Risk factors for diarrhoea and malnutrition among children under the age of 5 years in the Tigray Region of Northern Ethiopia

Abstract

BackgroundDiarrhoea and malnutrition are the leading cause of morbidity and mortality among children in areas with poor access to clean water, improved sanitation, and with low socioeconomic status. This study was designed to determine the prevalence of diarrhoea, malnutrition and risk factors among children aged 6–59 months in the Tigray Region of Northern Ethiopia.MethodsA community based cross-sectional study design was conducted from June to August 2017 to assess the magnitude and factors associated with diarrhoea and malnutrition among children. A standardized questionnaire was used to collect data on diarrhoea, environmental, demographic and behavioural factors from 610 mother-child pairs. Anthropometric measurements were collected from the children. SPSS ver.21 statistical software was used for analysis. Factors associated with diarrhoea and nutritional status were identified using bivariate and multivariate logistic regression. A p-value ≤ 0.05 was considered statistically significant.ResultsOf the 610 children monitored in this study, the incidence of diarrhoea among 6–59 month-old children in the two weeks preceding the day of the interview day was 27.2% (95% CI: 23.6–31%). Specifically, 35.9%, 9.7%, and 1.8% had 1–2, 3–4 and 5–6 times of diarrhoea episodes in a one year of time, respectively. The prevalence of stunting, underweight, wasting, and acute under-nutrition were 36.1% (95% CI: 31–38.6%), 37% (95% CI: 32–39.6%), 7.9% (95% CI: 5.5–9.7%), and 5.4% (95% CI: 3.8–7.4%), respectively. In a multivariate logistic regression analysis, type of drinking water source [AOR = 3.69; 95% CI: 2.03–6.71], mothers not hand washing at critical times [AOR = 15.42; 95% CI: 2.02–117.78], improper solid waste disposal [AOR = 12.81; 95% CI: 2.50–65.62], and child age (36–47 months) [AOR = 2.57; 95% CI: 1.45–4.55] were found to be predictors of diarrhoea. Being within the age range of 12–23 months was a predictor for wasting [AOR = 4.38; 95% CI: 1.61–11.90] and being underweight [AOR = 4.4; 95% CI: 1.7–11.2]. Similarly, the age range of 36–47 months was associated with wasting [AOR = 2.3; 95% CI: 1.45–3.85] and stunting [AOR = 1.7; 95% CI: 1.03–2.67]. Family size (less than 4) [AOR = 0.56; 95% CI: 0.368–0.959] was inversely associated for wasting.ConclusionsOur study revealed that the problem of diarrhoea and malnutrition amongst 6–59 months children in the study area was significant. Access to clean water was the main problem in the study area. Hence, improving access to clean water and providing health education to mothers on personal and environmental hygiene, and proper waste disposal could improve diarrhoea in the study area. Intervention on children’s nutrition should also be implemented to minimize the problem of malnutrition.

Determinants of diarrhoeal diseases and height-for-age z-scores in children under-five years of age in rural central Tanzania

“…Maternal handwashing during critical times, including before feeding children and after toilet use, is important in the control of gastrointestinal infections [ 40 , 41 ] and stunting [ 42 , 43 ]; however, handwashing should be properly executed. The current study shows that handwashing one at a time with running water was associated with increased HAZ in children, compared to one or more persons washing hands in a shared bowl of water.…”

Lowest wealth quintiles predispose under-five children to stunting in Ethiopia: Updates of systematic review and meta-analysis

“…Nine studies were from Amhara (21,38,61,72,75,76,80,82,85) and SNNPR regions (53,55,57,63,69,71,74,78,79). Studies in other regions included from Oromia (n=7) (22,51,54,62,67,73,83), Tigray (n=3) (60,65,66), Somalia(n=2) (52,70), Benishangul-Gumz(n=1) (84), and Afar(n=2) (64,77), and six studies were nation-based (56,58,68,81,86,87)(Table1). Three of the studies did not report sex of the study population, children (62,63,82), but all the other studies reported the sex of the children.…”

A double-blind placebo-controlled trial of azithromycin to reduce mortality and improve growth in high-risk young children with non-bloody diarrhoea in low resource settings: the Antibiotics for Children with Diarrhoea (ABCD) trial protocol

“…Taken together, these studies suggest that current treatment guidelines may be missing the opportunity to appropriately provide antibiotics to a highly selected group of young children who, because of aetiology, disease severity and/or undernutrition, are at a particularly high risk of diarrhoea-associated mortality [1,8,9]. Azithromycin, a macrolide with a broad spectrum of antibacterial activity and immunomodulatory properties, has been administered to children in the context of mass drug administration programmes largely for trachoma prevention [10].…”