ABSTRACT
Background:
Diarrheal
diseases, are major concerns for Ugandan
children; persistent in Obongi District despite high
rotavirus vaccination rates (2019-2021). The district recorded the country's highest annual acute watery
diarrhea (AWD)
incidence from 2017 to 2021. Our study, conducted in April 2022, assessed AWD
risk factors among 0-59-month-old
children in Obongi.
Methods:
We conducted a 12 (193386) unmatched
case-control study. A case was a
child (0-59 months) with ≥ 3 loose/liquid stools/day, negative
malaria/
pneumonia tests, residing in Itula/Parolinya subcounty from 1 to 30 April 2022.
Medical records from 10 facilities were reviewed.
Simple random sampling identified cases,
who were interviewed, and controls were randomly chosen from non-AWD neighboring households.
Child health cards provided
vaccination details. We used
logistic regression to identify factors associated with AWD.
Results:
Among 193 cases and 386 controls, 104 (54 %) cases and 183 (47 %) controls were
male, 58 (30 %) cases and 127 (33 %) controls were
aged 12-23 months, 187 (97 %) cases and 369 (96 %) controls had received at least one
dose of
rotavirus vaccine, 58 (30 %) cases and 120 (34 %) controls treated
drinking water.
Comorbidity presence (
undernutrition, diabetes,
HIV) (AOR = 12; CI 2.5-53),
caregiver's unwashed
hands post-
toilet (AOR = 3.9; CI 1.2-13), and borehole vs. piped
water (AOR = 4.0; CI 1.7-9.6) linked to AWD.
Conclusion:
Modifiable factors, including failure of
caregivers to wash their
hands with
soap after visiting
toilets and use of borehole
water were associated with AWD, suggesting that
community sensitization on
handwashing at critical times, using clean
water and
soap, and expanded use of piped
water could reduce AWD
incidence in this area.