Prevalence and Determinants of Diarrhea among Under-Five Children in Benna Tsemay District, South Omo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study in Pastoralist and Agropastoralist Context

Background. Diarrhea is the second leading cause of death among children under-five years globally and accounts for about 1.5 million deaths each year. In low-income countries, children under three years of age experience three episodes of diarrhea on average every year. In Ethiopia, diarrheal disease is one of the common causes of mortality in under-five children. In Benna Tsemay district, pastoralist community lives with lack of clean water, sanitation, and hygiene problems, which increase the risk of childhood diarrhea. Objective. To assess the prevalence and determinant of diarrheal disease among under five children in Benna Tsemay District, South Omo Zone, Southern Ethiopia. Methods. A community-based cross-sectional study was conducted on a sample of 722 under five children selected randomly from eight pastoralists and two agropastoralist kebels. Data were collected using an interviewer-administered questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Logic regression was performed to identify the association between diarrheal disease and independent variables. Adjusted odds ratio with 95% confidence intervals (CIs) was used to judge the presence of association. Results. The two-week period prevalence of childhood diarrheal disease in the study was 23.5% (95% CI: 20.4%-26.6%). Diarrheal illness was associated with nonavailability of latrine (AOR: 2.77, 95% CI: 1.66-4.63), faeces seen around the pit hole or floor of latrine (AOR: 2.92, 95% CI: 1.38-6.19), improper kitchen waste disposal (AOR: 2.31, 95% CI: 1.26-4. 24), unprotected drinking water source (AOR: 1.81, 95% CI: 1.14-2.88), mother's or caretaker's diarrhea history in the last two weeks (AOR: 6.74, 95% CI: 2.51-18.07), materials used for feeding the child (cup and spoon) (AOR: 0.60, 95% CI: 0.36-0.97), and being unvaccinated for "rotavirus" (AOR: 2.87, 95% CI: 1.86-4.44). Conclusion. Nearly one-fourth of children had diarrheal illness in the preceding two weeks. Water, sanitation and hygiene-related factors, child feeding practice, and children's vaccination status for rotavirus were the determinants of the occurrence of diarrhea among under-five children. The health office should conduct sustainable health education programs that emphasize on risk of open defecation, waste disposal mechanisms, and child feeding practices and also should strengthen rotavirus vaccination activities. The district administration and partners' needed to improve water sources.