cause of child mortality in Sub Saharan Africa, including Ethiopia. Studies hypothesized that there are regional variations. Thus, the study aimed to examine the spatial variations and to identify the determinants of childhood diarrhea in Ethiopia. Methods: Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was analyzed. This nationwide survey involved 10,337 children below 5 years old. The survey was carried out using a two-stage stratified sampling design. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Descriptive statistics followed by a mixed-effect logistic regression was used to identify the factors associated with the prevalence of diarrhea. Results: Overall, 11.87% of children were experienced childhood diarrheal illness. The study reveals high-risk areas were Southern and central Ethiopia, while eastern and west were indicated as low-risk regions. Younger children were more likely to suffer from childhood diarrhea than their older counterparts: age 6 to 12, 12 to 23, and 24 to 35 months were (AOR = 2.66, (95% CI 2.01, 3.52)), (AOR = 2.45, (95% CI 1.89, 3.17)), and (AOR = 1.53, (95% CI 1.17, 2.01)), respectively. Children living in Tigray (AOR= 1.69 (95% CI, 1.01, 2.83)), Amhara (AOR = 1.80, (95% CI, 1.06, 3.06), SNNPR (AOR = 2.04, 95% CI 1.22, 3.42), and Gambela (AOR = 2.05, (95% CI 1.22, 3.42)), faced greater risk than Addis Ababa city. The odds of getting diarrhea is decreased by 24% among households having ≥3 under-five children as compared to households having only one under-five child (AOR = 0.76 (95% CI: 0.61, 0.94)). The odds of children getting diarrheal illness among working mothers increase by 19% as compared to not working (AOR = 1.19 (95% CI 1.03, 1.38)). Conclusions: childhood diarrheal illness is highly prevalent among under-five children, particularly in SNNP, Gambella, Oromia, and Benishangul Gumuz regions. Capacity building programs with best experience sharing and better household environment may prove effective in reducing the incidence of childhood diarrhea in Ethiopia. Keywords: Spatial statistics, Ethiopia, under-five children, Diarrhea, Generalized Mixed Model

Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

“…Children aged 36-59 months were 3.17 times more affected by diarrhea than children age less than 12 months. This is consistent with other studies conducted in Amhara region, Gamo Gofa Zone, Sidama Zone, Ethiopia [ 4 , 7 , 29 ], Tanzania [ 31 ], and northern Uganda [ 14 ]. A higher percentage of diarrhea cases have occurred among the highest birth order.…”

“…The proportional change in variance for the final full model (model IV) revealed that both individual- and community-level factors accounted for about 67.04% of the variation observed for childhood diarrhea. Similar findings were also found in Tanzania [ 31 ].…”

Spatial disparities and associated factors of Under-five diarrhea disease in Ilubabor Zone, Oromia Regional State, Ethiopia

“…In short, from this graph we understand that child of young mother (<20) and that child of mother age >30 were at higher risk of diarrhea disease, as compared to mothers with age interval (20-29). Previous studies are also consistent with this result that under-five diarrhea disease is spatially correlated with neighboring region (cluster), where high (hot spot) value grouping occurred and another one at the opposite extreme with low (cold spot) values grouping occurred [2].…”

A Multilevel Analysis of Factors Associated with Childhood Diarrhea 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. 22,23…”

“…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. 22,23 Evidence at the national level to identify the contributing factors associated with diarrhea by considering the clustering effects is still limited. Limitation of the previously conducted studies are that none of them used a nationally representative pooled dataset to assess the determinants of childhood diarrhea.…”