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Prevalence and Determinate Factors of Diarrhea Morbidity Among Under fi Ve Children in Shake Zone, Southwest Ethiopia, a Community Based Cross-Sectional Study

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Prevalence and Determinate Factors of Diarrhea Morbidity Among Under fi Ve Children in Shake Zone, Southwest Ethiopia, a Community Based Cross-Sectional Study Medical Group Archives of Community Medicine and Public Health DOI: http://dx.doi.org/10.17352/acmph ISSN: 2455-5479 CC By Tezera Abebe Gashaw1* and Yilkal Messelu Walie2 Research Article 1Department of Statistics, Wolkite University, Ethiopia Prevalence and Determinate Factors 2Department of Statistics, Mizan-Tepi University, Ethiopia of Diarrhea Morbidity among Under Received: 03 January, 2019 Accepted: 06 February, 2019 fi ve Children in Shake Zone, Southwest Published: 07 February, 2019 *Corresponding author: Tezera Abebe Gashaw, Ethiopia, a Community Based Cross- Department of Statistics, Wolkite University, Ethiopia, E-mail: Sectional Study Keywords: Diarrhea morbidity; Under-fi ve children; Logistic regression; Sheka zone; Ethiopia https://www.peertechz.com Abstract Despite the global decline in the death rates of Under fi ve children, the risk of a child dying before becoming 5 years of age remains highest in the African Region (90 per 1000 live births), which is approximately seven times higher than that in the European Region (12 per 1000 live births).The purpose of this study was to identify socio-economic, demographic, environmental and nutrition characteristics predictors affecting diarrheal Morbidity of under-fi ve children in Sheka zone, South west Ethiopia. A Community-based cross-sectional study was conducted in Sheka zone, from September 1–September 14, 2018. A Sample of 582 under-fi ve children were selected randomly from Kebeles in the zone constituted the study population. Data were collected using structured and pre-tested questionnaire. Descriptive, Bivariate and multiple binary logistic regressions were employed for data analysis by using SPSS 20. The descriptive results showed that 21.8% of under-fi ve children have experienced diarrhea in the two weeks prior to the time of survey. The remaining 78.2% of under-fi ve children have no experienced diarrhea in the two weeks prior to the time of survey. In multiple logistic regression, the most important determinant factors associated with diarrhea morbidity were stunting, underweight, Child had fever, ever had Vaccination, Employment (working) status of mother, mother education level, source of water supply, and mother underweight. Therefore the Government local health organizations should provide health intervention programs and maternal health awareness (health education for mothers) to reduce under- fi ve children diarrhea morbidity. Introduction Globally, diarrhea is the third largest cause of morbidity and the sixth largest cause of mortality among population Despite the global decline in the death rates of Under fi ve of all ages [3]. Two decades ago diarrhea was responsible for children, the risk of a child dying before becoming 5 years of around 5 million deaths of children aged under-fi ve each age remains highest in the WHO African Region (90 per 1000 year. Recently, due to the joint effort of public health, it was live births), which is approximately seven times higher than reduced and account for less than 2 million child death a year that in the WHO European Region (12 per 1000 live births) [1]. [4]. Diarrhea is one of the leading causes of morbidity and mortality in developing countries, especially among under-fi ve Diarrheal disease is the most common cause of illness children [5]. and the second leading cause of child death in the world. The disease accounts for 4.3% of the total global disease burden; More than four-fi fths of all deaths among children younger the burden being greatest in the developing world including than 5 years old in 2011 occurred in sub-Saharan Africa and Ethiopia. In developing countries, a quarter of infant and South Asia. The problem in Ethiopia is even worse than childhood mortality is related to childhood disease, particularly elsewhere in the world, with an Ethiopian child being 30 times to diarrhea. Diarrhea is caused by ingesting certain bacteria, more likely to die by his/her fi fth birthday than a child in viruses or parasites found in fecal matter which may be spread Western Europe [1] . through water, food, hands, eating and drinking utensils, fl ies, and dirt under fi ngernails [2]. According to the 2011 Ethiopian Demographic and Health 008 Citation: Gashaw TA, Walie YM (2019) Prevalence and Determinate Factors of Diarrhea Morbidity among Under fi ve Children in Shake Zone, Southwest Ethiopia, a Community Based Cross-Sectional Study. Arch Community Med Public Health 5(1): 008-014. DOI: http://dx.doi.org/10.17352/2455-5479.000046 Survey [6], 13% of children in Ethiopia, both urban and rural, Study design have experienced diarrhea in the two weeks preceding the survey. Similarly, 25.5% of children in southern Ethiopia A community- based cross-sectional study was conducted in experience diarrhea, from which 22.8% are rural and 2.7% are south west Ethiopia September 1-septamber 14, 2018 to assess urban children. However, there is no study which documented magnitude and factors associated with diarrhea in under-fi ve the magnitude and factors associated with diarrheal disease in children. The source populations were all mothers/caretakers the study area. in the household, who has under-fi ve children, who lived in the study area for at least six months prior to data collection. In Ethiopia, morbidity reports and community-based The Study population were include all children under the age of studies have shown that diarrheal disease is a major public fi ve years living in Sheka Zone south west Ethiopia. According health problem that causes excess morbidity and mortality in to zonal health department population of Sheka Zone in 2017 children [7]. The diarrhea attributed mortality rate is about is 250971 of which 39,177 are children under fi ve years of age. 10 per 1000 under-fi ve populations [8]. Studies conducted The sample size is determined on the bases of national under in central rural Ethiopia revealed that diarrhea is one of the fi ve diarrhea prevalence (25.5%) [6]. It was calculated using common causes of under-fi ve mortality, accounting about 8.4 formula for the minimum sample size needed for an interval to 27% of all deaths [9]. estimate of a population proportion. Formula for sample size calculation. Information on demographic characteristics and health indicator is crucial in planning and evaluation of health 2 ZPQ services. So, the purpose of this study is identifying the major nDEFF /2 * 2 risk factor of diarrhea morbidity and its prevalence in Sheka d zone, South West Ethiopia. This again helps in preventing and Where, Z=95%confi dence interval under normal curve (1.96), treating the disease. d= precision required (allowable error) (5%). Those children, who have diarrhea during data collection, P=expected prevalence or proportion (25.5%) [6], DEFF= were given Oral Rehydration Salt (ORS) and severe cases 1.8=The design effect (DEFF) is a “correction factor” to account were advised to consult the nearby health facility for better for the heterogeneity between clusters with regard to the management by health worker (data collectors). Besides, it will measured indicator [10]. n = sample size = 292 Total samples. help as an input for researchers for further study, analysis and Considering design effect of =292*1.85 = 540.2 and allowance developing appropriate intervention methods of the disease. for possible non-response rate of 10% makes the fi nal sample Material and Methods size; 540.2+54.02= 594.22≈595. Study area The study was employ multi-stage sampling scheme using stratifi ed, cluster and simple random sampling. After Sheka is a Zone in Ethiopian, Southern Nations, Nationalities designing stratifi cation as stratum one (urban) and stratum and Peoples Region (SNNPR), which is bordered on the south two (rural) then in stratum one we have three Weredas which by Bench Maji, on the west by the Gambela Region, on the can be classifi ed as cluster and in strata two we have two city north by the Oromia Region, and on the east by Keffa. The administrative center which can also classifi ed as cluster. Five administrative center of Sheka is Masha. It is the western part Kebeles from each rural Wereda and city administration are of former Kefi cho Shekicho Zone. Based on the 2007 Census selected using simple random cluster sampling. The size of conducted by the CSA, the Zone has a total population of the sample in each stratum was determined by the number of 199,314, of whom 101,059 are men and 98,255 women; 34,227 or sample size allocation to each stratum. In this study the sample 17.17% are urban inhabitants. The seven largest ethnic groups is proportionally distributed to the selected Kebeles according reported in this Zone were the Shakacho (32.41%), the Amhara to their population size. (22.17%), the Kaffi cho (20.16%), the Oromo (7.39%), the Bench (5.23%), the Sheko (4.24%), and the Majang (1.73%); all other Mothers/care- givers were interviewed in their homes using ethnic groups made up 6.67% of the population. Shakacho is a structured questionnaire that had been pre-tested. If there spoken as a fi rst language by 33.44%, 26.98% speak Amharic, is more than one child of under fi ve years in the household, 20.15% Kafa, 6.54% speak Oromiffa, 5.24% Bench, and 4.35% mothers were asked about the last child. Respondents were not Sheko; the remaining 3.3% spoke all other primary languages including in the survey if there are not at home up to three reported. 39.93% were Protestants, 39.39% of the population times when the interviewers went to the house. said they practiced Ethiopian Orthodox Christianity, 15.09% Data were collected using a structured questionnaire were Muslim, and 3.51% practiced traditional beliefs.
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