The health and economic impact of improved sanitation on the reduction of diarrheal disease of under-five children in Gurage zone, SNNPR state, Ethiopia

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

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Diarrhea Prevention Practice and Associated Factors among Caregivers of Under-Five Children in Enemay District, Northwest Ethiopia

Journal of Environmental and Public Health ◽

10.1155/2019/5490716 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Melese Dubie Agegnehu ◽

Liknaw Bewket Zeleke ◽

Yitayal Ayalew Goshu ◽

Yonas Lamore Ortibo ◽

Yohannes Mehretie Adinew

Keyword(s):

Family Size ◽

Associated Factors ◽

Diarrheal Disease ◽

Good Practice ◽

Multivariable Analysis ◽

Sampling Technique ◽

Northwest Ethiopia ◽

Cross Sectional ◽

Under Five ◽

Under Five Children

Background. Diarrhea is the leading cause of mortality among infants and children younger than 5 years of age in both underdeveloped and developing countries. Factors determining the occurrence of diarrhea in children are complex, and the relative contribution of each factor varies as a function of interaction between socioeconomic, environmental, and behavioral variables. Objectives. To assess diarrhea prevention practice and associated factors of diarrheal disease among caregivers who have under-five children in Enemay district, Ethiopia, 2018. Methods. Community-based cross-sectional study was done from June 1–30, 2018, among 398 caregivers who have under-five children, in the Enemay district that were selected by using the simple random sampling technique. A structured and pretested data collection tool was used to collect the data. Data were entered using EPI DATA version 4.2, and analysis was done using SPSS version 20 statistical package to be cleaned and analyzed. Descriptive analysis was done to describe study participants, and logistic regression (bivariable and multivariable) analysis was done to identify factors that have association with the dependent variable. The P value was less than 0.05. Results. A total of 398 with a response rate of 97% under-five caregivers were participated in this study. Nearly, half (48.7%) of the participants were in the age group 25–34. The study revealed that good practice of diarrhea prevention was 52.8%. This study was also identified that occupation (AOR: 3.922, 95% CI: 1.593, 9.657), family size (AOR: 0.088, 95% CI: 0.009, 0.916), and understanding on diarrhea (AOR: 0.237, 95% CI: 0.091, 0.613) were associated factors of diarrhea prevention practice of under-five children caregivers. Conclusion. This finding showed that diarrhea prevention practice among under-five children caregivers was low and prevention practice was significantly associated with caregivers’ awareness on frequency of diarrhea in a day, occupation, and family size in a house.

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Diarrhea Prevalence and Sociodemographic Factors among Under-Five Children in Rural Areas of North Gondar Zone, Northwest Ethiopia

International Journal of Pediatrics ◽

10.1155/2018/6031594 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Atalay Getachew ◽

Tadesse Guadu ◽

Alebachew Tadie ◽

Zemichael Gizaw ◽

Mulat Gebrehiwot ◽

...

Keyword(s):

Risk Factors ◽

Breast Feeding ◽

Rural Areas ◽

Diarrheal Disease ◽

Sociodemographic Factors ◽

Under Five ◽

Under Five Children ◽

Diarrhea Prevalence ◽

One Year ◽

North Gondar Zone

Background. Diarrheal disease remains one of the principal causes of morbidity and mortality in infants and children in developing countries, including Ethiopia. Risk factors for diarrhea vary by settings and have important implications for developing intervention strategies to reduce the burden of the disease. Thus, the aim of this study was to assess diarrhea prevalence and sociodemographic factors among under-five children in rural areas of North Gondar Zone. Methods. A community-based cross-sectional study was conducted from April to June 2016 among 736 randomly selected households with one child under five years old. A structured questionnaire was used for collecting information on sociodemographic characteristics and diarrheal occurrence. Data was analyzed using SPSS version 20. The bivariate and multivariable logistic regression analysis were used to determine the association between risk factors and diarrheal occurrence, and a p value < 0.05 was taken as statistically significant. Results. A total of 736 under-five children and their respondents were enrolled during the study period. Almost all respondents were biological mothers 96.4% (709/736), married 94.2% (693/736), and house wives 86% (632/736). The overall prevalence of diarrheal disease among under-five children was 22.1% (163/743). Of these, children with age group of less than one year old, 7.7 % (57/736), were commonly infected with diarrheal diseases. Children less than or equal to one year [AOR=1.82, 95% CI= (1.39, 4.63)], guardians [AOR=4.37, 95% CI= (1.73, 11.1)], and children with no breast feeding practice [AOR=3.13, 95% CI= (1.62, 6.03)] were the major risk factors for the occurrence of diarrhea. Conclusion. Childhood diarrhea remains an important health concern in the study area. Occurrence of diarrhea was statistically associated with child age less than or equal to one year, educational status of mother/guardians, and breast feeding. To minimize the magnitude childhood diarrhea, various designing and implementing strategies, such as health education, child care, breast feeding, and weaning practice, integrated with the existing national health extension are quite essential.

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The impact of improved sanitation on the diarrhoeal reduction of under-five children in Democratic Republic of Congo

http://isrctn.com/ ◽

10.1186/isrctn10419317 ◽

2015 ◽

Author(s):

Seungman Cha

Keyword(s):

Democratic Republic ◽

Democratic Republic Of Congo ◽

Republic Of Congo ◽

Under Five ◽

Under Five Children ◽

Improved Sanitation ◽

The Impact

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The impact of improved sanitation on the diarrhoeal reduction of under-five children in Ethiopia

http://isrctn.com/ ◽

10.1186/isrctn82492848 ◽

2015 ◽

Author(s):

Seungman Cha

Keyword(s):

Under Five ◽

Under Five Children ◽

Improved Sanitation ◽

The Impact

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Effects of Community-led Total Sanitation and Hygiene Implementation on Diarrheal Diseases Prevention in children less than five years of age in South Western Ethiopia: A Quasi- Experimental study

10.21203/rs.3.rs-18692/v1 ◽

2020 ◽

Author(s):

Gedamu Bushen ◽

Hailu Merga ◽

Fasil Tessema

Keyword(s):

Experimental Study ◽

Diarrheal Disease ◽

Diarrheal Diseases ◽

Under Five ◽

Sanitation And Hygiene ◽

Hygiene Intervention ◽

Post Test ◽

Quasi Experimental ◽

Improved Sanitation ◽

Diarrhea Prevalence

Abstract Background: Diarrheal disease is one of the main causes of morbidity and mortality in children under five years of age in low and middle-income countries. Lack of improved sanitation is the most important contributing factor to diarrheal disease. Promotion of water, sanitation, and hygiene technologies combined with hygiene promotion is a key strategy for reducing diarrheal diseases in resource poor settings. Few studies have been conducted in rural areas of low-income countries where Community-Led Total Sanitation and Hygiene intervention is implemented. To our knowledge, no study was conducted in the study area to evaluate the effect of this intervention. This study was designed with the aim of finding the effects of Community-led Total Sanitation and Hygiene implementation for preventing diarrhea among under-five children.Methods: A community-based Quasi-Experimental study was conducted from March 01- April 10, 2019 in Kersa and Manna districts. Community-led Total Sanitation and Hygiene intervention is being implemented in Kersa district since 2005 Ethiopian calendar. Sample of 846 households were selected from intervention and comparison districts using four-stage random cluster-sampling method. Semi-structured questionnaire was used to collect data. Data was collected by 8 data collectors who attended secondary school. Data was cleaned, coded and entered into Epi data entry version 3.1 and exported to SPSS version 20 for analysis. Difference-in Difference method with McNemar’s tests was used to compare the prevalence of diarrhea between the intervention and comparison districts, and significance of change between the pre-test and post-test was declared at p-value of less than 0.05 with 95% confidence interval.Results: The intervention led to decreased diarrhea prevalence [pp = -8.2, 95% CI: -15.9, -0.5], increased latrine ownership [pp = 5.6, 95% CI: 0.5, 10.8], and increased latrine utilization [pp = 10.7, 95% CI: 4.7, 16.6] in intervention district at post-test compared to the baseline; while presence of hand washing facility near latrine, home based water treatment, and proper water storage and handling practice were decreased at post-test compared to the baseline.Conclusion: Implementation of Community-Led Total Sanitation improved sanitation and hygiene status of community that resulted in reduction of diarrhea prevalence in children less than five years of age. Further implementation, evaluation, and scale-up of the intervention is needed to reduce diarrheal disease in children less than five years of age.

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Different features of cholera in malnourished and non-malnourised children: analysis of 10-year surveillance data from a large diarrheal disease hospital in urban Bangladesh

10.1101/460782 ◽

2018 ◽

Author(s):

Sharika Nuzhat ◽

Md Iqbal Hossain ◽

Nusrat Jahan Shaly ◽

Rafiqul Islam ◽

Soroar Hossain Khan ◽

...

Keyword(s):

Nutritional Status ◽

Case Management ◽

Surveillance System ◽

Management Strategy ◽

Diarrheal Disease ◽

Policy Makers ◽

Under Five ◽

Under Five Children ◽

Severe Diarrhea ◽

Malnourished Children

AbstractBackground: Malnourished children are more prone to infectious diseases including severe diarrhea compared to non-malnourished children. Understanding of the differences in the presentation of severe diarrhea such as cholera in children with varying nutritional status may help in the early identification and management these children. However, data are scarce on differences in the presentation in such children. Thus, we aimed to identify the clinical differentials among children with cholera with or without malnutrition.Methods: Data were extracted from diarrheal disease surveillance system (DDSS) of the Dhaka Hospital of icddr,b for the period, January 2008 to December 2017. Among under-five children, cholera positive (culture confirmed) and malnourished children (weight-for-age, weight-for-length or height-for-age Z score (WAZ, WHZ or HAZ) <-2) were considered as the cases (n=305) and children with cholera but non-malnourished (WAZ, HAZ, and WHZ ≥-2.00 to ≤+2.00) were the controls (n=276).Results: A total of 14,403 under-five children were enrolled in the surveillance system during the study period. After adjusting for potential covariates such as maternal illiteracy and slum dwelling, it was revealed that under-five malnourished children with cholera significantly more often presented to the hospital during evening hours (6 pm to 12 mid-night) (OR=1.64, 95% CI=1.16-2.31, P<0.05), had fathers who were illiterate (OR=1.70, 95% CI=1.11-2.62, P<0.05), presented with history of cough within last 7 days (OR=1.64, 95% CI=1.10-2.43, P<0.05), dehydrating diarrhea (OR=1.70, 95% CI=1.15-2.53, P<0.05), and had longer hospitalization (OR=1.50, 95% CI=1.05-2.14, P<0.05).Conclusions: The study results underscore the importance of understanding of the basic differences in the presentation of severe cholera in malnourished children for prompt identification and the subsequent management of these children. These observations may help policy makers in formulating better case management strategy.Author Summary:Malnourished children are more vulnerable to infectious diseases including cholera in comparison to the non-malnourished children. They often have suboptimal immune function, though there is no precise information on whether there is any difference in associated factor(s) or clinical course of cholera in under-five children with varying nutritional status. Therefore, this study was conducted to elucidate these insights by using the surveillance data of the Dhaka hospital of icddr,b. Among all the under-five children with cholera, 305 malnourished (WAZ or WLZ or HAZ <-2) children constituted as the cases (malnourished), and another 276 non-malnourished (WAZ, HAZ, and WHZ ≥-2.00GtoG≤+2.00) cholera children formed the comparison group.In this study we revealed that care seeking at evening time was more common in the malnourished children with cholera compared to those without malnutrition. Dehydrating diarrhea was about two folds higher and prolonged hospitalization was frequent in malnourished children with cholera than their counterparts. These key findings may help policy makers in formulating better case management strategy in the near future.

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Diarrhea Prevalence and Associated Factors Among Under-Five Children in the Periphery Area of Azezo Sub-City, Gondar, Northwest Ethiopia: A community Based Cross-Sectional Study

10.21203/rs.3.rs-1129227/v1 ◽

2021 ◽

Author(s):

Bikes Destaw Bitew ◽

Atalay Getachew ◽

Jember Azanaw

Keyword(s):

Associated Factors ◽

Diarrheal Disease ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Age Group ◽

Monthly Income ◽

Community Based ◽

Cross Sectional ◽

Under Five ◽

Under Five Children

Abstract Background Although there has been a global decrease in childhood diarrheal disease in parallel with improvements in the standard of living, it still remains a significant public health problem that occurs due to poor WASH status and other related factors that cause massive childhood morbidity and mortality particularly in sub-Saharan Africa countries including Ethiopia. Objective To assess diarrheal disease prevalence and associated factors among under-five children in periphery area of Azezo sub-city, Gondar, northwest Ethiopia. Methods A community-based cross-sectional study was conducted in April 2019. A simple random sampling technique was applied to recruit the eligible clusters/villages. Structured interview questionnaires were used to collect data. The completed data were entered into Epi Info version 7 and exported to SPSS version 20 for further analysis. A binary logistic regression model was used to process bivariate and multivariable analysis of the data to establish the association between dependent and independent variables. The adjusted odds ratio (AOR) with 95% CI was used for the interpretation of data after controlling the confounders. Results The two-week prevalence of U5C diarrheal disease was 24.9% with 95% CI: (20.4 – 29.7). Age group of 1-12months [AOR: 9.22, 95%CI: (2.93-29.04)], age group of 13-24months [AOR: 4.44, 95%CI: (1.87-10.56)], low monthly income (AOR: 3.68, 95% CI: (1.81-7.51)], small family size [AOR: 0.32, 95% CI: (0.16-0.65)], poor hand washing practice [AOR: 8.37, 95% CI: (3.12-22.52), and immediate feed for cooked foods [AOR: 0.39, 95%CI: (0.19-0.81)] were significantly associated factors with childhood diarrhea. Conclusion Diarrhea was a common health problem among under-five children in the periphery area of Azezo sub-city. Age of children, family size, monthly income, hand-washing practice, and feeding time for cooked food were identified statistically significant risk factors. Therefore, an appropriate intervention program through health education would be recommended with a focus on identified risk factors to reduce the burden of diarrheal diseases.

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Domestic Hygiene Practices and Factors that Risks for Childhood Diarrhoea Among Under Five Children in Isolated Chars of Gaibandha, Bangladesh

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v10i1.43652 ◽

2019 ◽

Vol 10 (1) ◽

pp. 5-10

Author(s):

Muhammad Belal Hossain ◽

Lutfa Akther ◽

AAM Anisul Awwal

Keyword(s):

Maternal Education ◽

Diarrheal Disease ◽

Public Awareness ◽

Health Care Facilities ◽

Personal Hygiene ◽

Community Based ◽

Under Five ◽

Childhood Diarrhoea ◽

Under Five Children ◽

Hygiene Practices

Background: Worldwide diarrheal disease is the second leading cause of death in under-five years children. In Bangladesh diarrhoea kills half million under-five children every year second to pneumonia. The study was aimed to assess the domestic hygiene practices and find the factors that risked for diarrheal disease in under-five children among the families that resides in isolated chars of Gaibandha district. Method: A community based cross-sectional study design was employed in 2011 at three unions of Gaibandha district. Random sampling technique was employed to select 322 households that had at least one under-five children. Data was collected using pretested structured questionnaire. Result: A total of 322 children were enrolled. The overall diarrhoea prevalence was 20.8%. About 71% (n=255) of households collected drinking water from improved water sources and only 10.8% (n=17) had been using river water for their cooking. We found a lower prevalence of diarrhoea in children whose mother had a higher education level. More than 60% mothers didn't wash their hands before feeding their children. A good scenario has been observed that babies were breastfed for sufficient time period. Apart from diarrhoea, Otitis media and skin diseases were significantly found in chars babies. About 20% of the babies were found not immunized and 43.2% found immunized and over 40% partially immunized. Half of the families were found deprived from primary health care facilities and there were found only one satellite clinic in the study sites. Conclusion: The level of diarrheal disease variation was varied due to maternal education, socio-economic status, personal hygiene, waste disposal system and public awareness. Thus enhancing community based behavioural change communication that emphasize on personal hygiene and sanitation should be strengthening to reduce childhood diarrhoea. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 5-10

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Prevalence and Determinants of Diarrhea among Under-Five Children in Benna Tsemay District, South Omo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study in Pastoralist and Agropastoralist Context

Advances in Public Health ◽

10.1155/2020/4237368 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Mulusew Alemayehu ◽

Tsegaye Alemu ◽

Ayalew Astatkie

Keyword(s):

Diarrheal Disease ◽

Cross Sectional Study ◽

Southern Ethiopia ◽

Community Based ◽

Child Feeding ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Sanitation And Hygiene ◽

South Omo

Background. Diarrhea is the second leading cause of death among children under-five years globally and accounts for about 1.5 million deaths each year. In low-income countries, children under three years of age experience three episodes of diarrhea on average every year. In Ethiopia, diarrheal disease is one of the common causes of mortality in under-five children. In Benna Tsemay district, pastoralist community lives with lack of clean water, sanitation, and hygiene problems, which increase the risk of childhood diarrhea. Objective. To assess the prevalence and determinant of diarrheal disease among under five children in Benna Tsemay District, South Omo Zone, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted on a sample of 722 under five children selected randomly from eight pastoralists and two agropastoralist kebels. Data were collected using an interviewer-administered questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Logic regression was performed to identify the association between diarrheal disease and independent variables. Adjusted odds ratio with 95% confidence intervals (CIs) was used to judge the presence of association. Results. The two-week period prevalence of childhood diarrheal disease in the study was 23.5% (95% CI: 20.4%–26.6%). Diarrheal illness was associated with nonavailability of latrine (AOR: 2.77, 95% CI: 1.66–4.63), faeces seen around the pit hole or floor of latrine (AOR: 2.92, 95% CI: 1.38–6.19), improper kitchen waste disposal (AOR: 2.31, 95% CI: 1.26–4. 24), unprotected drinking water source (AOR: 1.81, 95% CI: 1.14–2.88), mother’s or caretaker’s diarrhea history in the last two weeks (AOR: 6.74, 95% CI: 2.51–18.07), materials used for feeding the child (cup and spoon) (AOR: 0.60, 95% CI: 0.36–0.97), and being unvaccinated for “rotavirus” (AOR: 2.87, 95% CI: 1.86–4.44). Conclusion. Nearly one-fourth of children had diarrheal illness in the preceding two weeks. Water, sanitation and hygiene-related factors, child feeding practice, and children’s vaccination status for rotavirus were the determinants of the occurrence of diarrhea among under-five children. The health office should conduct sustainable health education programs that emphasize on risk of open defecation, waste disposal mechanisms, and child feeding practices and also should strengthen rotavirus vaccination activities. The district administration and partners’ needed to improve water sources.

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