Determinants of Diarrhea Occurrence in Children Under Five Years in Bondhere District, Somalia

Abstract

Diarrhoea remains a significant health concern for children under five years old particularly in developing countries. In Somalia, the situation is even direr with diarrhoea accounting for a substantial proportion of deaths among children under five years. This study aimed to determine the predictors of diarrhoea among children under five years in Bondhere district, Somalia. The research focused on determining the prevalence of diarrhoea occurence among children, socio-demographic factors, hygiene and sanitation practices, and immunization status among caregivers as potential contributors to diarrheal diseases in this population. A cross-sectional study was conducted in Bondhere district, Somalia. The study population consisted of mothers and caregivers of children under 5 years. A sample size of 246 was calculated using a formula by Fischer et al. Cluster random sampling was used to identify respondents from four sub-districts. Data was collected using research administered semi-structured pre-coded questionnaires and observational checklists. Data analysis was performed using SPSS version 25, employing descriptive statistics, chi-square tests, and binary logistic regression. The study revealed that diarrhoea prevalence was 22.9% among children under five years in the two weeks prior to the study. Socio-demographic factors that were significantly associated with diarrhoea included the caregiver's education level (OR= 1.257, 95% CI = 0.436 - 2.100, p = 0.03), number of children under 5 years in the household (OR= 1.054, 95% CI = 0.510 - 2.784, p = 0.04), and household monthly income (OR= 1.909, 95% CI = 0.736 – 4.950, p = 0.04). Hygiene and sanitation practices were also significant factors, with unsafe water sourcing practices (OR= 1.187, 95% CI = 0.269 – 5.235, p = 0.02), improper handwashing (OR= 0.711, 95% CI = 0.145 – 3.500, p = 0.04), and improper sanitation practices (OR= 3.373, 95% CI = 0.564 – 6.143, p = 0.02) increasing the likelihood of diarrhoea. Interestingly, immunization status was not significantly associated with diarrhoea occurrence (p= 0.08). The study concludes that socio-demographic factors, particularly education level, household size, and income played a crucial role in the occurrence of diarrhoea among children under five in Bondhere district. Additionally, improper hygiene and sanitation practices, including unsafe water sourcing practices, improper handwashing, and improper sanitation practices, significantly influenced diarrhoea prevalence among the study population. Therefore, improving caregiver knowledge of hygiene and sanitation practices, alongside enhancing access to safe water sources and promoting proper handwashing techniques will improve diarrhea outcomes.