Diarrheal status and associated factors in under five years old children in relation to implemented and unimplemented community-led total sanitation and hygiene in Yaya Gulele in 2017

Abstract

Purpose

The aim of this study was to assess the diarrheal status and associated factors of under five-years old children among implemented and unimplemented community-led total sanitation and hygiene (CLTSH) in Yaya Gulele district, Ethiopia, in 2017.

Methods

Community-based comparative cross-sectional study involving 380 households from each implemented and unimplemented CLTSH area was conducted from December 1 to June 30, 2017. Pretested structured questionnaire and a complete observational checklist were used to collect data. Qualitative data were collected via focused group discussions and analyzed manually. Data were checked and entered to Epi-info 3.5.4 and analyzed by SPSS version 20. Bivariate and multivariable logistic regression analyses were computed

Results

In this study, 88% implemented and 66% unimplemented CLTSH had latrine. Of households owning latrine, 85% in implemented and 75% in unimplemented CLTSH utilize latrine properly. In the study area, 12% in implemented and 34% in unimplemented CLTSH area practice open defecation. Two weeks period diarrhea prevalence was 13.4% (95% CI: 10.2-17.3%) in implemented CLTSH and 36.3% (95% CI: 31.7–41.6%) in unimplemented CLTSH. Having two or more children under five years old (adjusted odds ratio [AOR] = 2.33; 95% CI: 1.09–4.96), lack of clean water storage (AOR = 2.36; 95% CI: 1.16–4.80), negative attitude of mothers/caregivers toward diarrhea (AOR = 2.07; 95% CI: 1.06–4.04), presence of feces in the compound (AOR = 1.88; 95% CI: 1.10–3.22), and lack of hand washing facility in the compound (AOR = 2.64; 95% CI: 1.47–4.74) were associated factors of the outcome.

Conclusion

Implementation of CLTSH is the applicable tool to reduce diarrhea prevalence. Having two or more children under five years old, unclean water storage, negative attitude of mothers toward diarrhea, existence of feces in the compound, and lack of hand washing facility in the compound were associated factors to the diarrheal status of children under five years old. Health workers and local authorities inspire the community to clean water-storage facilities and the environment, to change mothers’ behavior toward diarrhea, as well as construct hand washing facility in the compound.

Keywords:

• CLTSH
• diarrhea
• under-five children
• Yaya Gulele district

Acknowledgments

First and foremost, we are very grateful to the almighty God for giving us priceless health, well-being and support throughout our life. We would like to send sincere gratitude and invaluable acknowledgments to Mekelle University for sponsoring this research and to Dr Alemayehu Bayray for his scientific guidance, encouragement, comments and suggestions. Most importantly, we would like to thank the study participants. We are very grateful to Dr Carmen C Robles for her thorough English language evaluation.

Author contributions

Mamo Z Degebasa conceived the study, participated in the design of the study, performed statistical analysis and drafted the manuscript for important intellectual content. Dawit Zenebe Weldemichael directly participated in the planning of theresearch and guided all stages of the research, execution, and analysis of this study. Mokonnon T Marama was involved in the design and analysis of the study, helped to draft the manuscript, and revisited it critically for important intellectual content. All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.