Menu
Menu
Menu
Menu
Introduction: Although most deaths are preventable with simple and inexpensive measures, death from diarrhea accounts for one out of nine deaths in children worldwide which makes it the disease with the highest mortality rate in children under the age of five. Therefore, this study is aims to investigate diarrhea prevalence and risk factors among children under the age of five in Jawi district, Awi Zone, Ethiopia. Materials and methods: A comparative cross-sectional study was done among 440 study participants from March to June 2019. Data were collected with a face-to-face interviewer-administered questionnaire. Data was entered into EPI Info version 7 software and cleaned and analyzed using SPSS version 20 software. Binary logistic regression was done to assess independent factors associated with the dependent variable. A significant association was determined using an adjusted odds ratio at a confidence level of 95% and a p-value of less than or equal to 0.05. Results: In the current study, the overall under-five children diarrheal disease was found to be 15.5%. Diarrheal disease prevalence in model and non-model households was 10.9 and 20%, respectively. Shallow water [AOR: 6.12, 95%CI; (1.52, 24.58)], and maternal diarrhea [AOR: 4.11, 95%CI; (1.75, 9.61)] were determinants of childhood diarrhea. Place of birth [OR: 2.52, 95%CI (1.16, 5.49)] and maternal diarrhea [AOR: 3.50; 95%CI (1.28, 9.56)] in non-model households were also determinants of childhood diarrhea. Conclusion: Under-five children diarrheal disease was found to be high in the Jawi District. Thus, to decrease the disease prevalence in the study area, the health extension workers aim to better educate the mothers on how to handle diarrheal diseases. It is also better for concerned stakeholders to promote institutional delivery and to give access to safe water for the community.
A community-based comparative cross-sectional study was conducted from May to June 2019. The Jawi district is found in the Western Amhara region 540 km away from Addis Ababa, the capital of Ethiopia, and 200 km away from Bahir Dar, the capital city of Amhara regional state. A total of 163,102 people live in this district, of which 50% are female. From the total population, about 19,399 are under-five children. There are about 35 governmental health institutions (28 health posts, six health centers, and one primary hospital) and 38 non-governmental health institutions (four medium clinics and 34 primary clinics) in the district. The total health workforces were about 215 of which 63 were found to be health extensions in the district. The water source of the district was mainly shallow (425), followed by a hand pump (100) and a water pipe in three kebeles (Figure 1). All under-five children were included, but any children whose caregivers were mentally ill and had a hearing problem were excluded from the study. Map showing Jawi District, Awi Zone, Ethiopia. The sample size was determined by using a double population proportion formula considering, 6.4% the proportion of diarrhea in extension modeled HHs and 25.5% the proportion of diarrhea in extension none modeled HHs among under-five children (11), 95% confidence level and 80% power. In the study that was conducted in the Sheko district the n1 was 275 and n2 was 550 with a ratio of two, based on this information I was calculated and pulled p and q values. The pulled p-value is 0.1913 and q is 0.809. Therefore, by considering the design effect of 2 and 10 percent non-response rates, the total sample size was 440. n1 = number of exposed (number of model households). n2 = number of non-exposed (number of non-model households). p1 = proportion of diarrheal case among children living model households. p2 = proportion of diarrheal case among children living in non-model households –p = pulled p-value; –q = pulled q value. The largest sample size obtained using the associated factor for this study was 148. By considering 10% of non-response and two design effects, the largest sample size was estimated to be 326 which was less than the sample size calculated above. Therefore, the final sample size for this study was 440. In the study district, there were two health extension modeled and 26 non-modeled kebeles. The kebeles were stratified to health extension modeled and not modeled. From the non-model kebeles, three kebeles were randomly selected using the lottery method and two kebeles from the modeled stratum were surveyed. From each selected kebele, households that have at least one child were enumerated by data collectors. Then, systematic random sampling was used to select households. The lottery method was used if there was more than one child in the household. When a household was closed during data collection, the next household was included. Diarrhea was defined as passing three or more loose or watery stools in 24 h in the household within the 2 weeks before the survey, as reported by the mother/caretaker of the child (14). Model household was defined as having a household head/caregiver who had taken basic training for 96 h and graduated on the 16 health extension packages (15). Non-model family was defined as having a household head/caregiver who had not taken basic training on the 16 health extension packages (15). Handwashing at a critical time was based on whether a mother/caregiver practiced all simple hand washings before food preparation, before child feeding, after child cleaning, and after latrine visiting. If these criteria were met, it was considered to be “all practiced” otherwise it was considered to be “partially practiced (16).” Proper refuse disposal was defined as a way of disposal of refuse which includes burning, buried in a pit or stored in a container, composting, and disposed of at a designated site, whereas disposal in an open field was considered as improper refuse disposal (14). A pretested, face-to-face interviewer-administered structured questionnaire was used to collect the desired sample size. The tool was first developed in English and translated to the local language then back to English to keep the tool consistent. The data was collected by four nurses and there was one health officer for supervision. Data was collected from the mother, father, or other caregivers using an interviewer-administered questionnaire. Data collector nurses and a supervisor were trained on basic interviewing techniques. The data were checked daily for its completeness by supervisors and principal investigators. The tool was pre-tested in 5% of the sample in deke 01 kebele. Data was entered into EPI Info version 7 software and cleaned and analyzed using SPSS version 20 software. Frequency, percentage, and mean were used to describe the characteristics of study participants. Binary logistic regression was carried out to assess independent factors associated with the dependent variable. A significant association was determined using an adjusted odds ratio at a confidence level of 95% and a p-value of less than or equal to 0.05.
N/A
