Bezuayehu Alemayehu
PhD Jimma University,Doctoral training program Instistue of Health of Science,Jimma University, Ethiopia
Title: Individual and community level factors in under-five children diarrhea among agro-ecological zones in southwestern Ethiopia
Biography
Biography: Bezuayehu Alemayehu
Abstract
Ethiopia is Sub Saharan African country where under five children diarrhea (UFCD) is a major public health problem where the problem persisted due to poor environmental health and low access for basic water sanitation and hygiene (WaSH) services. Though, WaSH related problems are crosscutting in developing countries, investigation of socio-cultural and environmental factors help to design location specific intervention in a given community. This study aimed to examine spatiotemporal variability, detect hotspots areas and identify predictors of UFCD in Bench Maji zone, southwestern Ethiopia.
An integrated study design approaches (ISDA) was used to investigate hotspot areas and identify UFCD factors. Firstly, retrospective longitudinal analysis using 90716 cases of ten years diarrhea illness data registered at health institutions of Bench Maji zone Health Management Information System (HMIS) at district level from January 2008 to June 2017. Spatial, space- time and temporal analyses were done using SaTScan version 9.4. In the meantime, spatial autocorrelations, hotspot detection were done using ArcGIS 10.5 software. Secondly, community based cross-sectional data was collected from 826 mothers with under-five children in selected districts during 01 Feb. to 30 April 2018, where multivariable logistic regression model was fitted on STATA 12 to identify UFCD predictors.
Annually UFCD cases of 3610 per 100,000 was identified with a relative risk (RR) of 1.6. The highest incidence of UFCD was recorded during dry season and showed an increment from October to February. In spatial terms, risky cluster (RR>1) was detected in the districts of Bero, Maji, Surma, Minit Shasha, Guraferda, Mizan Aman town, and Sheko with non-random distribution. Six most likely clusters were identified as hotspot areas of UFCD. At individual level, child age in months (95% CI for AOR 1.20;1.08-1.36), supplementary feeding age (95% CI for AOR1.75;1.882.89), mothers’ occupation (95% CI for AOR 1.75;0.51-0.93), mothers’ educational status (95% CI for AOR 1.58;1.10-1.56), mothers’ knowledge of diarrhea (95% CI for AOR 1.25;1.44-2.99), absence of hand washing during critical time (95% CI for AOR 0.95;1.69-3.65), and shared residence with domestic animals (95% CI for AOR 1.16,2.85-4.89) whereas, at community level, spatial heterogeneity (95% CI for AOR 1.72; 1.46-2.19), unimproved water sources (95% CI for AOR1.04; 1.11-1.63), and unimproved latrine facility (95% CI for AOR 1.02;1.00-1.71) were identified as major causes of UFCD. Besides, the study indicated attention should be paid during dry season to avoid UFCD catastrophe. Likewise, UFCD risky districts needs targeted interventions to improve WaSH facilities and proper utilization, increase knowledge of mothers and change behavioral aspects of the community.
Keywords: Bench Maji, individual and community level factors under five diarrhea, Spatio-temporal, hotspot