Correlates of diarhoea among the underfives in Namwala District, Zambia

Abstract

Background: Globally, diarrhoeal diseases are the second leading cause of deaths in children under five years old, causing 6.9% of deaths. In Zambia, diarrhoeal disease accounts for 16% of mortality among the under fives. The objective of the study was to investigate the correlates of diarrhoea among the under fives in Namwala district and the extent to which water; sanitation, hygiene and socio-cultural practices were associated with child diarrhoea.

Methods: A Mixed method cross- sectional study design was used. Quantitative (survey) was used to establish how socio-demographic factors contributed to child diarrhoea .Quantitative data considered mothers /care givers of children under fives old using a structured questionnaire. Qualitative data was collected using focus group discussion and was thematically analysed. Quantitative data was analysed using Stata version 12. Chi (2) was used to determine association among the independent variables. A p- value of 0.05 was taken as a mark of significance that is any variable with p-value less than 0.05 was statically significant.

Results: Education level of caregivers was found to be associated with the use of safe water supply, (Chi (2) =18.3131, p-value 0.001). Water treatment with Chlorine (Fisher’s exact=17.4350, p-value 0.008) was also associated with education level. The practice of hand washing after using the toilet was associated with the age of the care givers (fisher s’ exact 7.0224, p-value 0.008) and education level of the care givers (fisher’s exact 12.7265, p-value 0.005). Water quality test (biological) results revealed that majority (65%) of the water samples were positive with faecal contamination that was indicated by the presence of E.coli, while 35% were negative. In the regression model, only hand washing was significant (p-value 0.001, C.I = -0.2910,-0.075). Age was significant in the model before stratifying into four groups, but after stratification age was found to be insignificant (p-value 0.065).

Conclusion: The study has shown that poor hand washing practices contributed to the increase in diarrhoeal cases among the under fives in Namwala District. The study has further ascertained that contaminated water sources, poor disposal of baby’s stool and poor hygiene practices on hand washing contributed to the increase of diarrhoeal cases.The research has equally revealed that most mothers/ caregivers for children under five years had inadequate knowledge of diarrhoea prevention and control. This is evident from educational status for mothers who had only attained up to primary school education level.