Assessment Of Diarrhea In Under-five Children A Comparative Cross-sectional Study In Open Defecation And Open Defecation Free Rural Settings In Dangla District North West Ethiopia

Background: Open defecation is a widespread problem in the developing world. This practicernfacilitates the transmission of diarrheal diseases – one of the leading causes of mortality in childrenrnunder 5 in sub-Saharan Africa. In Ethiopia, still the national open defecation rate in 2014 wasrn34.1% (37.9% rural, and 8.7% at urban)rnObjective:To assess diarrheal morbidity in under-five children and associated factors in ODFrnand non-ODF settings in Dangla district, north-west Ethiopia, 2016rnMethods: The study periodwasFebruary 2016.A community based comparative cross-sectionalrnstudydesign wasemployed. A multistage random sampling technique also applied. Thetotal samplernsize was be 550 i.e. 275 NODF and 275 ODF.A structured questionnaire and observation checklistrnwasapplied.After selecting 10 kebeles from each setting, the samples were distributedrnproportionally by their number of under-five children’s. SPSS version 20 was used for datarnanalysis. The study was approved by the Ethical Review Committee of Addis Ababa UniversityrnSchool of Public Health and Dangla woreda AdministrationrnResult:A total of 525 (263 from ODF and 262 from NODF) participants were interviewedrnmaking the response rate 95.45 %.The prevalence of diarrhea were 9.9% inODF and 36.1%inrnNODF kebeles (X2=50.791, P=0.000). From the total respondents, 158(60.3%) from ODF andrn188(71.5%) from NODF kebeles uses unimproved water sources. The majority of the respondentsrnin both ODF and NODF kebeles use jerrycan as their main storage for drinking water.The majorityrnof respondents in both settings have private latrine. In ODF kebeles,Child immunizationrn(AOR=0.037; 95%CI: 0.006-0.243), latrine presence (AOR=0.036; 0.006-0.233), water shortagern(AOR=8.756; 95%CI: 1.130-67.831) and solid waste disposal (AOR=0.143; 95%CI:rn0.020-0.998)have statistically significantassociationwith diarrhea. Whereas in NODF kebeles ChildrnImmunization (AOR=0.032; 95CI:0.008-0.123), water access of 7.5-15liter/day (AOR=0.029;rn95%CI: 0.006-0.152) and water access of greater than 15liter/dayrnAssessment of diarrhea in under-five children in OD and ODF rural settings, north west Ethiopiarnxiirn(AOR=0.068;95%CI:0.010-0.474),water shortage(AOR=18.478; 95%CI: 4.692-72.760) and Properrnsolid waste disposal(AOR=0.023;95%CI:0.005-0.117]) have statistically significantassociationrnwith diarrhea.rnConclusion and recommendation: ODF status reduced the overall prevalence of under-fiverndiarrhea among the individuals living in the ODF villages compared with the NODF villages. It isrnbetter to work together with line ministries, regions, zones, woreda health structures, governmentrnpartners, and local NGO`s to improve, latrine presence at household, water shortage in householdrnand solid waste disposal practices

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