Prevalence of diarrhoea and associated factors among children under five years in Lubombo region, Eswatini

Abstract

Introduction Diarrhoea is one of the leading causes of morbidity and mortality among children under five years of age, with the highest number of deaths being reported in sub-Saharan Africa and South Asia. The available morbidity and mortality data indicate that diarrhoea is a major public health problem in Eswatini. Despite this evidence on the burden of diarrhoeal disease among children under the age of five, there is paucity of epidemiological studies in the country to obtain up-todate information on diarrhoea and to assist decision makers to prioritize intervention to overcome the problem. Identification of determinants of diarrhoea may help in averting the burden of diarrhoeal diseases. Objectives The objective of this study was to estimate the prevalence of diarrhoea and identify its determinants among children under the age of five in the Lubombo region of Eswatini. Methodology This was a community-based cross-sectional study conducted in the Lubombo region of Eswatini. A total of 469 households with children under the age of five were selected from four (4) tinkundla (constituencies) to participate in the study. Data were collected using a structured questionnaire and observation checklist, coded and entered into the computer using EpiData software and analysed using Stata 14. Modified Poisson regression was used to identify factors associated with occurrence of diarrhoea among children under five years of age. To determine association of predictor variables, a p-value <0.05 was considered statistically significant. Results The prevalence of diarrhoea among children under the age of five in the Lubombo region was 17.5%. Independently, lack of maternal/caregivers education (adjusted PR: 2.43, CI: 1.42- 4.15), having two or more children under the age of five in a household (adjusted PR: 1.80, CI: 1.17-2.77), use of water from an unimproved source (adjusted PR: 2.33, CI: 1.60-3.40, lack of toilet facility at home (adjusted PR: 2.10, CI: 1.38-3.81), mothers/caregivers not washing hands with water and soap at critical times such as after using the toilet (adjusted PR: 1.94, CI: 1.29- 2.91), after cleaning the anus of children (adjusted PR: 1.50, CI: 1.01-2.23) and before preparing food (adjusted PR: 1.76, CI: 1.19-2.60) all showed positive association with xiii childhood diarrhoea. Conversely, mothers/caregivers being unemployed was negatively associated with occurrence of childhood diarrhoea (adjusted PR: 0.62 CI: 0.39-0.95) Conclusion and recommendation The prevalence of diarrhoea in Lubombo was 17.5%. Mother’s/caregiver’s lack of education was statistically associated with occurrence of childhood diarrhoea. Other factors associated with occurrence of childhood diarrhoea in Lubombo region included: mother’s/caregiver’s being employed, having two or more children under the age of five in a household, drinking water from unimproved source, lack of toilet facility and maternal handwashing practices. This study underscores the importance of empowering the girl child, improving access to improved water sources and sanitation facilities. The government and other stakeholders should strengthen the provision of health education services emphasizing on the importance of child spacing and proper hand hygiene.