Prevalence of diarrhoea and associated risk factors among children under five years old in Pader District, northern Uganda

Abstract

Background: Diarrhoea remains a major cause of morbidity and mortality in children under 5 years in sub-Saharan Africa. Of the three East African countries, Uganda has the worst mortality rate in children < 5 years, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children < 5 years in Pajule Subcounty, Pader District in northern Uganda. Methods: A cross-sectional survey was conducted in April 2018, covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last 2 weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Bivariate and multivariate logistic regression analyses with a 95% confidence interval and p < 0.05 was used to identify the risk factors associated with childhood diarrhoeal disease. Results: We found a prevalence of diarrhoea of 29.1% [95% CI (23.7-35.0)] among children < 5 years in Pajule Subcounty during the 2 weeks preceding the survey. Use of unprotected water sources, age of child caretaker, child weaning time and family size had significant associations with diarrhoeal morbidity. Conclusion: The prevalence of childhood diarrhoea among children < 5 years of age in rural settings of Pajule Subcounty was higher than the Ugandan national average. Use of unprotected water sources, age of child caretaker, child weaning time and family size were identified as predictors of diarrhoeal occurrence. These findings underscore the need for improving access to clean water and providing community health education as the best methods for fighting childhood diarrhoea in the study area.

Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

“…Regarding the educational level of parents, children of parents with lower education levels were at high risk of developing diarrhea compared to parents with higher education levels. This finding was in agreement with a study done in Ethiopia [ 16 , 20 , 32 ] and Uganda [ 14 ], which suggest that higher education levels of parents significantly affect in reducing childhood diarrhea. The possible reason might be due to the fact that education is expected to improve household health care and hygiene practices.…”

“…Children aged 36-59 months were 3.17 times more affected by diarrhea than children age less than 12 months. This is consistent with other studies conducted in Amhara region, Gamo Gofa Zone, Sidama Zone, Ethiopia [ 4 , 7 , 29 ], Tanzania [ 31 ], and northern Uganda [ 14 ]. A higher percentage of diarrhea cases have occurred among the highest birth order.…”

“…The prevalence of diarrhea in Ethiopia was 12% (95% CI: 11.39, 12.63). This result is lower than 29.1% in Pader District, northern Uganda [ 14 ], 29.9% in Farta District, Northern Ethiopia [ 4 ], and 27.5% in Gamo Gofa Zone, Southern Ethiopia [ 29 ], though it is higher than 11.9% in Tanzania [ 30 ] and 4.4% in Malaysia [ 21 ]. This may be due to the variation in the sample size of the study, sociodemographic characteristics of the respondents, study period, latrine coverage and utilization, and access to clean drinking water.…”

“…We selected explanatory variables based on the literature reviews [ 4 , 7 – 11 , 14 – 21 ] and their theoretical justification. The possible individual-level explanatory variables were sex of a child, age of a child, birth order, types of birth, size of child at birth, vaccination of child, age of mother, family size, number of U5 children, education level of parents, wealth index, anemia level, place of delivery, current marital status, mother's occupation, and exclusive breastfeeding.…”

Estimating the national and regional prevalence of drinking or eating more than usual during childhood diarrhea in Malawi using the bivariate sample selection copula regression

“…Usually, the presence of diarrhea in a child is associated with poor household characteristics, for example, poor parental education according to Asfaha et al (2018) (AOR = 2.88, 95% CI [1.70–4.88]) and Manun’Ebo & Nkulu-wa-Ngoie (2020) (AOR = 1.14, 95% CI [0.93–1.40]), and large household size according to Omona et al (2020) (AOR = 7.185, 95% CI [1.353–38.147]). Such poor household characteristics in turn are associated with poor feeding practices during diarrhea episode, for example, according to Fikadu & Girma (2018) , mothers who have one under-five child are 2 times (AOR = 2.11, 95% CI [1.38, 3.23]) more likely to have proper feeding practices during diarrhea episode as compared to those who have two and more under-five children.…”