Prevalence of diarrhea and associated factors among children under 5 years in Bugiri District, Uganda

Abstract

Diarrhoea remains a significant public health concern globally, particularly affecting children under five years, predominantly in resource-limited settings. This study investigated the prevalence of diarrhoea and associated factors among children under five years in Bugiri District, Uganda. Methods: Utilizing a cross-sectional study design, data was collected through a structured questionnaire administered to household heads within selected communities in Buwunga Sub County, Bugiri District. Diarrhoea prevalence was measured by asking whether any child under five had experienced diarrhoea in the 14 days preceding the survey. Data analysis involved descriptive and modified Poisson regression, including prevalence ratios, to measure associations between water practices and diarrhoea. Results: The prevalence of diarrhoea among children under 5 years was 43.67%, with 3-5 episodes per day being common. The study found that 99% (297/300) of households sourced water from boreholes, with a median collection frequency of five times per day. Water treatment was prevalent, with 90% using chlorination, and 56% treating water weekly. Among the households, 95% stored water in closed containers, with 98% storing it indoors, and 71% cleaning the containers weekly. Good water handling practices were evident, with 69% using a spoon or scoop to collect drinking water. Socio-demographic factors associated with diarrhoea included a higher number of children in the household (aPR = 1.20, 95% CI: 1.07- 1.34), caregiving by guardians (aPR =1.46, 95% CI: 1.11- 1.93), lower educational levels of caregivers (aPR = 0.44, 95% CI: 0.27- 0.71 for primary; aPR = 0.64, 95% CI: 0.35- 0.80 for secondary), and unemployment of caregivers (aPR = 2.29, 95% CI: 1.35, 3.88). Households that burned waste had a higher prevalence of diarrhoea (aPR = 2.00, 95% CI: 1.27, 3.14), while consistent hand-washing by children (aPR = 0.59, 95% CI: 0.37, 0.93) and the availability of hand washing facilities (aPR = 1.93, 95% CI: 1.50, 2.49) were associated with reduced diarrhoea prevalence. Conclusion: Despite good water treatment and storage practices in Bugiri District, the high diarrhoea prevalence indicates these measures alone are inadequate. To reduce diarrhoea prevalence, targeted educational programmes for caregivers on water treatment and storage, economic support to alleviate caregiver unemployment, and improved access to handwashing facilities, chlorination tablets, and clean water storage containers should be prioritized.