Determinants of Acute Diarrheal Disease Among Under-Five Children in Pawi Hospital, Northwest Ethiopia, 2013/14

Background: Diarrhea is one of the leading causes of morbidity and mortality among under-five children nationally and globally. This study identified determinants of acute diarrheal disease among under-five children using hierarchical logistic regression. Objective: This study was conducted to identify determinants for hospitalization of children with acute diarrhea in Pawi Hospital, Benishangul Gumuz Region, Northwest Ethiopia, 2013/14. Methods: A hospital-based case-control study was performed on 148 cases and 442 controls. Data were collected using structured questionnaires. Both bivariate and hierarchical logistic multivariate analyses were carried out to identify the determinants of acute diarrheal. Results: Determinants for acute diarrheal disease were identified. Rural residence [AOR=6.8, 95%CI= (3.3, 14)], mothers having a low education [AOR=4.0, 95%CI= (1.5, 11.0)], living in a non-model households [AOR=2, 95%CI= (1.1, 4.0)] were from socioeconomic variables. Improper child stool disposal [AOR=2. 7, 95%CI= (1.5, 4.8)], not treating water at home [AOR=2. 5, 95%CI= (1.3, 4.6)] were among the environmental sanitation factors. Child`s age 6-11 moths [AOR=3.8, 95%CI= (1.7, 8.9)], bottle feeding [AOR=10, 95%CI= (4.6, 21.9)], being malnourished [AOR=2.3, 95% CI= (1.3, 3.91)], and maternal diarrhea [AOR=8. 8, 95%CI= (4.0, 19.0)] were determinants of acute diarrheal disease in under fives. Conclusions: Acute diarrhea is influenced by factors from all hierarchical levels. Therefore, Avoiding bottle feeding and interpersonal transmission, strengthening women’s education, improving child nutrition; maximizing the health extension package model households and treating water at home are recommended with more emphasis on rural living children.

[1]  W. Godana,et al.  Environmental Factors Associated with Acute Diarrhea among Children Under Five Years of Age in Derashe District, Southern Ethiopia , 2013 .

[2]  Dessalegn Tamiru,et al.  Morbidity and Associated Factors of Diarrheal Diseases Among Under Five Children in Arba-Minch District, Southern Ethiopia, 2012 , 2013 .

[3]  M. Salam,et al.  Acute diarrhea in adults and children: a global perspective. , 2013, Journal of clinical gastroenterology.

[4]  C. Yilgwan,et al.  Prevalence of diarrhea disease and risk factors in Jos University Teaching Hospital, Nigeria. , 2012, Annals of African medicine.

[5]  Muluken Dessalegn,et al.  Predictors of under-five childhood diarrhea: Mecha District, West Gojam, Ethiopia. , 2011 .

[6]  A. Kumie,et al.  Assessment of the impact of latrine utilization on diarrhoeal diseases in the rural community of Hulet Ejju Enessie Woreda, East Gojjam Zone, Amhara Region , 2010 .

[7]  C. Yilgwan,et al.  Domestic water sourcing and the risk of diarrhoea: a cross-sectional survey of a peri-urban community in Jos, Nigeria. , 2010, Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria.

[8]  R. Muwonge,et al.  DETERMINANTS OF ACUTE DIARRHOEA IN CHILDREN AGED 0 - 5 YEARS IN UGANDA , 2010 .

[9]  A. Gebremariam,et al.  Environmental Determinants of Diarrhea among Under-Five Children in Nekemte Town, Western Ethiopia , 2009 .

[10]  Wondwossen Birke Eshete.  A stepwise regression analysis on under-five diarrhoael morbidity prevalence in Nekemte town, western Ethiopia: maternal care giving and hygiene behavioral determinants. , 2009, East African journal of public health.

[11]  Kenji Shibuya,et al.  Estimating child mortality due to diarrhoea in developing countries. , 2008, Bulletin of the World Health Organization.

[12]  Kwasi Owusu Boadi and Markku Kuitunen.  Childhood Diarrheal Morbidity in the Accra Metropolitan Area, Ghana: Socio-Economic, Environmental and Behavioral Risk Determinants , 2005 .

[13]  John M Colford,et al.  Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. , 2005, The Lancet. Infectious diseases.

[14]  M. Ezra,et al.  Breastfeeding, birth intervals and child survival: Analysis of the 1997 community and family survey data in southern Ethiopia , 2002 .

[15]  Ethiopia,et al.  Ethiopia demographic and health survey, 2000 , 2006 .

[16]  G. Woldemicael.  Diarrhoeal morbidity among young children in Eritrea: environmental and socioeconomic determinants. , 2001, Journal of health, population, and nutrition.

[17]  J. Bryce,et al.  Reducing deaths from diarrhoea through oral rehydration therapy. , 2000, Bulletin of the World Health Organization.

[18]  B. Sircar,et al.  Risk behavioural practices of rural mothers as determinants of childhood diarrhoea. , 1997, The Journal of communicable diseases.

[19]  S. Huttly,et al.  The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. , 1997, International journal of epidemiology.

[20]  K. Anand,et al.  Are diarrheal incidence and malnutrition related in under five children? A longitudinal study in an area of poor sanitary conditions. , 1994, Indian pediatrics.

[21]  J. Rice,et al.  Maternal behavioural risk factors for severe childhood diarrhoeal disease in Kinshasa, Zaire. , 1993, International journal of epidemiology.