Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study


Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children un-der 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based cross-sectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for col-lecting information on socio-economic charac-teristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regres-sion was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3-24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20-4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29-2.86), living in rural area (OR = 1.81, 95% CI: 1.12-3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33-2.28), and age of the child (OR= 2.25, 95% CI; 1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.

Share and Cite:

Mengistie, B. , Berhane, Y. and Worku, A. (2013) Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study. Open Journal of Preventive Medicine, 3, 446-453. doi: 10.4236/ojpm.2013.37060.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Black, R.E., Morris, S.S. and Bryce. J. (2003) Where and why are 10 million children dying every year? Lancet, 361, 2226-2234.
[2] Fisher Walker, L.C., Perin, J., Aryee, J.M., Boschi-Pinto, C. and Black, R.E. (2012) Diarrhea incidence in low-and middle-income countries in 1990 and 2010: A systematic review. BMC Public Health, 12.
[3] UNICEF/WHO (2009) Diarrhoea: Why children are still dying and what can be done. The United Nations Children’s Fund/World Health Organization, Geneva.
[4] WHO (2007) Combating waterborne disease at the household level. International Network to Promote Household Water Treatment and Safe Storage, World Health Organization, Geneva.
[5] Desalegn, M., Kumie, A. and Tefera, W. (2011) Predictors of under-five childhood diarrhea: Mecha District, West Gojjam, Ethiopia. Ethiopian Journal of Health Development, 25, 174-232.
[6] Teklemariam, S., Getaneh, T. and Bekele, F. (2000) Environmental determinants of diarrheal morbidity in underfive children, Keffa-Sheka zone, south west Ethiopia. Ethiopian Medical Journal, 38, 27-34.
[7] Mediratta, P.R., Feleke, A., Moulton, H.L., Yifru, S. and Sack, B.R. (2010) Risk factors and case management of acute diarrhoea in North Gondar zone, Ethiopia. Journal of Health, Population and Nutrition, 28, 253-263.
[8] Mekasha, A. and Tesfahun, A. (2003) Determinants of diarrhoeal diseases: A community based study in urban south western Ethiopia. East African Medical Journal, 80, 77-82.
[9] Boadi, K.O. and Kuitunen, M. (2005) Childhood diarrheal morbidity in the Accra Metropolitan Area, Ghana: Socio-economic, environmental and behavioral risk determinants. Journal of Health & Population in Developing Countries.
[10] Siziya, S., Muula, A.S. and Rudatsikira, E. (2009) Diarrhoea and acute respiratory infections prevalence and risk factors among under-five children in Iraq in 2000. Italian Journal of Pediatrics, 35.
[11] Bbaale, E. (2011) Determinants of diarrhoea and acute respiratory infection among under-fives in Uganda. Australasian Medical Journal, 4, 400-409.
[12] Chopra, M., Mason, E., Borrazzo, J., Campbell, H., Rudan, I., Liu, L., Black, R.E. and Bhutta, Z.A. (2013) Ending of preventable deaths from pneumonia and diarrhoea: An achievable goal. The Lancet, 381, 1499-1506.
[13] Kersa, D.H.O. (2011) Health service coverage. Kersa District Health Office, Eastern Hararge, Ethiopia.
[14] Kelsey, J.L., Whittemore, A.S., Evans, A.S. and Thompson, W.D. (1996) Methods of sampling and estimation of sample size. In: Kelsey, J.L., Whittemore, A.S., Evans, A.S. and Thompson, W.D., Eds., Methods in Observational Epidemiology, Oxford University Press, New York.
[15] CSA (2006) Ethiopian demographic and health survey 2005 Report. Central Statistics Authority, Addis Ababa.
[16] WHO (2005) The treatment of diarrhea. A manual for physicians and other senior health workers. World Health Organization, Geneva.
[17] WHO/UNICEF (2010) Progress on sanitation and drinking-water: 2010 update. World Health Organization/ United Nation Children’s Fund, Geneva.
[18] Vyas, S. and Kumaranayake, L. (2006) Constructing socioeconomic status indices: How to use principal components analysis. Health Policy Planning, 21, 459-468.
[19] El-Gilany, A.H. and Hammad, S. (2005) Epidemiology of diarrhoeal diseases among children under age 5 years in Dakahlia, Egypt. Eastern Mediterranean Health Journal, 11, 762-775
[20] Stanly, A.M., Sathiyasekaran, B.W.C. and Palani, G. (2009) A population based study of acute diarrhoea among children under 5 years in a rural community in South. Sri Ramachandra Journal of Medicine, 1, 1-7.
[21] Rego, R.F., Moraes, L.R. and Dourado, I. (2005) Diarrhoea and garbage disposal in Salvador, Brazil. Royal Society of Tropical Medicine and Hygiene, 99, 48-54.
[22] Regassa, G., Birke, W., Deboch, B. and Belachew, T. (2008) Environmental determinants of diarrhea among underfive children in Nekemte town, Western Ethiopia. Ethiopian Journal of Health Sciences, 18, 39-45.
[23] Root, G.P.M. (2001) Sanitation, community environment and childhood diarrhea in rural Zimbabwe. Journal of Health, Population and Nutrition, 19, 73-82.
[24] Punyaratabandhu, P., Sangchai, R. and Vathanophas, K. (1993) Risk factors for childhood diarrhoeal diseases in an urban community, Bangkok, Thailand. Journal of the Medical Association of Thailand, 76, 535-541.
[25] Mirza, N.M., Caulfield, L.E. and Black, R.E. (1997) Risk factors for diarrhoeal diseases duration. American Journal of Epidemiology, 146, 776-785.
[26] Strina, A., Cairncross, S., Barreto, L.M., Larrea, C. and Prado, S.M. (2003) Childhood diarrhea and observed hygiene behavior in Salvador, Brazil. American Journal of Epidemiology, 157, 1032-1038.
[27] Manun’ebo, M.N. (1994) Influence of demographic, socioeconomic and environmental variables on childhood diarrhoea in a rural area of Zaire. Journal of Tropical Medicine and Hygiene, 97, 31-38.
[28] Manun’ebo, M., Cousens, S. and Haggerty, P. (1997) Measuring hygiene practices: A comparison of questionnaires with direct observations in rural Zaire. Tropical Medicine and Internal Health, 2, 1015-1021.
[29] Halder, A.K., Tronchet, C., Akhter, S., Bhuiya, A., Johnston, R. and Luby, S.P. (2010) Observed hand cleanliness and other measures of handwashing behavior in rural Bangladesh. BMC Public Health, 10.
[30] Dewey, K.G. and Adu-Afarwuah, S. (2008) Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Maternal & Child Nutrition, 4, 24-85.
[31] Motarjemi, Y., Kaferstein, F., Moy, G. and Quevedo, F. (1993) Contaminated weaning food: A major risk factor for diarrhoea and associated malnutrition. Bulletin of the World Health Organization, 71, 79-92.
[32] WHO/UNICEF (2012) Progress on sanitation and drinking-water: 2010 update. World Health Organization, Geneva.
[33] Shah, M.S., Yousafzai, M., Lakhani, B.N., Chotanp, A.R. and Nowshad, G. (2003) Prevalence and correlates of diarrhea. Indian Journal of Pediatrics, 70, 207-211.
[34] Arif, A. and Naheed, R. (2012) Socio-economic determinants of diarrhoea morbidity in Pakistan. Academic Research International, 2, 398-432.

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.