Prevalance Of Diarrhea And Associated Factors Among Children Under Five Years In Internally Displaced Populations Of Hodan District, Somalia

Abstract

Introduction: Globally, diarrhea is a major cause of morbidity and mortality among children. It is one of the highest ranked cause of child mortality rate in Somalia with about 19% of all deaths of children aged below 5 years. Poor sanitation, unsafe water and inappropriate personal hygiene are responsible for 90% of diarrhea occurrence globally. Objective: This study sought to assess the prevalence of diarrheal disease and associated factors among children under 5 years among internally displaced populations of Hodan District, Somalia. Methods: This was a cross-sectional study that used a mixed methods approach. Participants were selected through a two-stage sampling process. In stage one, the camps were sampled proportional to the population size while in stage two, the households were randomly sampled from the list of all household in the internally displaced population camps of Hodan District. A total of 327 caregivers were interviewed using a structured questionnaire. Purposive sampling method was used to recruit participants for the focus group discussions. Interview guides were used to collect qualitative data. Logistic regression analysis was used to test for factors associated with diarrhea among children under 5 years. Qualitative data was thematically analyzed to provide an in-depth understanding of factors associated with diarrhea. Results: The study established that the prevalence of diarrhea among children under 5 years in Hodan internally displaced population camps was 21%. Factors that were significantly associated with diarrhea among these children were the child’s age (Adjusted Odds Ratio: 2.622; 95% Confidence Interval 1.237 - 5.559, p=0.01), the caregivers marital status (Adjusted Odds Ratio: 0.428; 95% Confidence Interval 0.238 - 0.769, p=0.01), disposal of feacal matter (Adjusted Odds Ratio: 2.372; 95% Confidence Interval 1.096 - 5.131, P 0.03), hand washing after using the toilet (Adjusted Odds Ratio: 0.497; 95% Confidence Interval 1.0.253 - 0.979, p=0.043), hand washing with soap (Adjusted Odds Ratio: 0.232; 95% Confidence Interval 0.70 - 0.772, p=0.017) and use of treated drinking water (Adjusted Odds Ratio: 0.144, 95% Confidence Interval 0.034 - 0.610, p=0.01). Conclusions: There was high prevalence of diarrhea among children of internally displaced populations of Hodan District in Somalia. The diarrhea is more likely to occur among children who are less than 25 months of age. Other factors that are independently associated with diarrhea in Hodan internally displaced population camps are the caregivers’ marital status, as well as their water, sanitation and hygiene practices. xi Recommendations: The government, the community and the Health and Water, Sanitation and Hygiene (WASH) implementing agencies in Somalia should consider: increasing awareness on care for children under 25 months of age who are most vulnerable to diarrhea. Furthermore, training caregivers in Hodan Internally Displaced Population camps on the recommended hand washing practices, use treated water in the households for food preparation and drinking as well as on use of toilet facilities in disposal of feacal matters. More rigorous qualitative studies should also be conducted in the Hodan internally displaced population camps to understand the factors associated with diarrhea among children under 5 years.