Diarrheal status and associated factors in under five years old children in relation to implemented and unimplemented community-led total sanitation and hygiene in Yaya Gulele in 2017

Purpose The aim of this study was to assess the diarrheal status and associated factors of under five-years old children among implemented and unimplemented community-led total sanitation and hygiene (CLTSH) in Yaya Gulele district, Ethiopia, in 2017. Methods Community-based comparative cross-sectional study involving 380 households from each implemented and unimplemented CLTSH area was conducted from December 1 to June 30, 2017. Pretested structured questionnaire and a complete observational checklist were used to collect data. Qualitative data were collected via focused group discussions and analyzed manually. Data were checked and entered to Epi-info 3.5.4 and analyzed by SPSS version 20. Bivariate and multivariable logistic regression analyses were computed Results In this study, 88% implemented and 66% unimplemented CLTSH had latrine. Of households owning latrine, 85% in implemented and 75% in unimplemented CLTSH utilize latrine properly. In the study area, 12% in implemented and 34% in unimplemented CLTSH area practice open defecation. Two weeks period diarrhea prevalence was 13.4% (95% CI: 10.2-17.3%) in implemented CLTSH and 36.3% (95% CI: 31.7–41.6%) in unimplemented CLTSH. Having two or more children under five years old (adjusted odds ratio [AOR] = 2.33; 95% CI: 1.09–4.96), lack of clean water storage (AOR = 2.36; 95% CI: 1.16–4.80), negative attitude of mothers/caregivers toward diarrhea (AOR = 2.07; 95% CI: 1.06–4.04), presence of feces in the compound (AOR = 1.88; 95% CI: 1.10–3.22), and lack of hand washing facility in the compound (AOR = 2.64; 95% CI: 1.47–4.74) were associated factors of the outcome. Conclusion Implementation of CLTSH is the applicable tool to reduce diarrhea prevalence. Having two or more children under five years old, unclean water storage, negative attitude of mothers toward diarrhea, existence of feces in the compound, and lack of hand washing facility in the compound were associated factors to the diarrheal status of children under five years old. Health workers and local authorities inspire the community to clean water-storage facilities and the environment, to change mothers’ behavior toward diarrhea, as well as construct hand washing facility in the compound.

[1]  Roba Argaw Tessema.  Assessment of the implementation of community-led total sanitation, hygiene, and associated factors in Diretiyara district, Eastern Ethiopia , 2017, PloS one.

[2]  World Gastroenterology Organisation News and Events. , 2017, Journal of Clinical Gastroenterology.

[3]  Abdiwahab Hashi,et al.  Prevalence of Diarrhoea and Associated Factors among Under-Five Children in Jigjiga District, Somali Region, Eastern Ethiopia , 2016 .

[4]  R. Haque,et al.  Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth. , 2016, The Journal of pediatrics.

[5]  J. Njuguna.  Effect of eliminating open defecation on diarrhoeal morbidity: an ecological study of Nyando and Nambale sub-counties, Kenya , 2016, BMC Public Health.

[6]  Marion W. Jenkins,et al.  Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India , 2016 .

[7]  D. Kaseje,et al.  Association of Community Led Total Sanitation to Reduced Household Morbidity in Nyando District , 2016 .

[8]  J. Bartram,et al.  Teachers and Sanitation Promotion: An Assessment of Community-Led Total Sanitation in Ethiopia , 2016, Environmental science & technology.

[9]  A. Bagtzoglou,et al.  Childhood diarrhea in high and low hotspot districts of Amhara Region, northwest Ethiopia: a multilevel modeling , 2016, Journal of Health, Population and Nutrition.

[10]  S. Sebayang,et al.  Association of Safe Disposal of Child Feces and Reported Diarrhea in Indonesia: Need for Stronger Focus on a Neglected Risk , 2016, International journal of environmental research and public health.

[11]  Myongjin Kim,et al.  The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial , 2015, International journal of environmental research and public health.

[12]  Kedir Addisu Alambo.  The Prevalence of Diarrheal Disease in under Five Children and associated Risk Factors in Wolitta Soddo Town, Southern, Ethiopia , 2015 .

[13]  A. Beyene,et al.  Implementation of Community-led Total Sanitation and Hygiene Approach on the Prevention of Diarrheal Disease in Kersa District, Jimma Zone Ethiopia , 2015 .

[14]  T. Alemayehu,et al.  Knowledge, Perception, and Management Skills of Mothers with Under-five Children about Diarrhoeal Disease in Indigenous and Resettlement Communities in Assosa District, Western Ethiopia , 2015, Journal of health, population, and nutrition.

[15]  A. Ayede,et al.  Hygiene and sanitation risk factors of diarrhoeal disease among under-five children in Ibadan, Nigeria. , 2015, African health sciences.

[16]  D. Amare,et al.  Maternal Knowledge and Practice Towards Diarrhoea Management in Under Five Children in Fenote Selam Town, West Gojjam Zone, AmharaRegional State, Northwest Ethiopia, 2014 , 2014 .

[17]  A. Kumie,et al.  Assessment of factors influencing hygiene behaviour among school children in Mereb-Leke District, Northern Ethiopia: a cross-sectional study , 2014, BMC Public Health.

[18]  E. Peter,et al.  Prevalence, one week incidence and knowledge on causes of diarrhea: household survey of under-fives and adults in Mkuranga district, Tanzania , 2014, BMC Public Health.

[19]  M. Marx,et al.  Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level , 2014, Global health action.

[20]  T. Clasen,et al.  Shared sanitation and the prevalence of diarrhea in young children: evidence from 51 countries, 2001-2011. , 2014, The American journal of tropical medicine and hygiene.

[21]  A. Mamo,et al.  Assessment of Prevalence and Related Factors of Diarrheal Diseases among Under-Five Year's Children in Debrebirehan Referral Hospital, Debrebirehan Town, North Shoa Zone, Amhara Region, Ethiopia , 2014 .

[22]  Wondwosen Kassahun,et al.  Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study , 2014, BMC Public Health.

[23]  Thomas Sinmegn Mihrete,et al.  Determinants of childhood diarrhea among underfive children in Benishangul Gumuz Regional State, North West Ethiopia , 2014 .

[24]  A. Worku,et al.  Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study , 2013 .

[25]  Martin J. Aryee,et al.  Global Causes of Diarrheal Disease Mortality in Children <5 Years of Age: A Systematic Review , 2013, PloS one.

[26]  Bilutkenaw Tamiru.  Predictors of Child Diarrheal Diseases in Cltsh and Phast Approach Implemented Areas in Shebedino District, Sidama Zone, South Ethiopia , 2013 .

[27]  S. Cairncross,et al.  Water, sanitation, hygiene and enteric infections in children , 2013, Archives of Disease in Childhood.

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

[29]  R. Kakulu.  Diarrhoea among under-five children and household water treatment and safe storage factors in Mkuranga district, Tanzania , 2012 .

[30]  Ajith C. Kumar,et al.  What does it take to scale up rural sanitation , 2012 .

[31]  Susan Watt,et al.  An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality , 2012, Environmental Health.

[32]  O. Awodele,et al.  A Study on Cervical Cancer Screening Amongst Nurses in Lagos University Teaching Hospital, Lagos, Nigeria , 2011, Journal of Cancer Education.