Hygiene and sanitation risk factors of diarrheal disease among children under five in NYARUGURU District, Rwanda

Abstract

Background In developing countries, including Rwanda, the leading cause of preventable death, particularly among children under five, is diarrheal illnesses. Despite efforts to minimize the morbidity and mortality caused by diarrheal diseases, there is little evidence of how well those efforts are working (K. Alemayehu et al., 2021). There are nearly1.7 million cases of childhood diarrheal infections that account for one in nine child deaths globally, making diarrhea the second leading cause of death among children under five years old (Kefalew Alemayehu et al., 2021). Diarrhea is ranked as the third leading cause of mortality in children under five years old in Rwanda, a small blocked-in nation with a population of 12.5 million. In 2015, it was responsible for 18.3% of child deaths (Claudine et al., 2021). Methods This study was conducted in Nyaruguru District among 950 children aged under five years in 2021. It aimed to assess hygiene and sanitation risk factors of diarrheal disease and related diseases among children under five who consulted Munini hospital January to September 2021. Characteristics of the study population were analyzed using chi-square test for binary variables. The odds ratios (OR), p-value and 95% confidence intervals (CI) for diarrhea were determined using binomial logistic regression analysis. All analyses were conducted using JAMOVI statistical software, version 2.2.5. A value of p <0.05 was considered statistically significant and applied in binomial logistic regression. Result Of the 950 participants included in this study, there were 466 male children (49.1%) and 484 female children (50.9%). The results are presented as OR, p-value (P), and 95% CI for binary variables. The risk of suffering from diarrhea is high among children who do not have access to soap (p<.001, OR=5.21), whose parents are farmers (p<.001, OR=0.512), who do not have towels (p<.001<0.05, OR =3.64), who do not wear shoes (p<.001, OR =2.18), in unclean environments (p<.001, OR =5.21), who drink untreated water (p=0.013, OR =1.49), whose hands are not washed properly (p<.001, OR =4.26), with dirty bedrooms (p<.001, OR =1.83), without well-lit rooms (p<.001, OR =5.21), and who do not use soap (p<.001, OR =2.69). Conclusion The causes of diarrheal illnesses in children under the age of five were identified in this study. These causes included the absence of a hand-washing facility near latrines, lack of hand-washing practice at crucial times, not wearing shoes, parents’ occupations, and children’s lack of cleanliness. Other causes included the absence of treated water, unclean bedrooms, dark rooms, lack of towels at the washing stations, and lack of soap. In the region where the study was conducted, most of the risk factors that have been connected to diarrheal disease among young children can be avoided. Supporting the delivery of continuous and customized health information programs for households is essential for reducing the prevalence of diarrheal illness in kids under the age of five.