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Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Determinants of childhood diarrhea in Medebay Zana District, Northwest Tigray, Ethiopia: a community based unmatched case–control study

Authors: Kiflom Fisseha Asfaha, Fessahaye Alemseged Tesfamichael, Gizienesh Kahsay Fisseha, Kebede Haile Misgina, Meresa Gebremedhin Weldu, Negassie Berhe Welehaweria, Yosef Sibhatu Gebregiorgis

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Globally, childhood diarrhea is amongst the most prevalent health problems and accounts for 9% of all deaths in children under-five. In Ethiopia, childhood diarrhea is a major public health problem in which the prevalence ranges from 13.5 to 30.5% and experienced by multiple factors. Although health extension program has been implementing for couples of years; diarrheal disease remains the second cause of morbidity and continues an important public health problem in the study district. Thus, this study assessed determinants of diarrheal disease among under-five children in the Medebay Zana district, northwest Tigray, Ethiopia, 2015.

Method

A community based case-control study was used. A multistage sampling procedure was employed to enroll the study participants. Data were collected using face to face administered questionnaire. The collected data were entered into Epi Info version 3.5.4 and exported to SPSS Version 21 for analysis. Frequencies with percentages were computed using univariate analysis. Finally, logistic regression model was fitted to identify factors associated with childhood diarrhea where P-values of less than 0.05 were considered statistically significant.

Results

Socio-demographic factors such as low maternal educational level [AOR = 2.88, 95% CI (1.70, 4.88)], being index child of older age, households with ≥3 number of children under-five [AOR = 4.05, 95% CI (1.91, 8.60)] and maternal history of diarrhea [AOR = 2.10, 95% CI (1.09, 4.05)] were statistically associated with childhood diarrhea. This study also revealed that child feeding practice; not exclusively breastfed [AOR = 4.84, 95% CI (2.21, 10.60)] and initiation of complementary feeding above 6 months [AOR = 1.78, 95% CI (1.09, 2.92)] were statistically associated with outcome variable. Environmental and behavioral practices such as unavailability toilet facility [AOR = 2.10, 95% CI (1.34, 3.30)], improper solid waste disposal [AOR = 2.29, 95% CI (1.53, 3.44)] and unprotected drinking water [AOR = 1.83, 95% CI (1.12, 2.98)] were also found significant factors of childhood diarrhea.

Conclusion

Maternal educational status, age of index child, number of < 5 children, child feeding practices, maternal history of diarrhea, toilet facility, solid waste disposal and household drinking water were found determinants of childhood diarrhea. These findings have policy implications and insight the strengthening for health intervention programs.
Literature
1.
go back to reference WHO. Diarrheal diseases: World Health Organization; 2013. WHO. Diarrheal diseases: World Health Organization; 2013.
2.
go back to reference UNICEF: Diarrhoea remains a leading killer of young children, despite the availability of a simple treatment solution. UNICEF data: monitoring the situation of children and women, Updated: Jun 2016. UNICEF: Diarrhoea remains a leading killer of young children, despite the availability of a simple treatment solution. UNICEF data: monitoring the situation of children and women, Updated: Jun 2016.
3.
go back to reference Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405–16.PubMedCrossRef Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O'Brien KL, Campbell H, Black RE. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405–16.PubMedCrossRef
4.
go back to reference Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2095–128.CrossRef Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013;380(9859):2095–128.CrossRef
5.
go back to reference Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(2):136–41.PubMedCrossRef Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(2):136–41.PubMedCrossRef
6.
go back to reference Demographic E. Health survey (2011). Addis Ababa. Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012. Demographic E. Health survey (2011). Addis Ababa. Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
8.
go back to reference Omore R, O'Reilly CE, Williamson J, Moke F, Were V, Farag TH, Van Eijk AM, Kotloff KL, Levine MM, Obor D. Health care-seeking behavior during childhood diarrheal illness: results of health care utilization and attitudes surveys of caretakers in western Kenya, 2007–2010. Am J Trop Med Hyg. 2013;89(1 Suppl):29–40.PubMedPubMedCentralCrossRef Omore R, O'Reilly CE, Williamson J, Moke F, Were V, Farag TH, Van Eijk AM, Kotloff KL, Levine MM, Obor D. Health care-seeking behavior during childhood diarrheal illness: results of health care utilization and attitudes surveys of caretakers in western Kenya, 2007–2010. Am J Trop Med Hyg. 2013;89(1 Suppl):29–40.PubMedPubMedCentralCrossRef
9.
go back to reference Diouf K, Tabatabai P, Rudolph J, Marx M. Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level. Glob Health Action. 2014;7:24895.PubMedCrossRef Diouf K, Tabatabai P, Rudolph J, Marx M. Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level. Glob Health Action. 2014;7:24895.PubMedCrossRef
10.
go back to reference Mekasha A, Tesfahun A. Determinants of diarrhoeal diseases: a community based study in urban south western Ethiopia. East Afr Med J. 2003;80(2):77–82.PubMed Mekasha A, Tesfahun A. Determinants of diarrhoeal diseases: a community based study in urban south western Ethiopia. East Afr Med J. 2003;80(2):77–82.PubMed
11.
go back to reference Deribew A, Tessema F, Girma B. Determinants of under-five mortality in Gilgel gibe field research center, Southwest Ethiopia. Ethiop J Health Dev. 2007;21(2):117–24.CrossRef Deribew A, Tessema F, Girma B. Determinants of under-five mortality in Gilgel gibe field research center, Southwest Ethiopia. Ethiop J Health Dev. 2007;21(2):117–24.CrossRef
12.
go back to reference MOFED: Ethiopia: 2010 MDGs report: trends and Prospects in meeting MDGs. Addis Ababa, 2010. Federal Ministry of Finance and Economic Development In.; 2015. MOFED: Ethiopia: 2010 MDGs report: trends and Prospects in meeting MDGs. Addis Ababa, 2010. Federal Ministry of Finance and Economic Development In.; 2015.
13.
go back to reference Demographic E. Health survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2011. Demographic E. Health survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2011.
14.
go back to reference Dessalegn M, Kumie A, Tefera W. Predictors of under-five childhood diarrhea: Mecha District, west Gojam, Ethiopia. Ethiop J Health Dev. 2011;25(3):192–200. Dessalegn M, Kumie A, Tefera W. Predictors of under-five childhood diarrhea: Mecha District, west Gojam, Ethiopia. Ethiop J Health Dev. 2011;25(3):192–200.
15.
go back to reference Eshete WB: A stepwise regression analysis on under-five diarrhoael morbidity prevalence in Nekemte town, western Ethiopia: maternal care giving and hygiene behavioral determinants. 2009. Eshete WB: A stepwise regression analysis on under-five diarrhoael morbidity prevalence in Nekemte town, western Ethiopia: maternal care giving and hygiene behavioral determinants. 2009.
16.
go back to reference Mengistie B, Berhane Y, Worku A. Prevalence of diarrhea and associated risk factors among children under-five years of age in eastern Ethiopia: a cross-sectional study. Open J Prev Med. 2013;3(07):446.CrossRef Mengistie B, Berhane Y, Worku A. Prevalence of diarrhea and associated risk factors among children under-five years of age in eastern Ethiopia: a cross-sectional study. Open J Prev Med. 2013;3(07):446.CrossRef
17.
go back to reference Gebru T, Taha M, Kassahun W. Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study. BMC Pub Health. 2014;14(1):1.CrossRef Gebru T, Taha M, Kassahun W. Risk factors of diarrhoeal disease in under-five children among health extension model and non-model families in Sheko district rural community, Southwest Ethiopia: comparative cross-sectional study. BMC Pub Health. 2014;14(1):1.CrossRef
18.
go back to reference Mihrete TS, Alemie GA, Teferra AS. Determinants of childhood diarrhea among underfive children in Benishangul Gumuz regional state, north West Ethiopia. BMC Pediatr. 2014;14(1):1.CrossRef Mihrete TS, Alemie GA, Teferra AS. Determinants of childhood diarrhea among underfive children in Benishangul Gumuz regional state, north West Ethiopia. BMC Pediatr. 2014;14(1):1.CrossRef
19.
go back to reference Azage M, Kumie A, Worku A, Bagtzoglou AC. Childhood diarrhea in high and low hotspot districts of Amhara region, Northwest Ethiopia: a multilevel modeling. J Health Popul Nutr. 2016;35(1):1.CrossRef Azage M, Kumie A, Worku A, Bagtzoglou AC. Childhood diarrhea in high and low hotspot districts of Amhara region, Northwest Ethiopia: a multilevel modeling. J Health Popul Nutr. 2016;35(1):1.CrossRef
20.
go back to reference Mohammed S, Tamiru D: The burden of diarrheal diseases among children under five years of age in Arba Minch District, southern Ethiopia, and associated risk factors: a cross-sectional study. International Scholarly Research Notices 2014, 2014. Mohammed S, Tamiru D: The burden of diarrheal diseases among children under five years of age in Arba Minch District, southern Ethiopia, and associated risk factors: a cross-sectional study. International Scholarly Research Notices 2014, 2014.
21.
go back to reference Tamiso A, Yitayal M, Awoke A. Prevalence and determinants of childhood diarrhoea among graduated households, in rural area of Shebedino district, southern Ethiopia, 2013. Science. 2014;2(3):243–51. Tamiso A, Yitayal M, Awoke A. Prevalence and determinants of childhood diarrhoea among graduated households, in rural area of Shebedino district, southern Ethiopia, 2013. Science. 2014;2(3):243–51.
22.
go back to reference TEKLIT A. Prevalence and associated factors of diarrhea among under-five children in laelay-Maychew district. Tigray Region, AAU; 2015. TEKLIT A. Prevalence and associated factors of diarrhea among under-five children in laelay-Maychew district. Tigray Region, AAU; 2015.
23.
go back to reference Zeleke T, Alemu ZA. Determinants of under-five childhood diarrhea in Kotebe health center, Yeka Sub City, Addis Ababa, Ethiopia: a case control study. Glob J Medical Research. 2014:14(4). Zeleke T, Alemu ZA. Determinants of under-five childhood diarrhea in Kotebe health center, Yeka Sub City, Addis Ababa, Ethiopia: a case control study. Glob J Medical Research. 2014:14(4).
24.
go back to reference Godana W, Mengistie B. Determinants of acute diarrhoea among children under five years of age in Derashe District, southern Ethiopia. Rural Remote Health. 2013;13(2329):10. Godana W, Mengistie B. Determinants of acute diarrhoea among children under five years of age in Derashe District, southern Ethiopia. Rural Remote Health. 2013;13(2329):10.
25.
go back to reference Simiyu S. Water risk factors pre-disposing the under five children to diarrhoeal morbidity in Mandera district, Kenya. East Afr J Pub Health. 2010;7(4):353-60. Simiyu S. Water risk factors pre-disposing the under five children to diarrhoeal morbidity in Mandera district, Kenya. East Afr J Pub Health. 2010;7(4):353-60.
26.
go back to reference Lamberti LM, Walker CLF, Black RE. Systematic review of diarrhea duration and severity in children and adults in low-and middle-income countries. BMC Pub Health. 2012;12(1):1.CrossRef Lamberti LM, Walker CLF, Black RE. Systematic review of diarrhea duration and severity in children and adults in low-and middle-income countries. BMC Pub Health. 2012;12(1):1.CrossRef
27.
go back to reference Ethiopia C. Summary and statistical report of the 2007 population and housing census. Federal democratic republic of Ethiopia population census commission. Addis Ababa; 2008. p. 1–10. Ethiopia C. Summary and statistical report of the 2007 population and housing census. Federal democratic republic of Ethiopia population census commission. Addis Ababa; 2008. p. 1–10.
28.
go back to reference MedebayZana Health office: Annual district health office report 2015. MedebayZana Health office: Annual district health office report 2015.
29.
go back to reference Regassa G, Birke W, Deboch B, Belachew T. Environmental determinants of diarrhea among under-five children in Nekemte town, western Ethiopia. Ethiop J Health Sci. 2008;18(2):939–45. Regassa G, Birke W, Deboch B, Belachew T. Environmental determinants of diarrhea among under-five children in Nekemte town, western Ethiopia. Ethiop J Health Sci. 2008;18(2):939–45.
30.
go back to reference Mohammed S, Tilahun M, Tamiru D. Morbidity and associated factors of diarrheal diseases among under five children in Arba-Minch district, southern Ethiopia, 2012. Sci J Pub Health. 2013;1(2):102–6.CrossRef Mohammed S, Tilahun M, Tamiru D. Morbidity and associated factors of diarrheal diseases among under five children in Arba-Minch district, southern Ethiopia, 2012. Sci J Pub Health. 2013;1(2):102–6.CrossRef
31.
go back to reference Boadi KO, Kuitunen M. Childhood diarrheal morbidity in the Accra metropolitan area, Ghana: socio-economic, environmental and behavioral risk determinants. World Health Popul. 2005;7:1-13. Boadi KO, Kuitunen M. Childhood diarrheal morbidity in the Accra metropolitan area, Ghana: socio-economic, environmental and behavioral risk determinants. World Health Popul. 2005;7:1-13.
32.
go back to reference Ferrer SR, Strina A, Jesus SR, Ribeiro HC, Cairncross S, Rodrigues LC, Barreto ML. A hierarchical model for studying risk factors for childhood diarrhoea: a case–control study in a middle-income country. Int J Epidemiol. 2008;37(4):805–15.PubMedCrossRef Ferrer SR, Strina A, Jesus SR, Ribeiro HC, Cairncross S, Rodrigues LC, Barreto ML. A hierarchical model for studying risk factors for childhood diarrhoea: a case–control study in a middle-income country. Int J Epidemiol. 2008;37(4):805–15.PubMedCrossRef
33.
go back to reference Amugsi DA, Aborigo RA, Oduro AR, Asoala V, Awine T, Amenga-Etego L. Socio-demographic and environmental determinants of infectious disease morbidity in children under 5 years in Ghana. Glob Health Action. 2015;8:29349.PubMedCrossRef Amugsi DA, Aborigo RA, Oduro AR, Asoala V, Awine T, Amenga-Etego L. Socio-demographic and environmental determinants of infectious disease morbidity in children under 5 years in Ghana. Glob Health Action. 2015;8:29349.PubMedCrossRef
34.
go back to reference Mashoto KO, Malebo HM, Msisiri E, Peter E. Prevalence, one week incidence and knowledge on causes of diarrhea: household survey of under-fives and adults in Mkuranga district, Tanzania. BMC Pub Health. 2014;14(1):1.CrossRef Mashoto KO, Malebo HM, Msisiri E, Peter E. Prevalence, one week incidence and knowledge on causes of diarrhea: household survey of under-fives and adults in Mkuranga district, Tanzania. BMC Pub Health. 2014;14(1):1.CrossRef
35.
go back to reference El Gilany A, Hammad S: Epidemiology of diarrhoeal diseases among children under age 5 years in Dakahlia, Egypt. 2005. El Gilany A, Hammad S: Epidemiology of diarrhoeal diseases among children under age 5 years in Dakahlia, Egypt. 2005.
36.
go back to reference Shah SM, Yousafzai M, Lakhani NB, Chotani RA, Nowshad G. Prevalence and correlates of diarrhea. Indian J Pediatr. 2003;70(3):207–11.PubMedCrossRef Shah SM, Yousafzai M, Lakhani NB, Chotani RA, Nowshad G. Prevalence and correlates of diarrhea. Indian J Pediatr. 2003;70(3):207–11.PubMedCrossRef
37.
go back to reference Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom millennium cohort study. Pediatr. 2007;119(4):e837–42.CrossRef Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom millennium cohort study. Pediatr. 2007;119(4):e837–42.CrossRef
38.
go back to reference Root GP. Sanitation, community environments, and childhood diarrhoea in rural Zimbabwe. J Health Popul Nutr. 2001:73–82. Root GP. Sanitation, community environments, and childhood diarrhoea in rural Zimbabwe. J Health Popul Nutr. 2001:73–82.
39.
go back to reference Mamo A, Hailu A. Assessment of prevalence and related factors of diarrheal diseases among under-five Year’s children in Debrebirehan referral hospital, Debrebirehan town, north Shoa zone, Amhara region, Ethiopia. Open Access Libr J. 2016;1(01):1. Mamo A, Hailu A. Assessment of prevalence and related factors of diarrheal diseases among under-five Year’s children in Debrebirehan referral hospital, Debrebirehan town, north Shoa zone, Amhara region, Ethiopia. Open Access Libr J. 2016;1(01):1.
40.
go back to reference Godana W, Mengiste B. Environmental factors associated with acute diarrhea among children under five years of age in derashe district, southern Ethiopia. Sci J Pub Health. 2013;1(3):119–24.CrossRef Godana W, Mengiste B. Environmental factors associated with acute diarrhea among children under five years of age in derashe district, southern Ethiopia. Sci J Pub Health. 2013;1(3):119–24.CrossRef
41.
go back to reference Tarekegn M, Enquselassie F. A case control study on determinants of diarrheal morbidity among under-five children in Wolaita Soddo town, southern Ethiopia. Ethiop J Health Dev. 2012;26(2):78–85. Tarekegn M, Enquselassie F. A case control study on determinants of diarrheal morbidity among under-five children in Wolaita Soddo town, southern Ethiopia. Ethiop J Health Dev. 2012;26(2):78–85.
42.
go back to reference Gascon J, Vargas M, Schellenberg D, Urassa H, Casals C, Kahigwa E, Aponte J, Mshinda H, Vila J. Diarrhea in children under 5 years of age from Ifakara, Tanzania: a case-control study. J Clin Microbiol. 2000;38(12):4459–62.PubMedPubMedCentral Gascon J, Vargas M, Schellenberg D, Urassa H, Casals C, Kahigwa E, Aponte J, Mshinda H, Vila J. Diarrhea in children under 5 years of age from Ifakara, Tanzania: a case-control study. J Clin Microbiol. 2000;38(12):4459–62.PubMedPubMedCentral
43.
go back to reference Nanan D, White F, Azam I, Afsar H, Hozhabri S. Evaluation of a water, sanitation, and hygiene education intervention on diarrhoea in northern Pakistan. Bull World Health Organ. 2003;81(3):160–5.PubMedPubMedCentral Nanan D, White F, Azam I, Afsar H, Hozhabri S. Evaluation of a water, sanitation, and hygiene education intervention on diarrhoea in northern Pakistan. Bull World Health Organ. 2003;81(3):160–5.PubMedPubMedCentral
Metadata
Title
Determinants of childhood diarrhea in Medebay Zana District, Northwest Tigray, Ethiopia: a community based unmatched case–control study
Authors
Kiflom Fisseha Asfaha
Fessahaye Alemseged Tesfamichael
Gizienesh Kahsay Fisseha
Kebede Haile Misgina
Meresa Gebremedhin Weldu
Negassie Berhe Welehaweria
Yosef Sibhatu Gebregiorgis
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1098-7

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