scholarly journals A Multilevel Analysis Factors Associated With Diarrhea Among Under-five Children in Ethiopia Using 2016 EDHS Data: Individual and Community Level Factors.

Author(s):  
Mekasha Demeke Getnet ◽  
Esubalew Tesfahun

Abstract Background: Despite numerous attempts, diarrhea remains one of the leading causes of death among children under the age of five around the world. Globally, diarrhea is the second prominent cause of death in children next to pneumonia. Every year, there are 1.7 billion children who develop diarrhea and at least 525,000 die from diarrhea. In low- and middle-income countries such as Ethiopia, diarrhea still remains one of the health problems due to its high morbidity and mortality. This study was conducted identify factors associated with diarrhea at community (cluster) level and individual level.Objectives: To assess individual and community level factors of childhood (0–59months) diarrhea in Ethiopia by using the 2016 Ethiopian Demography and Health surveys (EDHS) data, 2020. Methods: A cross-sectional secondary analysis of data pooled from 2016 Ethiopian Demographic and Health Surveys (EDHS) data was used. The analysis was done using Stata version 14.2. A multilevel logistic regression model was used to identify independent predictors of childhood diarrhea. Odds ratio with 95% CI was used in identifying the association between dependent and independent predictors Result: The prevalence of diarrhea in Ethiopia based on EDHS 2016 was 11.78%.The odds of diarrhea among children reside in rural area were 1.84 times more likely to develop diarrhea (AOR=1.82; 95% CI: 1.52-2.16) as compared to urban dwellers. Those children aged between 13 and 24 months were 2.2 times more likely to have diarrhea than (AOR=2.2, 2.15-2.98) their older counter parts (48-59 months). The measure of variation was also assessed by using ICC, MOR, and DIC with the result of 10.08, 1.56 and 316.18 respectively.Conclusion: Our findings identified that childhood diarrhea was affected by not only individual level factors but also community-level factors. At the individual level (age of the women, number of under five children in the households, age of the child, number of family members, maternal education, and the number of under-5 children) and the community-level, place of residence were significant factors associated with childhood diarrhea in Ethiopia.

2021 ◽  
Author(s):  
Delelegn Emwodew ◽  
Binyam Tariku ◽  
Getanew Aschalew ◽  
Elias Seid ◽  
Samuel Hailegebreal ◽  
...  

Abstract Background: Childhood stunting is a major challenge to the growth and development of nations by affecting millions of children across the world. Although Ethiopia has made steady progress in reducing stunting, the prevalence of stunting is still one of the highest in the world. This study aims to investigate the spatial variation and factors associated with childhood stunting in Ethiopia.Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A total of 4,971 children aged 0–59 months were included in the analysis. The Getis-Ord statistics tool has been used to identify areas with high and low hotspots of stunting. A multilevel logistic regression model was used to identify factors associated with stunting.Results: The prevalence of stunting was found to be 36.86% in Ethiopian under-five children. Statistically significant hotspots of stunting were found in northern parts of Ethiopia. Both individual and community-level factors determined the odds childhood stunting among under-five children. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 3.74; 95 % CI: (3.04–4.59)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.55; 95%CI: (0.38–0.82)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 2; 95 % CI: (1.46–2.73)]. Children living in Tigray (AOR =3.64; 95 % CI: 2.17–6.11), Afar (AOR 2.02; 95 % CI 1.19-3.39), Amhara (AOR =2.29; 95 % CI: 1.37–3.86), Benishangul Gumz (AOR=1.87; 95% CI: 1.10-3.17) and Harari (AOR=1.95; 95% CI: 1.17-3.25) regions were more likely to be stunted compared to children living in Addis Ababa.Conclusion: This study showed that both individual and community-level factors were significant predictors of childhood stunting. Improving maternal education, improving the economic status of households, improving age-specific child feeding practice, and providing additional resources to regions with high hotspots of childhood stunting are recommended.


2021 ◽  
Author(s):  
Biniyam Sahiledengle ◽  
Abera Kumie ◽  
Daniel Atlaw ◽  
Yohannes Tekalegn ◽  
Demelash Woldeyohannes ◽  
...  

Abstract Introduction: Diarrhea remains the second leading cause of mortality among under-five children in Ethiopia, spreads more easily in homes with dirt floors. Even though the determinants of diarrheal illness is widely recognized at the global level, there is a limited number of studies that identified the individual and community-level factors solely among children residing in households with sub-optimal flooring (i.e. earth, mud or sand, and dung). Therefore, this study aims to identify individual and community-level factors associated with childhood diarrhea in households with sub-optimal flooring in Ethiopia.Methods: Data from the fourth round of the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 is used to carry out the analysis. The EDHS was large, cross-sectional by design, and nationally representative. A total of 9,097 under-five children living in households with sub-optimal floors and 645 community clusters were included in the current analysis. A multi-level logistic regression analysis was used to examine both individual and community level factors while accounting for the hierarchal structure of the data.Results: The overall prevalence of childhood diarrhea in households with suboptimal flooring in Ethiopia was 11.9% (95% CI:11.2-12.6). Children aged 6-11 months (adjusted OR [AOR]=2.68, 95%CI: 1.89-3.82), and ≥ 12 months (AOR=1.65, 95%CI: 1.22-2.24) were more likely to have diarrhea compared with children aged 0-5 months. Having cough (AOR=6.09, 95% CI=4.93-7.52) and fever (AOR=1.62, 95%CI: 1.30-2.01) were found to increase the risk for the development of diarrhea in children. Maternal age (25-34 years) and paternal lack of educated were found to be associated with lower odds of childhood diarrheal prevalence rates. Further, children from households with higher family size (≥ 5 family size), low birth order (firstborn), and the number of under-five children (2-3 children) were reported decreased odds of diarrhea. At the community level, children living in pastoralist regions (such as Afar and Somali region) significantly less likely to have diarrhea vulnerability (AOR: 0.61, 95%CI: 0.40-0.91) compared to those who reside in cities. Conclusion: Both individual-level (age of the child, birth order, presence of cough and fever, maternal age, paternal education, household size, improper child stool disposal, number of under-five children) and community-level factor (place of residence) were revealed to be important factors for childhood diarrhea in households with suboptimal flooring.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Betregiorgis Zegeye ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya

Abstract Background Pneumonia is a leading public health problem in under-five children worldwide and particularly in Africa. Unfortunately, progress in reducing pneumonia related mortality has been slow. The number of children with symptoms of pneumonia taken to health facilities for treatment is low in Ethiopia, and disparities among sub-groups regarding health seeking behavior for pneumonia have not been well explored in the region. This study assessed the trends of inequalities in care seeking behavior for children under five years of age with suspected pneumonia in Ethiopia. Methods Using cross-sectional data from the 2005, 2011 and 2016 Ethiopia Demographic and Health Surveys (DHS) and the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT), this study investigated the inequalities in health seeking behavior for children with suspected pneumonia. Four measures of inequality were calculated: Difference, Ratio, Slope Index of Inequality and Relative Index of Inequality. Results were disaggregated by wealth, education, residence, and sex with computed 95% Uncertainty Intervals for each point estimate to determine significance. Results The percentage of under-five children with symptoms of pneumonia who were taken to a health facility was significantly lower for children in the poorest families, 15.48% (95% UI; 9.77, 23.64) as compared to children in the richest families, 61.72% (95% UI; 45.06, 76.02) in 2011. Substantial absolute (SII = 35.61; 95% UI: 25.31, 45.92) and relative (RII = 4.04%; 95% UI: 2.25, 5.84) economic inequalities were also observed. Both educational and geographic inequalities were observed; (RII = 2.07; 95% UI: 1.08, 3.06) and (D = 28.26; 95% UI: 7.14, 49.37), respectively. Economic inequality decreased from 2011 to 2016. There was no statistically significant difference between male and female under-five children with pneumonia symptoms taken to health facility, in all the studied years. Conclusions Health care seeking behavior for children with pneumonia was lower among the poorest and non-educated families as well as children in rural regions. Policies and strategies need to target subpopulations lagging behind in seeking care for pneumonia treatment as it impedes achievement of key UN sustainable development goals (SDGs).


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257522
Author(s):  
Getu Debalkie Demissie ◽  
Yigizie Yeshaw ◽  
Wallelign Aleminew ◽  
Yonas Akalu

Introduction Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa. Methods The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model. Result The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1–15.4). Those children of mothers aged 15–24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25–34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57–1.82), primary education (AOR = 1.73; 95%CI: 1.61–1.86) and secondary education (AOR = 1.49; 95%CI: 1.38–1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08–1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04–1.12) households had higher chance of having diarrhea compared to their counterparts. Conclusion This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Setegn Muche Fenta ◽  
Teshager Zerihun Nigussie

Background. Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year, it kills more than 525,000 children under 5 years. More than half of these deaths occur in five countries including Ethiopia. This study is aimed at identifying both individual- and community-level risk factors of childhood diarrhea in Ethiopia. Methods. Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multilevel mixed-effects logistic regression model was used to identify both individual- and community-level risk factors associated with childhood diarrhea. Result. The incidence of childhood diarrhea was 12% (95% CI: 11.39, 12.63). The random-effects model revealed that 67% of the variability of childhood diarrhea was explained by individual- and community-level factors. From the individual-level factors, children aged 36–59 months ( AOR = 3.166 ; 95% CI: 2.569, 3.900), twin child ( AOR = 1.871 ; 95% CI: 1.390, 2.527), birth order 5 and above ( AOR = 2.210 , 95% CI: 1.721, 2.839), not received any vaccination ( AOR = 1.197 ; 95% CI: 1.190, 1.527), smaller size of child at birth ( AOR = 1.303 ; 95% CI: 1.130, 1.504), and never breastfed children ( AOR = 2.91 ; 95% CI: 2.380, 3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ( AOR = 1.505 ; 95% CI: 1.233, 1.836)), unprotected source of drinking water ( AOR = 1.289 ; 95% CI: 1.060, 1.567), and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, children who live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR, and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion. The incidence of childhood diarrhea was different from cluster to cluster in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding, and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Betregiorgis Zegeye ◽  
Mpho Keetile ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
...  

Background. Childhood diarrhea remains a major public health problem in sub-Saharan Africa (SSA). Women empowerment reduces child mortality, and wife beating attitude is one of the indicators of women empowerment. There is a dearth of evidence about wife beating attitudes and childhood diarrhea in SSA. Therefore, the present study aimed to examine the association between attitude towards wife beating and diarrhea among under-five children. Methods. We used Demographic and Health Surveys from 25 countries in SSA that were conducted between 2010 and 2020. Using Stata version 14 software, we carried out the analysis on 153,864 children under five. Bivariate and multivariate logistic regression analyses were applied, and the results were presented using adjusted odd ratios (aOR) at 95% confidence interval (CI). Results. The pooled results show that 71.4% of married women disagreed with wife beating. About 20.5% of under-five children of married women had diarrhea. Childhood diarrhea varied from highest prevalence in Chad (27.9%) to the lowest prevalence in Sierra-Leone (8.5%). The study showed lower odds of diarrhea among children of married women who disagreed with wife beating (aOR = 0.66 95% CI; 0.54–0.80) compared to children of married women who agreed with wife beating. Moreover, the study results show that women’s age (35–39 years-aOR = 0.48, 95% CI; 0.31–0.74, 40–44 years-aOR = 0.57, 95% CI; 0.35–0.93, 45–49 years-aOR = 0.35, 95% CI; 0.16–0.79) was negatively associated with childhood diarrhea, while husband’s education (primary school-aOR = 1.36, 95% CI; 1.05–1.77), parity (ever born 3-4 children-aOR = 1.36, 95% CI; 1.09–1.70, and 5+ children-aOR = 1.56, 95% CI; 1.14–2.12), and religion (Muslim-aOR = 3.56, 95% CI; 1.44–8.83) were positively associated with diarrhea among under-five children. Conclusions. The study shows association between women attitude towards wife beating and childhood diarrhea. Therefore, empowering women, especially young women by increasing awareness about domestic violence, their rights, and empowering them through education and economic advancement need to be considered in order to reduce childhood diarrhea. Moreover, fertility control or birth spacing and working closely with religious leaders are important factors to consider in reducing childhood diarrhea.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Achamyeleh Birhanu Teshale ◽  
Alemneh Mekuriaw Liyew ◽  
Getayeneh Antehunegn Tesema

Abstract Background Zinc has a tremendous advantage to save the life of children. It reduces the mean duration of diarrhea and mortality due to diarrhea. Besides, it reduces the severity of the initial episode, and also it prevents future diarrhea episodes. But there is low utilization of zinc for the management of diarrhea in under-five children in Ethiopia and there is a paucity of literature regarding the factors associated with the utilization. Method The 2016 Ethiopian demographic and health survey data were used as a data source. A total weighted sample of 1228 under-five children with diarrhea within 2 weeks preceding the survey were used. A mixed-effects logistic regression analysis was done to account for the complex sample design of the data. Variables with p-value < 0.20 in the bivariable analysis were eligible for multivariable analysis and those variables with p value< 0.05 in the multivariable analysis were declared to be determinants of zinc utilization for the management of diarrhea in under-five children. Result In this study, we found multiple determinants of zinc utilization. Mothers with formal education (adjusted odds ratio (AOR) = 1.83;95% CI; 1.30–2.58) and media exposure (AOR = 1.46;95% CI; 1.04–2.04) had higher odds of zinc utilization. But mothers from five and above household size (AOR = 0.57;95% CI; 0.39–0.82) had lower odds of zinc utilization for the management of diarrhea in under-five children. Conclusion In our study maternal education, media exposure, and household size were determinants of zinc utilization for the management of diarrhea in under-five children. Being having a formal education and being exposed to all or either of the three media (radio, TV, and newspaper) increases the likelihood of zinc utilization while being mothers from large household size decreases the likelihood of zinc utilization. Therefore, giving special attention to those mothers with no formal education, and mothers from high family size could increase the utilization of zinc for the management of diarrhea in under-five children. Also, media campaigns regarding diarrhea management could be scaled up to potentially achieve the desired impact.


2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Ayantu Kebede ◽  
Alemi Kebede ◽  
Sena Belina ◽  
Yonas Biratu

BACKGROUND፡ Globally, Low Birth Weight (LBW) prevalence is estimated to be 14.6%. It is a major cause of neonatal mortality in developing countries including Ethiopia. Despite extensive institution-based studies in Ethiopia, there is no comprehensive study using countrywide data. Thus, this study aimed to investigate trends and determinants of Small Birth Weight (SBW) among under-five children in Ethiopia.METHODS: Under-five children data from 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHS) were used. However, only 2787 children were weighed at birth and used for analysis in this study. Descriptive statistics and the logistic regression model were used to determine trends and determinants of SBW respectively.RESULTS: The prevalence of SBW increased from 7.0% (95% CI; 3.1-10.0) to 13.2% (95% CI; 11.4-15.0) between 2000 and 2016. The odds of SBW increased by being a female child (AOR 1.50; 95% CI [1.07-2.09]), mother’s with partner occupation of agriculture (AOR 1.54; 95% CI [1.05-2.26]) and mothers who did not know their partner’s occupation (AOR 7.35; 95% CI [1.96-27.48]). However, infants born to mothers with primary (AOR 0.43;95% CI [0.29-0.65]), secondary (AOR 0.30; 95% CI [0.16-0.55]) and higher (AOR 0.55; 95% CI [0.31-0.97]) educational status versus no education and grandmultiparous mothers (OR 0.39; 95% CI [0.19-0.78]) versus primiparous had lower odds of SBW.CONCLUSION: In Ethiopia, during the survey period, there was an increment in prevalence of SBW, and maternal related factors were significant determinants. Therefore, empowering mothers through education and improving the socioeconomic status of the household can be one strategy to reduce SBW.


1970 ◽  
Vol 29 (4) ◽  
Author(s):  
Paul Edwin ◽  
Muluken Azage

BACKGROUND: Diarrhea remains the leading cause of morbidity and mortality among under 5 children in low- and middle-income countries. In Tanzania, diarrhea remains one of the major public health problems. This study aimed to investigate spatial variations and the factors correlated with diarrhea in under five children.METHODS: This is a secondary data analysis using data from the population-based cross section Tanzanian Demographic and Health Survey 2015-16 data. Spatial analysis was done using the Bernoulli model from SaTScan™ software, and a generalized linear mixed model was used to identify the factors associated with childhood diarrhea.RESULTS: The overall reported prevalence of childhood diarrhea for the under five children in Tanzania was 12.1% (95%CI 11.3%-12.9%). The SaTScan spatial statics analysis revealed that diarrhea in children was not random. The odds of diarrhea were 7.35 times higher (AOR= 7.35; 95%CI: 5.29, 10.22) among children in the 6- 11 months age group compared to children within the 48-59 months of age. As mother’s age increased, the risk of diarrhea for the under five children decreased whereas the highest risk of diarrhea was observed in the two rich income brackets richer (AOR=1.70, 95%CI=1.30, 2.22), and richest (AOR= 1.05, 95%CI=1, 1.09). The odds of diarrhea were 1.25 times higher (AOR=1.25, 95%CI=1.06, 1.46) among children with unsafe stool disposal compared to those with safe disposal.CONCLUSION: The socio-demographic factors associated with diarrhea among children were mother’s age in years, current age of the child, wealth index and child stool disposal.


Sign in / Sign up

Export Citation Format

Share Document