Prevalence and associated factors of acute diarrhea among under-five children in community-led total sanitation and hygiene implemented and non-implemented kebeles in Chiro Woreda, Eastern Ethiopia

Abstract

Diarrheal diseases, particularly acute diarrhea, remain a leading cause of morbidity and mortality among low-income children aged five years. Diarrheal diseases are characterized by the passage of three or more loose or watery stools within a 24-hour period and typically last for 14 days. This study aimed to determine the prevalence of acute diarrhea and identify associated factors among under-five-year-old children in Community-Led Total Sanitation and Hygiene implemented and non-implemented kebeles in Chiro Woreda, Eastern Ethiopia. A community-based cross-sectional study was conducted from March to May 2023 among 606 households selected using a multistage systematic sampling technique. Acute diarrhea was defined as the occurrence of three or more loose or watery stools within 24 h during the two weeks preceding the survey. Data were collected using a structured interviewer-administered questionnaire and observational checklist and analyzed using binary logistic regression. The two-week prevalence of diarrhea was 26.6% (95% CI: 23.1–30.1), with a lower prevalence in Community-Led-Total Sanitation and Hygiene implemented kebeles (19.8%) compared to non-implemented kebeles (30.0%). In multivariate analysis, factors significantly associated with acute diarrhea include an unimproved water source (AOR = 5.84; 95% CI: 2.66–12.70), taking more than 30 min to collect water (AOR = 3.18; 95% CI: 1.46–6.85), improper use of latrines (AOR = 7.45; 95% CI: 4.20–13.21), poor hand washing practices (AOR = 2.87; 95% CI: 1.62–5.10), lack of rotavirus vaccination (AOR = 96.30; 95% CI: 30.21–305.42), male sex, and household sizes greater than 5. Acute diarrhea remains a public health problem among under-five children in Chiro Woreda. The prevalence was lower in community-led total sanitation and hygiene implemented kebeles. Water source, water collection time, latrine utilization, hand washing practices, rotavirus vaccination, child sex, and household size were significantly associated with diarrhea. Strengthening sanitation and hygiene practices, improving access to safe water, and increasing vaccination coverage could help reduce the burden of childhood diarrhea.