PREVALENCE OF DIARRHEA AND ASSOCIATED FACTORS AMONG UNDER-FIVE CHILDREN IN WAHEL DISTRICT- DIRE DAWA ADMINSTRATIVE COUNCEL: A COMPARETIVE STUDY BETWEEN OPEN DAFICATION AND OPEN DAFICATION- FREE SETTING

Abstract

Childhood diarrhea is amajor public health problem especially in developing countries, including inEthiopia. Ethiopia has been advocated promotion of open defecation free (ODF) to decrease the burden of diarrhea. . However, diarrhea among under five children is still is one of the public health problems in the study area.Thus, it is crucial to assess the extenet of the problem and its related factors to address the problem in the study area. Objective:-To assess diarrheal morbidity and its associated factors among under-five children in Wahel district, Dire Dawa, Ethiopia, from September 23 – October 14,. Methods:-A community-based comparative cross-sectional study design was usedin Wahel district, Dire Dawa City Administration Council. The total 342 (171 open defecation free(ODF) and 171 open defecation(OD)) were involved in study. The study participants were slected using a multistage random sampling technique and data were collected face to face interview with the use of pretested structured questionnaire and observation checklist.Data were analyzed using descriptive statistical tests such as frequency, mean and standard devaitions. Bivariate and multivariate logistic regression analysis were computed to determine predictors of diarrhea. Adjust odds ratio with 95% confidence interval was reported; and statistical significances was declared at P-value < 0.05. Results:- The over all two week prevalence of diarrhea among under five children was 33.3%(95%CI: 28.4% - 38.6%),Proportion of diarahea among open defecation free (ODF) households was 26.9% (95% CI : 20.5% - 33.9% ) and in open defecation (OD) households was 39.8%(95% CI: 32.2% -47.4%). In open defecation free(ODF) house holds, Family size (AOR:2.67; 95% CI: 1.16 – 6.13), Duration of breast feeding for first child (AOR;0.31,95%CI:0.14 -0.70),Feces, flies and worms on floor of latrine (AOR:0.22;95%CI:0.1 - 0.49), Latrine utilization(AOR:0.36;95%CI:0.15 – 0.83),House shared with domstic animal (AOR;0.42;95%CI:0.19 – 0.94),Feces around the compound (AOR;0.37;95%CI:0.16 – 0.86),Water container sanitation(AOR;4.57;95%CI:1.39 – 15.00), and time to fetch water (AOR ;4.54; 95% CI: 1.83 – 17.45) have statistically significant association with diarrhea occurrence. While in open defecation (OD) house holds, Family size (AOR ;4.44; 95% CI: 1.99 – 9.90), Age of mother(AOR ;0.058; 95% CI: 0.01 – 0.23), Soap/ash utilization for hand washing (AOR xiii ;3.63;95%CI:1.87 – 7.02) Feces around the compound(AOR;0.41;95%CI:0.20 – 0.83) have significant association with diarrhea occurrence. Conclusions;- One third of the studied particiants had diarrhea. Of the studied varaibles, family planning, monthly family in come, duration of breast feeding, proper use of latrine, latrine presence and utilization, water storage sanitation/clean in household, house separation with domestic animals, distance to fetch water, age of mother for marriages, rota vaccination, detergents utilization for hand, water storage and food storage utensils washing, feces around the compound, were significantly related with under-fivediarrhea.Integrated efforts are needed from various sectors and organizations to improve the environamental and sanitation conditions of the study area