Prevalence and factors associated with diarrhoea among children under five years in Nyumanzi Refugee Settlement Camp Adjumani District, Uganda
Izale, Ayiga Godfrey Nick
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Background: Diarrhoea remains a major cause of mortality in children under five years of age in African refugees’ settlement camps. Broadly recognized risk factors for diarrhoeal diseases include little or no access to safe water and sanitation, as well as poor personal hygiene, unhygienic food preparations and unsafe faecal disposal practices at home. In general, children are at greater risk than adults of developing life threatening dehydration that can result from diarrhoea, a risk that is increased in emergency and refugee situation like in Nyumanzi refugee settlement camp. Objective: The objective of the study was to assess prevalence and factors associated with diarrhoea among children under five years of age at Nyumanzi refugee settlement camp in Adjumani district located in Northern Uganda. Methods: Community based cross sectional study was conducted in Nyumanzi refugee settlement camp, Adjumani in Northern Uganda from April 2015 to May 2015 among 491 randomly selected household with at least a child under five years of age. Interviewer-administered questionnaire were used for collecting data on socio-economic demographic and camp factors, and checklist was used for collecting data on observable sanitation and hygiene practices, and water samples from sources were analyzed for thermotolerant coliforms. Data were entered into computer, edited and analyzed using STATA version 11. Stepwise logistic regression model was used to calculate the odds ratios at 95% CI at multivariate analysis and statistically significant factors with p-value < 0.05 were considered as factors associated with diarrhoea. Results: The prevalence of diarrhoea among children under five years was 41.3%. (95% CI: 36.9% - 45.7%). Factors significantly associated with diarrhoeal diseases were: the child age (7-12) months (AOR: 8.1, 95% CI: 3.4-19.2); non-exclusive breastfeeding (AOR: 3.1 95% CI: 1.85-5.), mild/moderate wasting (AOR. 2.9, 95% CI 1.5-5.6), lack of hand washing after toilet visit (AOR: 3.8 95% CI: 1.2-12.1), inadequate water per person per day (AOR: 4.6, 95% CI: 2.7-8.0); wide mouth container (AOR: 4.13 95% CI 2.18 – 7.83), open dumping of child’s stool (AOR:3.6 95%CI:1.8-7.4), lack of hand washing facility (AOR: 3.9 95% CI 2.1-7.1) and perception that diarrhoeal diseases cannot be treated at health facility (AOR: 4.4, 95%CI: 1.8-10.8). Conclusions and recommendations: In this study, the prevalence of diarrhoeal diseases revealed diarrhoea is major health problem among under five children in this camp and associated factors were restricted to hygiene and sanitation. The findings of this study have important policy implications for health intervention program, since most of the established factors are modifiable through community sensitization, program that emphasize on hygiene, water and sanitation, and importance of duration of breast feeding in child care should be strengthened to reduce child morbidity on diarrhoeal.