Implications of COVID-19 prevention on the occurrence of childhood diarrhea in the Semen Bench district, Bench Sheko zone, southwestern Ethiopia.

Background: Coronavirus (COVID-19) is a virus that occurred in Wuhan, China, in December 2019 and has spread to several countries. Although interventions in water, sanitation, and hygiene (WASH) for COVID-19 are likely a pre-existing response to childhood diarrhea, evidence of the effects of COVID-19 preventative strategies on childhood diarrhea has been lacking. This study aimed to assess the implications of COVID-19 prevention for the occurrence of childhood diarrhea in rural communities of Ethiopia. Methods: A community-based cross-sectional study was conducted from 10 May 2020 to 30 July 2020 involving selected households in the Semen Bench district, Bench Sheko zone, southwestern Ethiopia. A single population proportion formula was used to obtain a total of 768 sample sizes. Data were collected from selected households using a simple random sampling technique. Epidata 3.1 was used to enter the data and then exported to Stata 14 for analysis. Descriptive statistics along with binary and multivariable logistic regression analyses were used to identify factors of COVID-19 knowledge and practices related to childhood diarrhea. The chi-squared test was used to check the association between COVID-19 prevention and childhood diarrhea reduction. Results: A total of 720 (93.75%) households participated in the study to achieve the study objectives. Approximately 55% of the participants had a good understanding of COVID-19 prevention, while only 48.5% had good COVID-19 prevention practices. The prevalence of childhood diarrhea was 19.3% which was more common among households with poor practices of COVID-19 prevention. The respondents with poor COVID-19 prevention knowledge were 42% (AOR = 0.58, 95% CI: 0.398, 0.847, P = 0.005) less likely to develop childhood diarrhea than those who had good COVID-19 prevention knowledge. Households with poor practices for COVID-19 prevention were 75.1% more likely to develop childhood diarrhea than those who had good preventive practices for COVID-19 prevention (AOR = 1.751, 95% CI: 1.193, 2.571, P = 0.004). The lower risk of childhood diarrhea is significantly related to good COVID-19 prevention practices. However, households with no formal education and a lack of WASH facilities have a higher likelihood of having childhood diarrhea in the household. Conclusion: COVID-19 preventative strategies help reduce the prevalence of diarrhea in children. More research using prospective study designs and advanced statistical models is needed to better understand the implication of COVID-19 preventative efforts in reducing childhood diarrhea.

Effects of household vectors on child health and its determinants in southwest, Ethiopia correspondence analysis.

Background: Household vectors transmit pathogens from one child to another. This study aimed to investigate the prevalence and determinants of household vectors on child health. Methods: A community-based cross-sectional study design was conducted, during which a total of 846 household data were collected using a pretested questionnaire and simple random sampling technique. The data was entered into EpiData3.4 and then exported to Stata 14 software for analysis. A multivariable logistic regression analysis was conducted to identify significant factors associated with household vectors that contribute child health problems. The correspondence analysis was used to determine statistically significant effects or associations between household vectors and child health problems, that was explained by the percentage of variance. Results: This study revealed that the prevalence of household vector effects among children was 35.5% suchas itching, allergies, nuisances and aesthetically displeasing factors. Households with no formal education were significantly 36% less likely to be affected compared to their counterparts (AOR 0.64, 95% CI 0.41, 0.99). Housewives are significantly 2.21 times more likely to be bexposed to household vectors compared to government workers (AOR 2.21, 95% CI 1.23, 3.70). Caregivers who had limited awareness of household vectors were 98.6% less likely to be affected compared to their counterparts (AOR 0.014; 95% CI 0.01-0.04). Similarly, children from households that consumed less than 20 liters of water per individual were 1.45 times more likely to be at risk compared to children from households that consumed more water (AOR 1.45, 95% CI 1.02, 2.07). The infestations of household vectors were found to be statistically significant and were associated with the occurrence of child health problems. This significant association accounted for 86.8 percent of the explained variance. Conclusion: Addressing the high burden of household vectors on child health requires interventions that target informal education, limited access to information, and inadequate access to safe water. Implementing effective vector control measures is crucial to reduce the incidence of vector-borne diseases among children.

Exploring the association between childhood diarrhea and meteorological factors in Southwestern Ethiopia.

Childhood diarrhea has been one of the major public health concerns in countries that have limited resources like Ethiopia. Understanding the association between childhood diarrhea and meteorological factors would contribute to safeguard children from adverse health effects through early warning mechanisms. Thus, this study aimed at exploring the association between childhood diarrhea and meteorological factors to enable reducing health risks. A retrospective study design was used to explore the association between meteorological factors and childhood diarrhea in southwestern Ethiopia from 2010 to 2017. Mann Kendall trend test and Spearman's correlation were computed to test the association of childhood diarrhea and meteorological factors. The space-time permutation model was used to identify the risky periods, seasons with most likely clusters, and high childhood diarrhea. Similarly, a negative binomial regression model was fitted to determine the predictability of meteorological factors for childhood diarrhea. The highest childhood diarrhea morbidity was 92.60 per 1000 per under five children. The risk of childhood diarrhea increased by 16.66% (RR: 1.1666; 95% CI: 1.164-1.168) per increase in 1 °C temperature. Furthermore, rainfall was found to be a significant risk factor of childhood diarrhea, with 0.16% (RR: 1.00167; 95% CI: 1.001306-1.001928) per 1 mm increase in rainfall. The temperature was positively correlated with the occurrence of childhood diarrhea. But the association with rainfall showed spatial variability. The space-time permutation model revealed that dry season was found to be a high-risk period with excess childhood diarrhea. The results showed that the observed association between meteorological factors and childhood diarrhea could be used as evidence for early warning systems for the prevention of childhood diarrhea.

Spatiotemporal and hotspot detection of U5-children diarrhea in resource-limited areas of Ethiopia.

Under-five children (U5-children) diarrhea is a significant public health threat, where the World Health Organisation (WHO) reported it as the second leading cause of children's death worldwide. Nearly 1.7 billion cases occur annually with varied temporal and spatial factors. Identification of the spatiotemporal pattern and hotspot areas of U5-children diarrhea can assist targeted intervention and provide an early warning for more effective response measures. This study aimed at examining spatiotemporal variability along with the detection of hotspot areas for U5-children diarrhea in the Bench Maji Zone of southwestern Ethiopia, where resources are limited and cultural heterogeneity is highest. Retrospective longitudinal data of ten years of diarrhea records from January 2008 to December 2017 were used to identify hotspot areas. The incidence rate per 1,000 per year among children was calculated along with seasonal patterns of cases. The spatiotemporal analysis was made using SaTScan version 9.4, while spatial autocorrelations and hotspot identification were generated using ArcGIS 10.5 software. A total of 90,716 U5-children diarrhea cases were reported with an annual incidence rate of 36.1 per 1,000 U5-children, indicating a relative risk (RR) of 1.6 and a log-likelihood ratio (LLR) of 1,347.32 (p < 0.001). The highest incidence of diarrhea illness was recorded during the dry season and showed incidence rate increment from October to February. The risky clusters (RR > 1) were in the districts of Bero, Maji, Surma, Minit Shasha, Guraferda, Mizan Aman Town, and Sheko with annual cases of 127.93, 68.5, 65.12, 55.03, 55.67, 54.14 and 44.97 per 1,000, respectively. The lowest annual cases reported were in the four districts of Shay Bench, South Bench, North Bench, and Minit Goldiya, where RR was less than a unit. Six most likely clusters (Bero, Minit Shasha, Surma, Guraferda, South Bench, and Maji) and one lower RR area (North Bench) were hotspot districts. The U5-children's diarrhea in the study area showed an overall increasing trend during the dry seasons with non-random distribution over space and time. The data recorded during ten years and analyzed with the proper statistical tools helped to identify the hotspot areas with risky seasons where diarrhea could increase.

Individual and community-level risk factors in under-five children diarrhea among agro-ecological zones in southwestern Ethiopia.

Under-five children diarrhea remains a major public health problem in resource-limited areas, including Ethiopia, due to multiple risk factors. This study aimed to identify individual and community-level risk factors affecting under-five children diarrhea (UFCD) in five districts of the Bench Maji Zone, southwestern Ethiopia. A community-based cross-sectional study was conducted from February to April 2018. A total of 826 households were recruited from five randomly selected districts using stratified sampling. A multivariable logistic regression model was fitted to identify risk factors associated with UFCD. The prevalence of UFCD in the study area was found to be 18.3%. Children less than six months of age are more at risk for diarrhea (95% CI for AOR2.5;1.23-4.90). Most probably initiating supplementary feedings before six months of age is one of the main risk factor for diarrhea (95% CI for AOR 0.65; 0.45-0.98). Similarly, mothers with low educational status (95% CI for AOR 0.30; 0.10-0.84), limited knowledge of mothers' about diarrhea (95% CI for AOR 0.24; 0.15-0.40), absence of hand washing among mothers/caregivers at critical times (95% CI for AOR 4.6; 2.88-7.67), and sharing of the residence with domestic animals (95% CI for AOR 2.87, 1.75-4.67) were the predictors of UFCD at individual-level. Children living in semi pastoral areas (95% CI for AOR 0.22; 0.10-0.50) unvaccinated children for rotavirus prevention (95% CI AOR 5.22, 3.33-8.20), households obtaining water from unimproved sources (95% CI for AOR 2.53; 1.60-4.40), and households with unimproved latrine facilities (95% CI for AOR 0.60; 0.33-0.99) were the risk factors of UFCD at the community-level. The study revealed that UFCD is a critical health concern in southwestern Ethiopia, where integrated intervention approach at individual and community level could help to alleviate the problem. At individual level, behavioral change intervention on handwashing, exclusive breast-feeding before the age of six months, and awareness on diarrhea prevention methods are critical areas of intervention. Likewise, provision of safe and adequate water source combined with household water chlorination, and vaccination for rotavirus are interventions at community that need to be integrated with the individual-level of intervention. This could significantly contribute for the reduction of UFCD in the resource limited areas through intersectoral collaboration of the health and other sectors.