Prevalence of diarrhoea and treatment-seeking practices among children &lt;2 years of age in the Birhan cohort, Ethiopia, 2018–19

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Abstract

Background

Estimating the proportion of children with diarrhoea and those who are taken in as inpatients or outpatients is important for policy planning, resource allocation, and to evaluate the effectiveness of diarrhoea prevention and control interventions. We aimed to estimate the proportion of children <2 years of age with diarrhoea, explore their treatment-seeking practices, and identify factors associated with both diarrhoea and treatment seeking.

Methods

We designed a longitudinal study based on a sample of children <2 years of age in the Birhan field site from September 2018 to September 2019. The study site collected data on child mortality and morbidity and treatment-seeking practice for those with a history of illness every three months. Mothers/caregivers were asked about signs or symptoms of illnesses for a two-week period prior to each study visit. We estimated the proportion of children <2 years of age with diarrhoea and treatment-seeking practices for each of the four rounds of data collection and identified associated factors through bivariable and multivariable logistic regression.

Results

We enrolled 4678 children <2 years of age. The proportion of children with diarrhoea was the highest from 11 September 2018 to 9 December 2018 (4.47%; 95% confidence interval (CI) = 3.70–5.35) and the lowest from 10 December 2018 to 9 March 2019 (2.48%; 95% CI = 1.90–3.19). Children from households with chlorinated drinking water had a 50% (adjusted odds ratio (aOR) = 0.50; 95% CI = 0.28–0.88) lower odds of developing diarrhoea compared to those who did not. Among 339 children with diarrhoea, 275 (81.12%; 95% CI = 76.54–85.15) were taken to health facilities for treatment. Female children had lower odds of being taken to health facilities for treatment (aOR = 0.37; 95% CI = 0.17–0.80) compared to males.

Conclusions

While the proportion of children with diarrhoea in our study was lower than that observed in prior research conducted in Ethiopia, treatment-seeking practices were higher. Female children and children from the poorest families had lower odds of treatment. We recommend more studies to explore gender-based and socioeconomic differences affecting treatment-seeking practices.

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Most cited references 31

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Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis

Animut Alebel, Cheru Tesema, Belisty Temesgen … (2018)

Background Despite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia. Methods International databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I 2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model. Results After reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea. Conclusion In this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.

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Prevalence of diarrheal diseases and associated factors among under-five children in Dale District, Sidama zone, Southern Ethiopia: a cross-sectional study

Behailu Melese, Wondimagegn Paulos, Feleke Astawesegn … (2019)

Background Globally childhood diarrhoeal diseases continue to be the second leading cause of death, while in Ethiopia it kills half-million under-five children each year. Sanitation, unsafe water and personal hygiene are responsible for 90% of the occurrence. Thus, this study aimed to assess the prevalence and associated factors of diarrheal diseases among under-five children in Dale District, Sidama Zone, Southern Ethiopia. Methods A community-based cross-sectional study was conducted. A face to face interview using a structured questionnaire and observation checklist was used. A total of 546 households with at least one under-five children were selected using simple random sampling techniques. The data entry and cleaning were performed using Epidemiological information software (EPI Info) 3.5.1 and then exported to Statistical Package for Social Science (SPSS) version 16.0 for analysis. Frequencies and proportions were computed as descriptive analysis. Initially using bivariate analysis a crude association between the independent and dependent variables was investigated. Then, those variables with p-value ≤0.25 were included in multivariable analysis to determine the predictor variables for the outcome variables. Finally, further analyses were carried out using multivariable analysis at a significance level of p-value ≤0.05. Results A total of 537 children under the age of 5 years were included. The 2 weeks prevalence of diarrhea among children under the age of 5 years was 13.6, 95% CI (10.7, 16.5%). Educational level [AOR: 3.97, 95% CI (1.60, 8.916)], age of indexed child [AOR: 12.18, 95% CI (1.78, 83.30)], nutritional status [AOR: 6.41, 95% CI (2.47, 16.77.)], hand washing method [AOR, 3.10, 95% CI (1.10, 8.67)], hand washing after latrine [AOR: 2.73, 95% CI (1.05, 6.56)], refuse disposal method [AOR, 3.23, 95% CI (1.37, 7.60)] and housing floor material [AOR: 3.22, 95% CI (1.16, 8.91] were significantly associated with the occurrence of childhood diarrheal diseases. Conclusion Childhood diarrhea remains the commonest health problem in the study area. The findings have important policy implications for childhood diarrhoeal disease intervention programs. Thus, activities focusing on proper handwashing techniques at all appropriate times, proper refuse disposal, improving nutrition and better childcare also highly recommended.

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Prevalence of diarrhoea and risk factors among children under five years old in Mbour, Senegal: a cross-sectional study

Sokhna Thiam, Aminata Diène, Samuel Fuhrimann … (2017)

Background Diarrhoeal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. In Senegal, diarrhoea is responsible for 15% of all deaths in children under the age of five and is the third leading cause of childhood deaths. For targeted planning and implementation of prevention strategies, a context-specific understanding of the determinants of diarrhoeal diseases is needed. The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour, Senegal. Methods Between February and March 2014, a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. The zones covered urban central, peri-central, north peripheral and south peripheral areas. Overall, 596 households were surveyed by a questionnaire, yielding information on sociodemographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea. Results The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18–2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00–3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20–3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11–2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11–2.56). Conclusion We found a high prevalence of diarrhoea in children under the age of five in Mbour, with the highest prevalence occurring in the central and peri-central areas. These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups. Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0323-1) contains supplementary material, which is available to authorized users.

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Author and article information

Journal

Journal ID (nlm-ta): J Glob Health

Journal ID (iso-abbrev): J Glob Health

Journal ID (publisher-id): JGH

Title: Journal of Global Health

Publisher: International Society of Global Health

ISSN (Print): 2047-2978

ISSN (Electronic): 2047-2986

Publication date (Electronic, pub): 1 November 2024

Publication date (Electronic, collection): 2024

Volume: 14

Electronic Location Identifier: 04181

Affiliations

[1 ]Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

[2 ]Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia

[3 ]School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

[4 ]Department of Population and Family Health, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia

[5 ]Knowledge Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

[6 ]Department of Paediatrics and Child Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

[7 ]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

[8 ]HaSET Maternal and Child Health Research Program, Addis Ababa, Ethiopia

[9 ]Department of Gynaecology and Obstetrics, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

[10 ]Research and Technology Transfer Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

[11 ]Department of Paediatrics, Boston Children's Hospital, Harvard Medical School, Boston, USA

Author notes

Correspondence to: Gedefaw Abeje Fekadu Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University H9FX+Q62, Amhara Ethiopia  abejegedefaw@ 123456gmail.com