Background: Diarrhea is one of the leading causes of morbidity and mortality among children in sub-Saharan Africa, including Ethiopia. In Ethiopia in general and in Harar in particular, there is a scarcity of information on determinants of acute diarrhea and on mothers’ feeding practice of their children aged 0-59 months.Objective: The aim of this study was to identify the determinants of acute diarrhea among children aged 0-59 months in Harar Town, Ethiopia, from May 10 to 20, 2015.Methods: A community based case control study was conducted on 358 mothers/caregivers (cases = 179, and controls = 179) of under-five children. The study participants were selected by a simple random sampling technique. Twelve experienced data collectors, supported by two supervisors, collected the data from the study participants using a pretested structured face-to-face interview questionnaire. The data were entered into Epi Data Version 3.1and processed with SPSS Version16.0. A bivariate and a multivariate logistic regression analyses were done to measure the association between the dependent and independent factors, and results are reported using Odds ratio and its 95% confidence interval (CI).Results: The odds of diarrhea was five time higher among the children who hadn’t been exclusively breastfeed [AOR=5.23, 95% CI (2.458-11.153)]. The children whose mothers’ had history of diarrhea in the past two weeks [AOR=4.25, 95% CI (1.469-12.342)] and from households which hadn’t practiced home based drinking water treatment [AOR=4.27, 95%CI (2.118-8.603)] were four time higher odds of diarrhea. Children consumed leftover foods [AOR=3. 17, 95% CI (1.249-8.059)], and from households contain feces around their latrine [AOR=3. 86, 95% CI (1.88-7.44)] were three time higher odds of diarrhea than their counterparts.Conclusion: Poor practice of drinking water treatment, presence of feces around the latrine, maternal history of diarrhea, and inadequate exclusive breastfeeding were the major factors associated with the occurrence of acute diarrhea. Hence, continuous target specific education on home-based drinking water treatment, personal hygiene, environmental sanitation, and improved child-feeding practices should be strengthened.
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