Determinants of Acute Diarrheal Disease Among Under-Five Children in Pawi Hospital, Northwest Ethiopia, 2013/14
American Journal of Pediatrics
Volume 3, Issue 6, November 2017, Pages: 68-75
Received: Jan. 24, 2017; Accepted: Feb. 21, 2017; Published: Nov. 3, 2017
Views 2750      Downloads 160
Hayelom Brhanu, Department of Environmental Health and Health Extension Service, Pawi Health Science College, Pawi, Ethiopia; Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Digsu Negese, Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Mulat Gebrehiwot, Department of Environmental and Occupational Health and Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Article Tools
Follow on us
Background: Diarrhea is one of the leading causes of morbidity and mortality among under-five children nationally and globally. This study identified determinants of acute diarrheal disease among under-five children using hierarchical logistic regression. Objective: This study was conducted to identify determinants for hospitalization of children with acute diarrhea in Pawi Hospital, Benishangul Gumuz Region, Northwest Ethiopia, 2013/14. Methods: A hospital-based case-control study was performed on 148 cases and 442 controls. Data were collected using structured questionnaires. Both bivariate and hierarchical logistic multivariate analyses were carried out to identify the determinants of acute diarrheal. Results: Determinants for acute diarrheal disease were identified. Rural residence [AOR=6.8, 95%CI= (3.3, 14)], mothers having a low education [AOR=4.0, 95%CI= (1.5, 11.0)], living in a non-model households [AOR=2, 95%CI= (1.1, 4.0)] were from socioeconomic variables. Improper child stool disposal [AOR=2. 7, 95%CI= (1.5, 4.8)], not treating water at home [AOR=2. 5, 95%CI= (1.3, 4.6)] were among the environmental sanitation factors. Child`s age 6-11 moths [AOR=3.8, 95%CI= (1.7, 8.9)], bottle feeding [AOR=10, 95%CI= (4.6, 21.9)], being malnourished [AOR=2.3, 95% CI= (1.3, 3.91)], and maternal diarrhea [AOR=8. 8, 95%CI= (4.0, 19.0)] were determinants of acute diarrheal disease in under fives. Conclusions: Acute diarrhea is influenced by factors from all hierarchical levels. Therefore, Avoiding bottle feeding and interpersonal transmission, strengthening women’s education, improving child nutrition; maximizing the health extension package model households and treating water at home are recommended with more emphasis on rural living children.
Determinants, Acute Diarrhea, Children, Case-Control, Pawi Hospital, Ethiopia
To cite this article
Hayelom Brhanu, Digsu Negese, Mulat Gebrehiwot, Determinants of Acute Diarrheal Disease Among Under-Five Children in Pawi Hospital, Northwest Ethiopia, 2013/14, American Journal of Pediatrics. Vol. 3, No. 6, 2017, pp. 68-75. doi: 10.11648/j.ajp.20170306.12
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Boschi-Pinto C, Velebitb L, Shibuyac K. Estimating child mortality due to diarrhoea in developing countries. Bulletin of the World Health Organization May 30, 2008; 86: (9): 710–7.
Farthing M, Salam M, Lindberg G, Dite P, Khalif I, Salazar-Lindo E, et al. Acute diarrhea in adults and children: a global perspective. World Gastroenterology Organisation Global Guidelines. World Gastroenterology Organisation. 2012 February.
CDC. Diarrhea: Common Illness, Global Killer. Centers for Disease Control and Prevention, 2009.
PATH. Diarrheal disease: solutions to defeat a global killer. PATH, May, 2009.
FMoH. Health and Health Related Indicators. Addis Abeba: Federal ministry of Health policy planning Directorate; 2011/12.
Central Statistical Agency Addis Ababa E. Ethiopia Demographic and Health Survey 2011. In: Central Statistical Agency Addis Ababa EIIC, Maryland, USA., editor. Addis Ababa, Ethiopia: Central Statistical Agency 2012.
Pawi-Hospital. Woreda-based health sector plan, hospital annual plan. pawe: pawi hospital; 2012/13.
Victora CG, Huttly SR, Fuchs SC. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997; 26: 224-27.
Wondwossen B. A stepwise regression analysis on under-five diarrhoael morbidity prevalence in Nekemte town, western Ethiopia: maternal care giving and hygiene behavioral determinants. East Afr J Public Health. 2008 Dec; 5 (3): 193-8.
Woldemicael G. Diarrhoeal morbidity among young children in Eritrea: environmental and socioeconomic determinants. J Health Popul Nutr. 2001 Jun; 19 (2): 83-90.
Yilgwan C. S, Okolo S. N. Prevalence of diarrhea disease and risk factors in Jos University Teaching Hospital, Nigeria. Ann Afr Med. 2012 Oct-Dec; 11 (4): 217-21.
Yilgwan C. S, Yilgwan G, Abok II. Domestic water sourcing and the risk of diarrhoea: a cross-sectional survey of a peri-urban community in Jos, Nigeria. Niger J Med. 2010 Jul-Sep; 19 (3): 271-4.
Senyonga R, Muwonge R, Twebaze FBN, Mutyabule R. Determinants of acute diarrhea in children aged 0 – 5 years in Uganda. East African Medical Journal 2009 November; 86 (11): 513-9.
Mohammed S, Tilahun M, Tamiru D. Morbidity and Associated Factors of Diarrheal Diseases Among Under Five Children in Arba-Minch District, Southern Ethiopia. Science Journal of Public Health. 2013 2012; 1 (2): 102-6.
Shikur M, Marelign T, Dessalegn T. Morbidity and associated factors of diarrheal diseases among under five children in Arba-Minch district, Southern Ethiopia, 2012. Science Journal of Public Health. 2013 June 10, 2013 1 (2): 102-6.
Oadi KO, Kuitunen M. Childhood diarrheal morbidity in the Accra Metropolitan Area, Ghana: Socio-economic, environmental and behavioral risk determinants. J Health Pop Dev Countries. 2005: 33-46.
Dikassa L, Mock N, Magnani R, Rice J, Abdoh A, Mercer D. Maternal behavioral risk factors for severe childhood diarrheal disease in Kinshasa, Zaire.. Int J Epidemiol. 1993 (22): 327-33.
Cesar GV, Bryce J, Fontaine O, Monasch R. Reducing deaths from diarrhoea through oral rehydration therapy. Bull World Health Organization 2000 (78): 1246-55.
Dessalegn M, Kumie A, W T. Predictors of under-five childhood diarrhea: Mecha District, West Gojam, Ethiopia. Ethiop J Health Dev. 2011; 25 (3): 190-200.
Fewtrell L, Kaufmann B, Kay D, Enanoria W, Haller L, Colford J. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries. A systematic review and meta-analysis.. Lancet Infectious Disease. 2005 (5): 42-52.
Wanzahun G, Bezatu M. Environmental Factors Associated with Acute Diarrhea among Children Under Five Years of Age in Derashe District, Southern Ethiopia. Science Journal of public Healh. 2013; 1 (3): 119-24.
Tarekegn M, Enquselassie F. A case control study on determinants of diarrheal morbidity among under-five children in Wolaita Soddo Town, Southern Ethiopia. School of Public Health, Addis Ababa University;. Ethiop J Health Dev. 2012; 26 (2).
Andualem A. Assessment of the impact of latrine utilization on diarrhoeal diseases in the rural community of Hulet Ejju Enessie Woreda, East Gojjam Zone, Amhara Region. Ethiopian. Journal of Health Development. 2010; 24 (3): 110-18.
Girma R, Wondwossen B, Bishaw D, Tefera B. Environmental determinants of diarrhoea among under-five children in Nekemte Town, western Ethiopia.. Ethiopia Jornal of Health Sciences. 2007; 18 (2): 39-44.
Mock N, Sellers T, Abdoh A, Franklin R. Socioeconomic, environmental, demographic and behavioral factors associated with the occurrence of diarrhea in young children.. Soc Sci Med. 1993; 36 (6): 807-16.
Ezra M GE. Breastfeeding, birth intervals and child survival: Analysis of the 1997 community and family survey data in southern Ethiopia.. Ethiop J Health Dev. 2002; 16 (1): 41-51.
Ghosh S, Sengupta PG, Mondal SK, Banu MK, Gupta DN, Sircar BK. Risk behavioural practices of rural mothers as determinants of childhood diarrhoea.. J Commun Dis. 1997; 29 (1): 7-14.
WHO. World Health Organization global database on child growth and malnutrition. Geneva: World Health Organization 1997.
Anand K, Sundaram KR, Lobo J, Kapoor SK. Are diarrheal incidence and malnutrition related in under five children? a longitudinal study in an area of poor sanitary conditions. Indianpediatrics. 1994 Aug; 31 (8): 943-8.
Tomiso A. Prevalence and determinants of childhood diarrhea among graduated households, in rural area of shebedino district, southern Ethiopia. 2013.
Destaw B. Prevalence and associated factors for diarrhea disease among under-five children in Dabat district, northwest Ethiopia. 2013.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186