Solomon Ephrem Tefera, Gari Sirak Robele, Kloos Helmut, Mengistie Bezatu
Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Trop Med Health. 2020 Aug 6;48:66. doi: 10.1186/s41182-020-00253-4. eCollection 2020.
Diarrheal diseases remain a leading cause of preventable death among children under-five in low- and middle-income countries (LMICs). In Ethiopia, diarrhea is the major contributor to deaths for children under the age of 5 years. In order to develop prevention strategies for the alleviation of childhood diarrhea, it is necessary to identify the important predisposing factors. These predisposing factors have been observed to vary by location across Eastern Ethiopia. Moreover, the evidence on prevalence and determinants of diarrhea among children under 5 years of age in Dire Dawa and its suburbs is very limited and those available have been erratic. The objective of this study was to determine the prevalence and predisposing factors of diarrhea among children under the age of 5 years in rural Dire Dawa, East Ethiopia.
A community-based cross-sectional study was conducted in rural Dire Dawa City Administration in May 2018. Multistage sampling technique was employed to recruit 1180 under-five children from the rural population of Dire Dawa City Administration. Data on socio-demographic, environmental, and child hygiene-related factors were collected by trained data collectors using a structured questionnaire. Logistic regression was used to identify independent risk factors for childhood diarrhea.
The 2-week prevalence of diarrhea among the under-five children was 23% (95% CI 20.8-25.7%). Maternal diarrhea (AOR = 2.22, 95% CI 1.10-4.47), handwashing after contact with child feces (AOR = 6.27, 95% CI 2.01-19.55), use of a dipper to draw water from containers (AOR = 2.88, 95% CI 1.41-5.89), and presence of a refuse disposal facility (AOR = 2.47, 95% CI 1.09-5.60) were the significant predisposing factors of diarrhea.
Our study identified a high burden of childhood diarrheal disease in rural Dire Dawa City Administration in Eastern Ethiopia. The identified risk factors were maternal diarrhea, handwashing after contact with child feces, use of a dipper to draw water from containers, and presence of refuse disposal facility. To minimize the risk of diarrhea, health education programs focusing on good hygiene practice and sanitation as well as early treatment are recommended.
腹泻病仍是低收入和中等收入国家（LMICs）五岁以下儿童可预防死亡的主要原因。在埃塞俄比亚，腹泻是五岁以下儿童死亡的主要原因。为了制定缓解儿童腹泻的预防策略，有必要确定重要的诱发因素。据观察，这些诱发因素在埃塞俄比亚东部各地因地点而异。此外，关于迪雷达瓦及其郊区五岁以下儿童腹泻患病率和决定因素的证据非常有限，且现有证据并不稳定。本研究的目的是确定埃塞俄比亚东部迪雷达瓦农村地区五岁以下儿童腹泻的患病率和诱发因素。
2018年5月在迪雷达瓦农村城市行政区开展了一项基于社区的横断面研究。采用多阶段抽样技术从迪雷达瓦农村城市行政区的农村人口中招募了1180名五岁以下儿童。经过培训的数据收集人员使用结构化问卷收集了社会人口学、环境和儿童卫生相关因素的数据。采用逻辑回归分析确定儿童腹泻的独立危险因素。
五岁以下儿童腹泻的两周患病率为23%（95%CI 20.8 - 25.7%）。母亲腹泻（比值比[AOR]=2.22，95%CI 1.10 - 4.47）、接触儿童粪便后洗手（AOR = 6.27，95%CI 2.01 - 19.55）、使用水瓢从容器中取水（AOR = 2.88，95%CI 1.41 - 5.89）以及有垃圾处理设施（AOR = 2.47，95%CI 1.09 - 5.60）是腹泻的重要诱发因素。
我们的研究发现埃塞俄比亚东部迪雷达瓦农村城市行政区儿童腹泻病负担较重。确定的危险因素包括母亲腹泻、接触儿童粪便后洗手、使用水瓢从容器中取水以及有垃圾处理设施。为了将腹泻风险降至最低，建议开展侧重于良好卫生习惯和环境卫生以及早期治疗的健康教育项目。
