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Birhan TA, Bitew BD, Dagne H, Amare DE, Azanaw J, Genet M, Engdaw GT, Tesfaye AH, Yirdaw G, Maru T. Prevalence of diarrheal disease and associated factors among under-five children in flood-prone settlements of Northwest Ethiopia: A cross-sectional community-based study. Front Pediatr 2023; 11:1056129. [PMID: 36756237 PMCID: PMC9899848 DOI: 10.3389/fped.2023.1056129] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Diarrheal illnesses are a long-standing public health problem in developing countries due to numerous sanitation issues and a lack of safe drinking water. Floods exacerbate public health issues by spreading water-borne infectious diseases such as diarrhea through the destruction of sanitation facilities and contamination of drinking water. There has been a shortage of studies regarding the magnitude of diarrheal disease in flood-prone areas. Therefore, this research aimed to evaluate the prevalence of diarrheal disease and its predictors among under-five children living in flood-prone localities in the south Gondar zone of Northwest Ethiopia. METHOD A community-based cross-sectional research was carried out in flood-prone villages of the Fogera and Libokemkem districts from March 17 to March 30, 2021. Purposive and systematic sampling techniques were used to select six kebeles and 717 study units, respectively. Structured and pretested questionnaires were used to collect the data. A multivariable analysis was performed to determine the predictors of diarrheal disease, with P-value <0.05 used as the cut-off point to declare the association. RESULT The prevalence of a diarrheal disease among under-five children was 29.0%. The regular cleaning of the compound [AOR: 2.13; 95% CI (1.25, 3.62)], source of drinking water [AOR: 2.36; 95% CI: (1.26, 4.41)], animal access to water storage site [AOR: 3.04; 95% CI: (1.76, 5.24)], vector around food storage sites [AOR: 9.13; 95% CI: (4.06, 20.52)], use of leftover food [AOR: 4.31; 95% CI: (2.64, 7.04)], and fecal contamination of water [AOR: 12.56; 95% CI: (6.83, 23.20)] remained to have a significant association with diarrheal diseases. CONCLUSION The present study found that the prevalence of the diarrheal disease among under-five children was high. Routine compound cleaning, the source of drinking water, animal access to a water storage site, vectors near food storage sites, consumption of leftover food, and fecal contamination of water were significant predictors of diarrheal disease. Therefore, it is advised to provide improved water sources, encourage routine cleaning of the living area, and offer health education about water, hygiene, and sanitation.
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Affiliation(s)
- Tsegaye Adane Birhan
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bikes Destaw Bitew
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagnachew Eyachew Amare
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengesha Genet
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amensisa Hailu Tesfaye
- Department of Environmental & Occupational Health & Safety, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getasew Yirdaw
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tadele Maru
- Department of Environmental Health, Teda College of Health Sciences, Gondar, Ethiopia
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Kraay ANM, Man O, Levy MC, Levy K, Ionides E, Eisenberg JNS. Understanding the Impact of Rainfall on Diarrhea: Testing the Concentration-Dilution Hypothesis Using a Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:126001. [PMID: 33284047 PMCID: PMC7720804 DOI: 10.1289/ehp6181] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Projected increases in extreme weather may change relationships between rain-related climate exposures and diarrheal disease. Whether rainfall increases or decreases diarrhea rates is unclear based on prior literature. The concentration-dilution hypothesis suggests that these conflicting results are explained by the background level of rain: Rainfall following dry periods can flush pathogens into surface water, increasing diarrhea incidence, whereas rainfall following wet periods can dilute pathogen concentrations in surface water, thereby decreasing diarrhea incidence. OBJECTIVES In this analysis, we explored the extent to which the concentration-dilution hypothesis is supported by published literature. METHODS To this end, we conducted a systematic search for articles assessing the relationship between rain, extreme rain, flood, drought, and season (rainy vs. dry) and diarrheal illness. RESULTS A total of 111 articles met our inclusion criteria. Overall, the literature largely supports the concentration-dilution hypothesis. In particular, extreme rain was associated with increased diarrhea when it followed a dry period [incidence rate ratio ( IRR ) = 1.26 ; 95% confidence interval (CI): 1.05, 1.51], with a tendency toward an inverse association for extreme rain following wet periods, albeit nonsignificant, with one of four relevant studies showing a significant inverse association (IRR = 0.911 ; 95% CI: 0.771, 1.08). Incidences of bacterial and parasitic diarrhea were more common during rainy seasons, providing pathogen-specific support for a concentration mechanism, but rotavirus diarrhea showed the opposite association. Information on timing of cases within the rainy season (e.g., early vs. late) was lacking, limiting further analysis. We did not find a linear association between nonextreme rain exposures and diarrheal disease, but several studies found a nonlinear association with low and high rain both being associated with diarrhea. DISCUSSION Our meta-analysis suggests that the effect of rainfall depends on the antecedent conditions. Future studies should use standard, clearly defined exposure variables to strengthen understanding of the relationship between rainfall and diarrheal illness. https://doi.org/10.1289/EHP6181.
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Affiliation(s)
- Alicia N. M. Kraay
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Olivia Man
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
| | - Morgan C. Levy
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
- School of Global Policy and Strategy, University of California San Diego, La Jolla, California, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Edward Ionides
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
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Abuzerr S, Nasseri S, Yunesian M, Hadi M, Zinszer K, Mahvi AH, Nabizadeh R, Abu Mustafa A, Mohammed SH. Water, sanitation, and hygiene risk factors of acute diarrhea among children under five years in the Gaza Strip. JOURNAL OF WATER, SANITATION AND HYGIENE FOR DEVELOPMENT 2019. [DOI: 10.2166/washdev.2019.072] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Abstract
This cross-sectional community household-based study aims to evaluate the water, sanitation, and hygiene facilities in the Gaza Strip and to investigate their associations with the occurrence of acute diarrhea among children under five years. A survey using a structured questionnaire was conducted on 1,857 households with an child under five years from August 2017 to June 2018. About 69.7% of heads of households reported a diarrheal episode among their children during the two months preceding the survey. Multivariable logistic regression showed that sewage water observed around the households was associated with an increased risk of acute diarrhea (AOR = 2.45; P < 0.001; 95% CI: 1.83–3.27). Nevertheless, the allocation of a special water tank for desalinated drinking water at home (AOR = 0.3; P = 0.02; 95% CI: 0.1–0.8), the connection of households to a closed sewerage system (AOR = 0.56; P < 0.001; 95% CI: 0.43–0.73), and handwashing practices before and after eating (AOR = 0.42; P = 0.003; 95% CI: 0.24–0.74 and AOR = 0.50; P = 0.03; 95% CI: 0.26–0.94, respectively), as well as using desalinated water sources for drinking purposes, were inversely associated with the incidence of acute diarrhea among children under five. Further improvements in the existing sewerage system and the intensification of sanitation and hygiene promotion programs at the household levels may reduce the risk of acute diarrhea among children under five years in the Gaza Strip.
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Affiliation(s)
- Samer Abuzerr
- Department of Environmental Health Engineering, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, Canada
| | - Simin Nasseri
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Water Quality Research (CWQR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, TUMS, Tehran, Iran
| | - Mahdi Hadi
- Center for Water Quality Research (CWQR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Kate Zinszer
- School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, Canada
| | - Amir Hossein Mahvi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Water Quality Research (CWQR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ayman Abu Mustafa
- Department of Research, Directorate General of Human Resources Development, Ministry of Health, Gaza Strip, Palestine
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Kabhele S, New-Aaron M, Kibusi SM, Gesase AP. Prevalence and Factors Associated with Diarrhoea among Children between 6 and 59 Months of Age in Mwanza City Tanzania. J Trop Pediatr 2018; 64:523-530. [PMID: 29342306 DOI: 10.1093/tropej/fmx109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Childhood diarrhoea is a global public health problem especially in unplanned settlements of low- and middle-income countries. Different studies have associated household settlement and childhood diarrhoea, but the prevalence and risk factors associated with childhood diarrhoea at the community level are not clearly known. METHOD A community-based cross-sectional study was performed to determine the prevalence and risk factors associated with diarrhoea in among 480 children between 6 and 59 months of age in Mwanza city from June to August 2016. Risk factors associated with childhood diarrhoea in Mwanza city were determined using univariate, bivariate and multivariate analysis. RESULTS The study showed a prevalence of diarrhoea of 20.4% and an association between type of settlement and childhood diarrhoea (p < 0.001) in a chi-square analysis. During bivariate analysis, and logistic regression, after controlling for other factors, unplanned settlement was significantly associated with childhood diarrhoea (odds ratio=3.475, p < 0.001 and AOR=3.469, p < 0.001). Other factors associated with childhood diarrhoea were behaviour of mother washing hands before preparing food (AOR = 0, 193, p < 0.001), mother washing hands after changing child's napkins (AOR = 0.544, p < 0.036) and the behaviour of the child washing hands after toilet (AOR = 0.447, p < 0.006). CONCLUSION Risk factors associated with childhood diarrhoea in Mwanza city are unplanned settlement and behaviour of mother and child washing hands during critical time; hence, continuous community health promotion insisting on washing hands with soap and water during critically time is the best method for fighting childhood diarrhoea in Mwanza city.
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Affiliation(s)
- Silas Kabhele
- College of Health Sciences, Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Moses New-Aaron
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Centre, NE, USA
| | | | - Ainory P Gesase
- College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
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Alebel A, Tesema C, Temesgen B, Gebrie A, Petrucka P, Kibret GD. Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis. PLoS One 2018; 13:e0199684. [PMID: 29953555 PMCID: PMC6023116 DOI: 10.1371/journal.pone.0199684] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia. METHODS International databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model. RESULTS After reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea. CONCLUSION In this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.
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Affiliation(s)
- Animut Alebel
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Cheru Tesema
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Alemu Gebrie
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
- School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
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Razmus W, Laguna M. Dimensions of Entrepreneurial Success: A Multilevel Study on Stakeholders of Micro-Enterprises. Front Psychol 2018; 9:791. [PMID: 29892242 PMCID: PMC5985317 DOI: 10.3389/fpsyg.2018.00791] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/03/2018] [Indexed: 11/13/2022] Open
Abstract
The study provides an insight into the indicators and dimensions of entrepreneurial success as evaluated from the external stockholders' perspective. As each firm is embedded in a network of relations with stakeholders (business partners), understanding how they evaluate entrepreneurial success is important. The initial qualitative study in the form of in-depth interviews allowed us to identify the indicators of entrepreneurial success that are identified by external stakeholders of micro-firms. In the quantitative study on 475 stakeholders of 57 micro-firms, we identified the dimensions of entrepreneurial success. Using a multilevel approach, we found six dimensions of entrepreneurial success at the individual stakeholder level and four dimensions at the firm level. The results show that stakeholders perceive entrepreneurial success in terms of many dimensions, not focusing solely on economic indicators. This knowledge may inform micro-firm management and the strategies employed by practitioners supporting entrepreneurs.
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Affiliation(s)
- Wiktor Razmus
- Institute of Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Mariola Laguna
- Institute of Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
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Knowledge and practice of care-givers who have under-five diarrhoeal children: a quantitative cross-sectional study in Mataniko settlements in Honiara, Solomon Islands, 2016. GLOBAL HEALTH JOURNAL 2017. [DOI: 10.1016/s2414-6447(19)30077-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Adane M, Mengistie B, Kloos H, Medhin G, Mulat W. Sanitation facilities, hygienic conditions, and prevalence of acute diarrhea among under-five children in slums of Addis Ababa, Ethiopia: Baseline survey of a longitudinal study. PLoS One 2017; 12:e0182783. [PMID: 28854200 PMCID: PMC5576656 DOI: 10.1371/journal.pone.0182783] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/23/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In developing countries, children under the age of five years who live in slums are highly vulnerable to diarrhea. However, there is a paucity of information on the relationship between sanitation facilities and hygienic conditions to acute diarrhea among under-five children in slum areas of Addis Ababa, Ethiopia. Therefore, this study examines the sanitation facilities and hygienic conditions in the slums of Addis Ababa and identifies the main factors significantly associated with acute diarrhea among children aged 0-50 months in those slums. METHODS A community-based cross-sectional household survey was carried out between September and November 2014, that then served as the baseline survey of a longitudinal study. For this survey, 697 children aged 0-50 months were recruited from two slum districts in Addis Ababa. A pre-tested structured questionnaire and an observational checklist were used for data collection. Multivariable logistic regression analysis was used to identify sanitation facilities and hygiene-related factors that were significantly associated with acute diarrhea by controlling potential confounding effects of selected socio-demographic factors. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was used to quantify the strength of association. MAIN FINDINGS The prevalence of acute diarrhea among children aged 0-50 months in the study area was 11.9% and 94.6% of the sanitation facilities were unimproved. Sharing of a sanitation facility by six or more households (AOR = 4.7; 95% CI: 2.4-9.4), proximity of sanitation facilities within 15 meters of homes (AOR = 6.6; 95% CI: 2.5-17.0), presence of feces (AOR = 3.9; 95% CI: 1.5-10.3) and flies (AOR = 2.5; 95% CI: 1.3-5.0) on the floor of and/or around sanitation facilities, and presence of uncollected garbage inside house compounds (AOR = 3.2; 95% CI: 1.2-8.4) were significantly associated with acute diarrhea. CONCLUSION This study reveals the slum environment to be high risk for diarrhea due to close proximity of sanitation facilities to homes, sharing of sanitation facilities, and poor hygiene of the sanitation facilities and housing compounds. We recommend the development of a comprehensive diarrheal disease prevention program that focuses on improving the cleanliness of the sanitation facilities and housing compounds. Increasing the number of improved sanitation facilities at an appropriate distance from houses is also essential in order to reduce the number of households that share one latrine.
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Affiliation(s)
- Metadel Adane
- Ethiopian Institute of Water Resources (EIWR), Addis Ababa University, Addis Ababa, Ethiopia
| | - Bezatu Mengistie
- College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Worku Mulat
- Department of Civil and Environmental Engineering, University of Connecticut, Storrs, United States of America
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