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Azanaw J, Malede A, Yalew HF, Worede EA. Determinants of diarrhoeal diseases among under-five children in Africa (2013-2023): a comprehensive systematic review highlighting geographic variances, socioeconomic influences, and environmental factors. BMC Public Health 2024; 24:2399. [PMID: 39232730 PMCID: PMC11373296 DOI: 10.1186/s12889-024-19962-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 09/02/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Diarrhea diseases continue to present a significant threat to the well-being of children under the age of five in Africa, thereby contributing substantially to both morbidity and mortality rates. The period spanning between January 2013 and December 2023 has witnessed persistent challenges in the fight against these diseases, thereby necessitating a thorough investigation into the factors that determine their occurrence. It is important to note that the burden of diarrhea diseases is not evenly distributed across the continent, with residence, socioeconomic, and environmental factors playing pivotal roles in shaping the prevalence and incidence rates. Consequently, this systematic review aimed to consolidate and analyze the existing body of literature on the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. METHOD The systematic review employed a rigorous methodological approach to examine the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. A comprehensive search strategy was implemented, utilizing databases such as PubMed, Scopus, and Web of Science, and incorporating relevant keywords. The inclusion criteria focused on studies published within the specified timeframe, with a specific focus on the determinants of diarrhea disease among children under the age of five in Africa. The study selection process involved a two-stage screening, with independent reviewers evaluating titles, abstracts, and full texts to determine eligibility. The quality assessment, employing a standardized tool, ensured the inclusion of studies with robust methodologies. Data extraction encompassed key study details, including demographics, residence factors, socioeconomic influences, environmental variables, and intervention outcomes. RESULTS The search yielded a total of 12,580 articles across 25 African countries; however, only 97 of these articles met the inclusion criteria and were ultimately included in the systematic review. The systematic review revealed geographic and seasonal disparities in the prevalence of diarrhoeal diseases across different countries in Africa. Factors such as age-related vulnerabilities, gender disparities, maternal occupation, disposal of young children's stools, and economic status were identified as significant determinants of the prevalence of diarrhea disease. CONCLUSION This systematic review provides a comprehensive understanding of the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. The nuanced analysis of residence variations, socioeconomic influences, environmental factors, and intervention outcomes underscores the complex nature of this issue. The findings highlight the necessity for region-specific and context-sensitive interventions to address the unique challenges faced by diverse communities. This review serves as a valuable resource for policymakers, healthcare professionals, and researchers, guiding the development of evidence-based strategies aimed at reducing the burden of diarrhea diseases and improving child health outcomes in Africa.
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Affiliation(s)
- Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Asmamaw Malede
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailemariam Feleke Yalew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eshetu Abera Worede
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Demoze L, Dessie A, Azanaw J, Yitageasu G, Asrat K, Gizaw Z. Under five children diarrhea prevalence and associated factors in slum areas of Gondar City Northwest Ethiopia: a community based cross-sectional study. Sci Rep 2024; 14:19095. [PMID: 39154097 PMCID: PMC11330445 DOI: 10.1038/s41598-024-70102-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024] Open
Abstract
Slum areas in Ethiopia have high poverty status. In addition, they possess poor water and sanitation accesses such as unsafe drinking water, a lower number of sanitation facilities and poor hygienic conditions. These scenarios are important in the occurrence of diarrhea among under five children's. However, there are many studies conducted on diarrhea among under five children in Ethiopia, unfortunately, the majority usually didn't give enough coverage for the burden of diarrhea among under five children in slum areas. This study aimed to determine the prevalence of diarrhea and associated factors among under five children in slum areas of Gondar City. This community-based cross-sectional study was conducted in slum areas of Gondar City among under five children from March 28 to April 28, 2023. A multi-stage sampling technique was used to collect a sample of 836 through interview-administered methods using a structured data collection tool. The collected data was manually checked for completeness, coded, and entered into EPI Info version 7.1.5.2 software. It was then exported to Stata version 14.1 software for descriptive analysis, as well as bivariable and multivariable binary logistic regression analyses, to identify factors associated with diarrhea among under five children. The prevalence of diarrhea among under five children at 95% confidence interval was 24.64% (CI 21.71-27.56). Mothers/caretakers age < 25 years (AOR = 1.88, 95% CI 1.16-3.06), mothers/caretakers age between 28 and 31 years (AOR = 1.82, 95% CI 1.08-3.05), mothers/caretakers who had no formal education (AOR = 3.18, 95% CI 1.86-5.41), mothers/caretakers who had primary education (AOR = 1.67, 95% CI 1.09-2.57), income level between 4877 and 5643 Ethiopian Birr (AOR = 1.81, 95% CI 1.04-3.15), family size greater than five (AOR = 1.54, 95% CI 1.00-2.36), flies around the house (AOR = 2.27, 95% CI 1.38-3.73), playground not clean (AOR = 2.70, 95% CI 1.62-4.50), breastfed for ≥ 1 year (AOR = 0.63, 95% CI 0.41-0.97), mothers/caretakers who did not wash their hands before food preparation and eating (AOR = 2.31, 95% CI 1.39-3.58), mothers/caretakers who did not wash their hands after visiting latrine (AOR = 1.60, 95% CI 1.07-2.38) were significantly associated factors with diarrhea among under five children in slum areas of Gondar City. The study indicates that the prevalence of diarrhea was higher among under five children in slum areas of Gondar City. The Gondar City Administration Education Bureau should give great emphasis on improving mother's and caretaker's education. In addition, the Gondar City Administration Health Bureau should educate mothers and caretakers about breastfeeding, sanitation, and hygiene in the slum areas of Gondar City.
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Affiliation(s)
- Lidetu Demoze
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Awrajaw Dessie
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gelila Yitageasu
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kidist Asrat
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Aydamo AA, Gari SR, Mereta ST. The nexus between household water insecurity, mother's handwashing practices, and diarrheal diseases among under-five children. JOURNAL OF WATER AND HEALTH 2024; 22:1357-1371. [PMID: 39212275 DOI: 10.2166/wh.2024.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/05/2024] [Indexed: 09/04/2024]
Abstract
This study aimed to examine the association between household water insecurity (HWIS), mother's handwashing practices, and childhood diarrhea in the peri-urban and informal settlements of Hosanna town. A community-based cross-sectional study involving 424 mothers was carried out in Hosanna town, and the data were collected using a pretested structured questionnaire, HWISE Scale, and an observational checklist. Bivariate and multivariable logistic regression models were used to analyze the data. The study revealed that the prevalence of HWIS and diarrhea among under-five children was 68.6% and 16%, respectively. Only 42.2% of the mothers had good handwashing practices. Good knowledge of handwashing, positive attitudes toward handwashing, household water security (HWS), and the presence of handwashing facilities were significantly associated with good handwashing practices. Children aged 6-11 months, HWIS, uncovered and wide-mouthed water storage containers, unsafe child's stool disposal practices, and hands not washed with soap after defecation, before preparing food, and feeding a child were significantly associated with the occurrence of diarrhea. The prevalence of diarrhea and HWIS was very high. The majority of the mothers had poor handwashing practices. Therefore, findings suggest interventions to improve HWS and mother's handwashing practices, which could reduce the risk of diarrheal diseases.
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Affiliation(s)
- Abiot Abera Aydamo
- Water and Health, Ethiopian Institute of Water Resources (EiWR), Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia; Department of Environmental Sciences, Wachemo University, P.O. Box: 667, Hosanna, Ethiopia E-mail: ;
| | - Sirak Robele Gari
- Water and Health, Ethiopian Institute of Water Resources (EiWR), Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia
| | - Seid Tiku Mereta
- Department of Environmental Health and Technology, Jimma University, P.O. Box: 1995, Jimma, Ethiopia
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Yitageasu G, Feleke H, Andualem Z, Demoze L, Asrat K, Gizaw Z. Detection of spatial, temporal and spatiotemporal distribution of diarrhea incidence among under-five children in Central Gondar zone, Northwest Ethiopia: a time-series study (2019-2022). BMC Pediatr 2024; 24:433. [PMID: 38969969 PMCID: PMC11225151 DOI: 10.1186/s12887-024-04900-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
Under-five children's diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children's diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.
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Affiliation(s)
- Gelila Yitageasu
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hailemariam Feleke
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lidetu Demoze
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kidist Asrat
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Sahiledengle B, Atlaw D, Mwanri L, Petrucka P, Kumie A, Tekalegn Y, Desta F, Zenbaba D, Mesfin T, Gomora D, Agho KE. Burden of Childhood Diarrhea and Its Associated Factors in Ethiopia: A Review of Observational Studies. Int J Public Health 2024; 69:1606399. [PMID: 38903206 PMCID: PMC11188320 DOI: 10.3389/ijph.2024.1606399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Objectives: This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of acute diarrheal illnesses among under-five children in Ethiopia. Methods: A comprehensive systematic search was conducted in PubMed, SCOPUS, HINARI, Science Direct, Google Scholar, Global Index Medicus, Directory of Open Access Journals (DOAJ), and the Cochrane Library. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological quality of each included article was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional and case-control studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of diarrheal illnesses. Heterogeneity and publication bias were assessed using I2 test statistics and Egger's test, respectively. The statistical analysis was done using STATA™ software version 14. Results: Fifty-three studies covering over 27,458 under-five children who met the inclusion criteria were included. The pooled prevalence of diarrhea among under-five children in Ethiopia was found to be 20.8% (95% CI: 18.69-22.84, n = 44, I2 = 94.9%, p < 0.001). Our analysis revealed a higher prevalence of childhood diarrhea in age groups of 12-23 months 25.42% (95%CI: 21.50-29.35, I2 = 89.4%, p < 0.001). In general, the evidence suggests that diarrheal risk factors could include: i) child level determinants (child's age 0-23 months, not being vaccinated against rotavirus, lack of exclusive breastfeeding, and being an under-nourished child); ii) parental level determinants {mothers poor handwashing practices [pooled odds ratio (OR) = 3.05; 95% CI:2.08-4.54] and a history of maternal recent diarrhea (pooled OR = 3.19, 95%CI: 1.94-5.25)}; and iii) Water, Sanitation and Hygiene (WASH) determinants [lack of toilet facility (pooled OR = 1.56, 95%CI: 1.05-2.33)], lack handwashing facility (pooled OR = 4.16, 95%CI: 2.49-6.95) and not treating drinking water (pooled OR = 2.28, 95% CI: 1.50-3.46). Conclusion: In Ethiopia, the prevalence of diarrhea among children under the age of five remains high and is still a public health problem. The contributing factors to acute diarrheal illnesses were child, parental, and WASH factors. A continued focus on improving access to WASH facilities, along with enhancing maternal hygiene behavior will accelerate reductions in diarrheal disease burden in Ethiopia.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, SA, Australia
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Abera Kumie
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannes Tekalegn
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Telila Mesfin
- School of Medicine, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
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Alpaugh V, Ortigoza A, Braverman Bronstein A, Pérez-Ferrer C, Wagner-Gutierrez N, Pacifico N, Ezeh A, Caiaffa WT, Lovasi G, Bilal U. Association Between Household Deprivation and Living in Informal Settlements and Incidence of Diarrhea in Children Under 5 in Eleven Latin American Cities. J Urban Health 2024; 101:629-637. [PMID: 38652338 PMCID: PMC11189882 DOI: 10.1007/s11524-024-00854-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
Diarrhea is a leading cause of death in children globally, mostly due to inadequate sanitary conditions and overcrowding. Poor housing quality and lack of tenure security that characterize informal settlements are key underlying contributors to these risk factors for childhood diarrhea deaths. The objective of this study is to better understand the physical attributes of informal settlement households in Latin American cities that are associated with childhood diarrhea. We used data from a household survey (Encuesta CAF) conducted by the Corporación Andina de Fomento (CAF), using responses from sampled individuals in eleven cities. We created a household deprivation score based on household water and sewage infrastructure, overcrowding, flooring and wall material, and security of tenure. We fitted a multivariable logistic regression model to estimate odds ratios (OR) and 95% confidence intervals (95% CI) to test the association between the deprivation score and its individual components and childhood diarrhea during the prior 2 weeks. We included a total of 4732 households with children, out of which 12.2% had diarrhea in the 2-week period prior to completing the survey. After adjusting for respondent age, gender, and city, we found a higher risk of diarrhea associated with higher household deprivation scores. Specifically, we found that the odds of diarrhea for children living in a mild and severe deprived household were 1.04 (95% CI 0.84-1.28) and 3.19 times (95% CI 1.80-5.63) higher, respectively, in comparison to households with no deprivation. These results highlight the connections between childhood health and deprived living conditions common in informal settlements.
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Affiliation(s)
- Victoria Alpaugh
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
| | - Ana Ortigoza
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Social and Environmental Determinants of Health Equity, Pan American Health Organization, Washington, D.C., USA
| | - Ariela Braverman Bronstein
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Institute for Community Health, Cambridge Health Alliance, Malden, MA, USA
| | - Carolina Pérez-Ferrer
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Natalia Pacifico
- Institute of Collective Health, National University of Lanús, Remedios de Escalada, Argentina
- FJ Muñiz Infectious Hospital, Buenos Aires, Argentina
| | - Alex Ezeh
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Community Health and Prevention, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Waleska Teixeira Caiaffa
- Observatory for Urban Health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gina Lovasi
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA.
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3600 Market St. Suite 730, Philadelphia, PA, 19104, USA.
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Yonas B, Sisay T, Gizeyatu A, Feleke A, Daba C, Gebrehiwot M. To do's after war: Priorities for acute diarrheal diseases intervention among under-five children in conflict settings of Raya Kobo district, Northeastern Ethiopia. Heliyon 2024; 10:e28394. [PMID: 38633653 PMCID: PMC11021898 DOI: 10.1016/j.heliyon.2024.e28394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 10/25/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Diarrheal diseases are significant causes of under-five children mortality and morbidity in developing countries. This is particularly alarming among the community living in conflict zones where less attention is given for basic services including water, food, and health. However, there are no detailed investigations on acute diarrhea among under-five children in conflict-affected areas, which impedes intervention approaches. Therefore, this study was designed to assess the prevalence of acute diarrhea and associated factors among under-five children in conflict-affected setting of Raya Kobo, Northeast Ethiopia. Methods A community-based cross-sectional study was employed among 463 under-five children in Raya Kobo district, from February to March 2021. The study participants were selected from ten rural kebeles. Pre-tested questionnaire and observational checklist were used to collect the data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the prevalence of acute diarrhea. Results The prevalence of acute diarrhea among under-five children was 21% (95% confidence interval (CI): 18.50-23.91%). Unimproved drinking water source (Adjusted odds ratio (AOR) = 2.89; 95%CI: 1.38-6.06), disposal of garbage in open field (AOR = 3.33; 95%CI:1.66-6.67), having low monthly income (AOR = 5.73; 95%CI: 3.07-10.59), absence of latrine facility (AOR = 3.18; 95%CI: 1.09-8.78), poor hand washing practice at critical times (AOR = 2.52; 95%CI:1.28-4.05), not regularly cleaning food utensil before child feeding (AOR = 2.54; 95%CI:1.31-4.94), and not received Rota vaccine (AOR = 4.28; 95%CI: 1.82-10.11) were the determinant factors. Conclusions To reduce the burden of acute diarrheal diseases, post-war intervention approaches should emphasize on advocating for Rota virus vaccination, regularly cleaning food utensils before feeding, improving hand washing practice at critical times, provision of improved drinking water source, and use of proper solid and domestic sewage discharge/disposal methods.
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Affiliation(s)
| | - Tadesse Sisay
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Adinew Gizeyatu
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alelgne Feleke
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Wasonga J, Miyamichi K, Hitachi M, Ozaki R, Karama M, Hirayama K, Kaneko S. Effects of Community-Led Total Sanitation (CLTS) Boosting and Household Factors on Latrine Ownership in Siaya County, Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6781. [PMID: 37754640 PMCID: PMC10531019 DOI: 10.3390/ijerph20186781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Community-led total sanitation (CLTS) is a widely used approach for enhancing sanitation practices. However, the impact of boosted CLTS on household latrine ownership has not been adequately evaluated. This study aims to investigate the factors associated with latrine possession among households, with a specific focus on single and CLTS-boosting implementation. A community-based repeated cross-sectional study was conducted in Siaya County, Kenya, involving 512 households at the baseline and 423 households at the follow-up. Data were analyzed using the mixed-effects logistic regression model. At the baseline, latrine possession was significantly associated with CLTS implementation (adjusted OR [aOR]: 3.01; 95% confidence interval [CI]: 1.41-6.44), literacy among households (aOR: 1.83; 95% CI: 1.12-2.98) and higher socioeconomic status (SES) (second level: aOR: 2.48; 95% CI:1.41-4.36, third level: aOR: 3.11; 95% CI: 1.76-5.50, fourth level: aOR: 10.20; 95% CI: 5.07-20.54). At follow-up, CLTS boosting (aOR: 7.92; 95% CI: 1.77-35.45) and a higher SES were associated with increased latrine ownership (second level: aOR: 2.04; 95% CI: 0.97-4.26, third level: aOR: 7.73; 95% CI: 2.98-20.03, fourth level: aOR: 9.93; 95% CI: 3.14-28.35). These findings highlight the significant role played by both single and CLST boosting in promoting universal latrine ownership and empowering vulnerable households to understand the importance of sanitation and open defecation-free practices.
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Affiliation(s)
- Job Wasonga
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Kazuchiyo Miyamichi
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (K.M.); (M.H.); (R.O.)
| | - Mami Hitachi
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (K.M.); (M.H.); (R.O.)
| | - Rie Ozaki
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (K.M.); (M.H.); (R.O.)
| | - Mohamed Karama
- Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi 20752-00202, Kenya;
- AMREF Health Africa Ethics and Scientific Research Committee, Amref Health Africa, Nairobi 27691-00506, Kenya
| | - Kenji Hirayama
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Satoshi Kaneko
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan;
- Department of Ecoepidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan; (K.M.); (M.H.); (R.O.)
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan;
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Adhikari S, Hunter E, Vossenberg JVD, Thomas J. A review of latrine front-end characteristics associated with microbial infection risk; reveals a lack of pathogen density data. Int J Hyg Environ Health 2023; 254:114261. [PMID: 37734133 DOI: 10.1016/j.ijheh.2023.114261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
Unsafe sanitation accounts for an estimated 898,000 global deaths annually. The faecal pathogen transmission pathway is complex with several possible routes. Latrine front-end characteristics and usage behaviours are one key transmission pathway for microbial pathogens, however, there has not yet been a synthesis of the available research. This review aims to compare the microbial infection risks with latrine front-end components including any quantified microbial densities within the household latrines. This review was conducted with no restriction on the geographical location of the research. Of 118 studies reviewed, only ten (8%) have quantified the microbial density inside the household latrines compared to 109 (92%) measuring the infection risks. The reported risks were most frequent for specific bacterial (n = 34), and helminths infections (n = 32) compared to diarrhoea (n = 23), combined (n = 15), protozoan (n = 4), and viral (n = 4) infections. The infections risk decreased for using latrines lying at a higher position on the sanitation ladder (for example flush latrines) compared to those lying lower (for example pit latrines). The trend was similar for using floor materials that were easier to clean and less favourable for pathogen survival inside the latrines (for example, concrete as opposed to earth). Faecal coliforms were reported highest on the surface of the squat pan (743 CFU/cm2) of pour-flush latrines and helminths on earth floors of pit latrines (1.5 eggs and larvae per gram of soil). Irrespective of latrine type and its position on the sanitation ladder, a dirty latrine, evidenced by a visible lack of cleanliness, significantly increased the risk for all infections. This study recommends that effective microbial infection risk reduction in latrines can be gained efficiently by ensuring washable surfaces and consistent cleaning practices. Future studies should include more rigorous measurements of microbial densities in various latrine types incorporating the different front-end components and usage behaviours.
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Affiliation(s)
- Sabita Adhikari
- School of Civil Engineering, The University of Sydney, Australia.
| | - Erin Hunter
- Department of Public Health Sciences, College of Behavioural, Social and Health Sciences, Clemson University, United States.
| | - Jack van de Vossenberg
- Water Supply, Sanitation and Environmental Engineering Department, IHE Delft Institute of Water Education, the Netherlands.
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Girmay AM, Weldetinsae A, Mengesha SD, Adugna EA, Alemu ZA, Wagari B, Serte MG, Awoke KS, Bedada TL, Weldegebriel MG, Dinssa DA, Alemayehu TA, Kenea MA, Tekulu KT, Gobena W, Fikresilassie G, Wube W, Melese AW, Redwan E, Hoffmann V, Tessema M, Tollera G. Associations of WHO/UNICEF Joint Monitoring Program (JMP) Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e071296. [PMID: 37500269 PMCID: PMC10387618 DOI: 10.1136/bmjopen-2022-071296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To determine the associations of WHO/UNICEF Joint Monitoring Program Water, Sanitation and Hygiene (WASH) Service Ladder service levels and sociodemographic factors with diarrhoeal disease among children under 5 years in Bishoftu town, Ethiopia. DESIGN A community-based cross-sectional study. SETTING Bishoftu town, Ethiopia, January-February 2022. PARTICIPANTS A total of 1807 mothers with at least one child under 5 years were included. Sociodemographic and WASH variables were collected using a structured questionnaire. 378 drinking water samples were collected. OUTCOME The response variable was diarrhoeal disease among children under 5 years. RESULTS The 2-week prevalence of diarrhoeal disease among children under 5 years was 14.8%. Illiteracy (adjusted OR 3.15; 95% CI 1.54 to 6.47), occupation (0.35; 0.20 to 0.62), mother's age (1.63; 1.15 to 2.31), family size (2.38; 1.68 to 3.39), wealth index (5.91; 3.01 to 11.59), residence type (1.98; 1.35 to 2.90), sex of the child (1.62; 1.17 to 2.24), child's age (3.52; 2.51 to 4.93), breastfeeding status (2.83; 1.74 to 4.59), food storage practice (3.49; 1.74 to 8.26), unimproved drinking water source (8.16; 1.69 to 39.46), limited drinking water service (4.68; 1.47 to 14.95), open defecation practice (5.17; 1.95 to 13.70), unimproved sanitation service (2.74; 1.60 to 4.67), limited sanitation service (1.71; 1.10 to 2.65), no hygiene service (3.43; 1.91 to 6.16) and limited hygiene service (2.13; 1.17 to 3.86) were significantly associated with diarrhoeal disease. CONCLUSION In this study, diarrhoea among children is a significant health issue. Child's age, drinking water service, residence type and hygiene service were the largest contributors with respect to the prevalence of diarrhoeal disease. This investigation provides information that could help to inform interventions to reduce childhood diarrhoea. The findings suggest that state authorities should initiate robust WASH strategies to achieve the Sustainable Development Goal 3 agenda.
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Affiliation(s)
- Aderajew Mekonnen Girmay
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abel Weldetinsae
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sisay Derso Mengesha
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ermias Alemayehu Adugna
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zinabu Assefa Alemu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bedasa Wagari
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gizaw Serte
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kaleab Sebsibe Awoke
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tesfaye Legesse Bedada
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesaye Getachew Weldegebriel
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Danial Abera Dinssa
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tsigereda Assefa Alemayehu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Moa Abate Kenea
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kirubel Tesfaye Tekulu
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Waktole Gobena
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getinet Fikresilassie
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wendayehu Wube
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Abayew Wassie Melese
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Ekram Redwan
- Department of Hygiene and Environmental Health, Ministry of Health, Addis Ababa, Ethiopia
| | - Vivian Hoffmann
- International Food Policy Research Institute (IFPRI), Washington, DC, USA
- Department of Economics and School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
| | - Masresha Tessema
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getachew Tollera
- Department of Nutrition and Environmental Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Addis GT, Dagnew SB, Anagaw A, Ayele TM, Tadesse TY. Evaluation of antibiotic utilization pattern in the treatment of acute diarrheal diseases at Debre Tabor comprehensive specialized hospital, Debre Tabor, Ethiopia: A retrospective cross-sectional study. Heliyon 2023; 9:e18049. [PMID: 37449097 PMCID: PMC10336787 DOI: 10.1016/j.heliyon.2023.e18049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
Background In clinical settings all across the world, including Ethiopia, the irrational use of antibiotics to treat acute diarrhea is common. The main causes of resistance are antibiotic abuse, misuse, and underuse, and among infectious diseases, antibiotic overuse is pervasive in diarrheal infections around the world. As a result, the primary goal of this study was to evaluate antibiotic use patterns for the treatment of acute diarrheal diseases at Debre Tabor Comprehensive Specialized Hospital in North-West Ethiopia. Methodology A retrospective cross-sectional study was conducted to assess the antibiotic utilization pattern used to treat acute diarrheal illness, taken from the record cards of 243 patients who received treatment for acute diarrheal illness, employing structured questions from September 1 to September 30, 2022. The results are displayed using percentages and frequency distributions in tables along with figures. Results A total of 243 patients were involved, 134 (55.1%) of whom were male and 134 (55.1%) were under the age of five. Out of the 103 cases of acute watery diarrhea, 83 received antibiotics that were given improperly. Additionally, 88 individuals had bloody diarrhea diagnoses, but 58 of them received the currently administered antibiotics. Amoxicillin and co-trimoxazole were the most frequently prescribed medications, with 193 (79.5%) of the 243 cases of patients receiving some form of antibiotic. Conclusion The results of the study revealed that there is inappropriate antibiotic use in acute diarrheal disease at Debre Tabor Comprehensive Specialized Hospital, which might be the cause for the overall increase in antimicrobial resistance as well as the associated costs of treatment. The finding is helpful as evidence for prescribers' inappropriate use of antibiotics for the treatment of acute diarrheal sickness.
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Berihun G, Abebe M, Hassen S, Gizeyatu A, Berhanu L, Teshome D, Walle Z, Desye B, Sewunet B, Keleb A. Drinking water contamination potential and associated factors among households with under-five children in rural areas of Dessie Zuria District, Northeast Ethiopia. Front Public Health 2023; 11:1199314. [PMID: 37361152 PMCID: PMC10289289 DOI: 10.3389/fpubh.2023.1199314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Objective More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia. Methods The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit. Results A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water. Conclusion Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment.
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Affiliation(s)
- Gete Berihun
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Masresha Abebe
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Seada Hassen
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Adinew Gizeyatu
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Leykun Berhanu
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Teshome
- Department of Pre-clerkship, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zebader Walle
- Department of Public Health, College of Health Sciences, Debre Tabor University, Gondar, Ethiopia
| | - Belay Desye
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Birhanu Sewunet
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Awoke Keleb
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Tsegaw M, Mulat B, Shitu K. Safe stool disposal and associated factors among mothers of children aged under-two years in Gambia: Evidence from Gambia Demographic Health Survey 2019/20. PLoS One 2023; 18:e0284986. [PMID: 37126505 PMCID: PMC10150983 DOI: 10.1371/journal.pone.0284986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/12/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Appropriate disposal of child stool is vital in preventing the spread of faecal-oral diseases. According to WHO/ UNICEF Joint Monitoring Program, Safe child stool disposal includes disposing a stool in a Flush or pour-flush toilet/latrine (to a piped sewer system, septic tank, pit latrine), Ventilated improved pit (VIP) latrine or a Pit latrine with slab. OBJECTIVE The study aimed to assess safe child stool disposal practice and associated factors among mothers with children aged under-two years in Gambia. METHODS This study was based on a large community-based cross-sectional survey, conducted from 21 November 2019 to 30 March 2020 in Gambia. The survey employed a two-staged stratified cluster sampling technique to recruit study participants. Descriptive statistics and logistic regression models were used to summarize descriptive data and identify factors associated with safe waste disposal, respectively. A p-value of less than 0.05 and 95% confidence interval were used to determine statistical significance. RESULTS The prevalence of safe stool disposal among mothers with children aged under-two years were 56.3% (95% CI: 54.6%, 58.1%). Mothers aged 25-34 (AOR = 0.78 (95%CI: 0.62, 0.98)), the highest wealth quintile (AOR = 0.43 (95%CI: 0.33, 0.56)), being exposed to media (AOR = 1.37 (95%CI: 1.07, 1.76)), increasing age of children (AOR = 1.06 (1.05, 1.07)), Being employed (AOR = 1.31 (1.11, 1.55)) and Geographic region were significantly associated with safe child disposal practice. CONCLUSION The prevalence of safe child stool disposal was low in Gambia. Age of the mother, age of the child, region, wealth index, media exposure and occupational status of the mother were significantly associated with safe child stool disposal. Public health intervention strategies designed to promote safe child stools disposal need to conduct thorough community assessments to identify community-specific facilitators, needs and barriers. Additionally, public health experts and policy makers should take into consideration the geographical and wealth inequalities when designing programs aimed to improve safe child stool disposal practice.
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Affiliation(s)
- Menen Tsegaw
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Bezawit Mulat
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Meki CD, Ncube EJ, Voyi K. Frameworks for mitigating the risk of waterborne diarrheal diseases: A scoping review. PLoS One 2022; 17:e0278184. [PMID: 36490262 PMCID: PMC9733858 DOI: 10.1371/journal.pone.0278184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diarrhea is one of the major cause of death and morbidity around the world. OBJECTIVES This scoping review summarizes existing frameworks that aim to mitigate the risks of waterborne diarrheal diseases and describe the strengths and weaknesses of these frameworks. ELIGIBILITY CRITERIA Published frameworks designed to mitigate the risks of waterborne diarrheal diseases. Frameworks published in English, from around the world and published since inception to date. SOURCES OF EVIDENCE PubMed, Scopus, Web of Science, Google Scholar, Google Free Search, organization websites and reference lists of identified sources. CHARTING METHODS Data were charted using the Joanna Briggs Institute tool. Results were summarized and described narratively. A criterion to score the strengths and weaknesses of the included frameworks was also developed. RESULTS Five frameworks were identified including: the hygiene improvement framework, community led total sanitation, global action plan for pneumonia and diarrhea, participatory hygiene and sanitation transformation, and sanitation and family education. These frameworks shared several common components, including identification of problems and risk factors, identification and implementation of interventions, and evaluation and monitoring. The frameworks had several interventions including different infrastructure, health promotion and education, enabling environment and clinical treatments. Most of the frameworks included health promotion and education. All the frameworks were strengthened by including strategies for implementing and delivering intervention, human resource aspect, community involvement, monitoring, and evaluation. The main weakness included not having components for collecting, storing, and transferring electronic data and the frameworks not being specifically for mitigating waterborne diarrheal diseases. In addition, the identified frameworks were found to be effective in mitigating the risk of diarrhea diseases among other health effects. CONCLUSIONS Existing frameworks should be updated specifically for mitigating waterborne diarrheal diseases that includes the strengths and addresses weaknesses of reviewed frameworks.
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Affiliation(s)
- Chisala D. Meki
- School of Public Health, University of Zambia, Lusaka, Zambia
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Esper J. Ncube
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- Rand Water, Johannesburg, South Africa
| | - Kuku Voyi
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Mulatu G, Ayana GM, Girma H, Mulugeta Y, Daraje G, Geremew A, Dheresa M. Association of drinking water and environmental sanitation with diarrhea among under-five children: Evidence from Kersa demographic and health surveillance site, eastern Ethiopia. Front Public Health 2022; 10:962108. [PMID: 36452955 PMCID: PMC9703461 DOI: 10.3389/fpubh.2022.962108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background Diarrhea remains one of the leading causes of mortality and morbidity, despite the global progression of eradicating the burden of diarrhea-related morbidity and mortality in the past two decades. In Sub-Saharan African (SSA) countries, there is inadequate supply and sanitation of safe water. However, there is a lack of literature that estimates the impact of drinking water and sanitation service on childhood diarrhea in Kersa Demographic and Health Surveillance. Therefore, the current study aimed to assess the prevalence and effect of water supply and environmental sanitation on diarrhea among under-five children from 2017 to 2021 in Kersa Demographic and Health Surveillance, Eastern Ethiopia. Method A prospective cohort study design was implemented among 6,261 children from the Kersa Health Demographic Surveillance System (HDSS), Eastern Ethiopia, from 1 January 2016 to 31 December 2021. STATA statistical software was used to extract data from the datasets. The binary logistic regression was used to identify the impact of water supply and environmental sanitation on diarrhea by controlling important confounders. The adjusted odds ratio (AOR) with a 95% confidence interval measures this association. Result The current study showed that among 6,261 under-five children, 41.75% of them had developed active diarrhea during the follow-up time. The final model depicted that having media exposure of 22% [AOR - 0.78 CI: (0.61, 0.98)], a protected tube well source of drinking water of 50% [AOR - 1.50, CI: (1.32, 1.71)], unprotected tube well source of drinking water of 66% [AOR - 1.66 CI: (1.27, 2.18)], having toilet facility of 13% [AOR - 0.87 CI: (0.78, 0.97)], and accessibility of source of water [AOR - 1.17 CI: (1.05, 1.30)] showed a significant association with diarrhea among under-five children. Conclusion The prevalence of diarrhea is found to be high in the Kersa District. The main predictors of diarrhea under five were a lack of latrines, an unimproved source of drinking water, and a distance from access to drinking water. The study setting should focus on increasing the adequacy of safe drinking water and sanitation.
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Affiliation(s)
- Gutema Mulatu
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Galana Mamo Ayana
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia,*Correspondence: Galana Mamo Ayana gelomamo724gmail.com
| | - Haileyesus Girma
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Yohannis Mulugeta
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Gamachis Daraje
- Department of Statistics, College of Computing and Informatics, Haramaya University, Dire Dawa, Ethiopia
| | - Abraham Geremew
- Department of Environmental Health, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia
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Jubayer A, Hafizul Islam M, Nowar A, Islam S. Exploring Household Water, Sanitation, and Hygiene and Acute Diarrhea among Children in St. Martin's Island, Bangladesh: A Cross-Sectional Study. Am J Trop Med Hyg 2022; 107:441-448. [PMID: 35895417 PMCID: PMC9393463 DOI: 10.4269/ajtmh.22-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/20/2022] [Indexed: 08/03/2023] Open
Abstract
Basic sanitation, safe drinking water, and proper hygiene practice may lessen the burden of waterborne illnesses and neglected tropical diseases. The current study sought, for the first time, to evaluate household water, sanitation, and hygiene (WASH) practices and acute diarrhea among children under 5 years of age and their associated factors on St. Martin's Island. Two hundred one households with at least one child aged under 5 years were interviewed using a pretested semi-structured questionnaire designed according to UNICEF/WHO Joint Monitoring Program for Water Supply, Sanitation, and Hygiene 2019 and on-the-spot observations. Multiple logistic regression analyses investigated the association between potential sociodemographic characteristics, WASH components, and acute diarrhea. Almost all sampled households (99.5%) had improved drinking water facilities. More than one-third (36.5%) did not have an improved sanitation facility, and open defecation was reported by 12.4% of study subjects. Only one-third of respondents reported washing their hands with soap or detergent after defecation, and approximately 29% of respondents reported sharing their toilet with other family members. A handwashing station with soap and water was observed in only 14.4% of cases, whereas more than 22% had none. More than one-quarter (26.4%) of children aged under 5 years were reported to experience acute diarrhea. Access to WASH facilities and the occurrence of acute diarrhea were found to be associated with a set of demographic and socioeconomic characteristics. Sanitation facilities are limited and inappropriate WASH practices are prevalent in the studied population with linkage to diarrhea in children; therefore, urgent attention is needed to improve WASH facilities and encourage health-promoting WASH behavior in St. Martin's Island population.
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Affiliation(s)
- Ahmed Jubayer
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
- Bangladesh Institute of Social Research Trust, Dhaka, Bangladesh
| | - Md. Hafizul Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Abira Nowar
- National Heart Foundation and Research Institute, Dhaka, Bangladesh
| | - Saiful Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
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