Abstract
Background: The Diarrhoeal diseases remain to be a public health concern despite the existence of preventive measures and developing are the most affected. It affects more children less than five years compared to the rest of the population. The burden of childhood diarrhoea varies with geographical area and time bound. A part from this variation, the link between climate change and diarrhoea among under-five children has not been well understood. This study aims to determine the trends, spatial temporal and seasonal characteristics of diarrhoea diseases among Rwandan under-five children using routine Health Management Information System (HMIS) data from 2014 to 2018. Methods: Data on cases of diarrhoeal diseases in children under-five years were extracted from HMIS for a period of 5 years. The Rwanda Meteorology Agency provided climatology data including daily minimum and maximum temperature, and daily rainfall. Incidence rate were calculated to examine the trend, and excess hazard was assessed to determine the risk and likelihood for the occurrence of cases. Linear regression was used to assess relationship between climatology variables and the occurrence of diarrhoea. Results: 1,012,827 new diarrhoeal diseases episodes were reported. Excess risk was noticed in 40% of country’s districts. We found a statistically significant positive and negative relationship between diarrhoeal disease, and maximum temperature and mean monthly rainfall respectively (p<0.001). Increase in one millimeter of rainfall was associated with decrease of 14 cases of diarrhoea while increase of one degree Celsius of maximum temperature was associated with an increase of 15 diarrhoea cases. Conclusion: More districts with risk of diarrhoea were remarked which require targeted control intervention. Furthermore, significant association between diarrhoea case and climate dynamics was observed. This call for the public attention to climate changes which affect health especially children aged less than five years. Key words: Diarrhoeal, children under five, spatiotemporal, temperature, rainfall
Change and continuity in the management of diarrhoeal diseases in under-five children in rural Malawi
