Natnael Tarikuwa, Lingerew Mistir, Adane Metadel
Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
BMC Pediatr. 2021 Jun 26;21(1):290. doi: 10.1186/s12887-021-02762-5.
Diarrheal disease is still one of the most common causes of mortality and morbidity in children under five in developing countries, including Ethiopia. Lack of specific data on the prevalence of acute diarrhea and associated factors among under-five children in the semi-urban areas of Gelsha, found in northeastern Ethiopia's South Wollo zone, remains a major gap. Therefore, this study was designed to provide data that is important for proper planning of intervention measures to reduce the problem in this area.
A community-based cross-sectional study was conducted among 340 systematically selected children under five in semi-urban areas of Gelsha from January to March 2019. The data was collected using a structured questionnaire and an observational checklist. Bivariable (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were employed using binary logistic regression model with 95% CI (confidence interval). Variables with a p-value < 0.05 from the multivariable analysis were declared as factors significantly associated with acute diarrhea.
The prevalence of acute diarrhea among children under five in the study area was 11% (95%CI: 7.8-14.3%). About two-thirds (63.60%) of study participants used water from improved sources. About half (54.90%) of study participants practiced poor handwashing and 45.10% practiced good handwashing. We found that factors significantly associated with acute diarrhea were a child's age of 12-23 months (AOR = 4.68, 95% CI: 1.45-1.50), the presence of two or more under-five children in the house (AOR = 2.84, 95% CI: 1.19-6.81), unimproved water sources (AOR = 2.97, 95% CI: 1.28-6.87) and presence of feces around the pit hole/slab/floor of the latrine (AOR = 3.34, 95% CI: 1.34-8.31).
The prevalence of acute diarrhea among children under five was relatively high. To reduce the problem, various prevention strategies are essential, such as the provision of health education to mothers/caregivers that focuses on keeping sanitation facilities clean and child care, and construction of improved water sources. Furthermore, implementing a strong health extension program, advocating an open defecation-free environment, and practicing a community-led total sanitation and hygiene approach might be helpful to sustainably reduce childhood diarrhea.
腹泻病仍然是包括埃塞俄比亚在内的发展中国家五岁以下儿童死亡和发病的最常见原因之一。在埃塞俄比亚东北部南沃洛州的盖尔沙半城市地区,缺乏五岁以下儿童急性腹泻患病率及相关因素的具体数据,这仍是一个重大空白。因此,本研究旨在提供重要数据,以合理规划干预措施,减少该地区的这一问题。
2019年1月至3月,在盖尔沙半城市地区对340名系统选取的五岁以下儿童进行了一项基于社区的横断面研究。数据通过结构化问卷和观察清单收集。采用二元逻辑回归模型进行双变量(粗比值比[COR])和多变量分析(调整比值比[AOR]),95%置信区间(CI)。多变量分析中p值<0.05的变量被视为与急性腹泻显著相关的因素。
研究地区五岁以下儿童急性腹泻患病率为11%(95%CI:7.8 - 14.3%)。约三分之二(63.60%)的研究参与者使用改良水源的水。约一半(54.90%)的研究参与者洗手习惯不良,45.10%洗手习惯良好。我们发现与急性腹泻显著相关的因素包括:儿童年龄为12 - 23个月(AOR = 4.68,95%CI:1.45 - 1.50)、家中有两个或更多五岁以下儿童(AOR = 2.84,95%CI:1.19 - 6.81)、水源未改良(AOR = 2.97,95%CI:1.28 - 6.87)以及厕所坑洞/平板/地面周围有粪便(AOR = 3.34,95%CI:1.34 - 8.31)。
五岁以下儿童急性腹泻患病率相对较高。为减少这一问题,各种预防策略至关重要,例如为母亲/照顾者提供健康教育,重点是保持卫生设施清洁和儿童护理,以及建设改良水源。此外,实施强有力的健康推广计划、倡导无露天排便环境以及采用社区主导的全面环境卫生和个人卫生方法可能有助于可持续地减少儿童腹泻。