Abstract
Background Under-five diarrhea is one of the major causes of morbidity and mortality in developing countries. Despite the tremendous achievement in reducing child mortality and morbidity in the last two decades, diarrhea is still the major causes of morbidity and mortality in resource-limited countries like Ethiopia due to the absence of clean water and poor sanitation and hygiene. Objective This study aimed to assess the association of water, sanitation, and hygiene on the prevalence of diarrhea among under-five children in the rural community of Ethiopia. Methods A cross-sectional study was conducted among randomly selected 419 under-five children from October to December 2021 in Dangila district, Northwest Ethiopia. A structured questionnaire was used to collect sociodemographic, environmental, and behavioral data. Data were entered into Epi Info and analyzed using SPSS software. Descriptive analysis was used to calculate the prevalence of diarrhea. Univariate and multivariate logistic regression were used to compute the association of water, sanitation, and hygiene with diarrhea. Statistical significance was considered if P < 0.05. Results Among 419 participants, the prevalence of diarrhea was 106 (25.3%). The absence of handwashing habit of children (AOR = 7.70; 95% CI: 2.71–21.79) and caregivers after toilet (AOR = 19.10; 95% CI: 5.46–66.52), absence of latrine (AOR = 3.87; 95% CI: 1.24–12.08), playing with soil (AOR = 8.40; 95% CI: 4.58–36.66), and eating soil (AOR = 6.24; 95% CI: 1.99–19.78) were significantly associated with under-five diarrhea. Children who drink unprotected water were 2.21 times (AOR = 2.21; 95% CI: 0.51–9.69) more exposed to under-five diarrhea than who drink protected water, but it is not statistically significant (P = 0.29). Conclusion The prevalence of under-five diarrhea is high in Dangila district. The absence of clean water and poor handwashing practice and the absence of latrine are the main factors associated with diarrhea. Therefore, strengthening water, sanitation, and hygiene strategy in the rural community should be prioritized.
Highlights
Diarrheal disease remains one of the major causes of mortality and morbidity among under-five children worldwide, especially in sub-Sahara African (SSA) countries which have poor sanitation and hygiene [1]
Diarrhea and Other Health Complications of Under-Five Children. e prevalence rates of diarrhea 56.6% (60/106) among females and 60.4% (64/106) in the age group of 0 to 2 years was higher than the respective males 43.4% (46/106) and 39.6% (42/106) in the age group of 3 to 4 years. e prevalence of loss of appetite among under-five children was 28.9% (121/419) which accounted for high prevalence (59.5% (72/121)) among females and (61.2% (74/121)) in the 0- to 2year age groups. e prevalence of sense of tiredness among the study was (32.5% (136/419)) which was highly prevalent among female participants (52.9% (72/136)) and in the age group of 0 to 2 years (58.1% (79/136))
It is lower than 29.9% in north central Ethiopia [14], and 32.6% in rural Burundi [15]. e difference might be due to the variation in the time period of data collection, socio-demographic characteristics of the study subjects, the sanitation and hygiene practice, the educational level of parents in the household level and study periods. e other justification might be only active cases of diarrhea were collected in this study
Summary
Diarrheal disease remains one of the major causes of mortality and morbidity among under-five children worldwide, especially in sub-Sahara African (SSA) countries which have poor sanitation and hygiene [1]. Despite the tremendous achievement in reducing child mortality and morbidity in the last two decades, diarrhea is still the major causes of morbidity and mortality in resource-limited countries like Ethiopia due to the absence of clean water and poor sanitation and hygiene. Is study aimed to assess the association of water, sanitation, and hygiene on the prevalence of diarrhea among under-five children in the rural community of Ethiopia. E absence of clean water and poor handwashing practice and the absence of latrine are the main factors associated with diarrhea. Conclusion. e prevalence of under-five diarrhea is high in Dangila district. e absence of clean water and poor handwashing practice and the absence of latrine are the main factors associated with diarrhea. erefore, strengthening water, sanitation, and hygiene strategy in the rural community should be prioritized
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