Abstract
Background: Diarrhoeal illness is still a serious public health challenge in middle- and low-income countries, especially among children under the age of 5 years. South Asia and the sub-Saharan regions are believed to contribute nearly 75% of diarrhoeal cases in the world. Uganda is among the top 10 countries in the sub-Saharan Africa region that have the highest prevalence of diarrhoeal disease. Evidence suggests that the severity of childhood diarrhoeal disease is escalated through various sociodemographic and environmental factors.
Aim: To investigate factors associated with the occurrence of childhood diarrhoeal disease in a sample of children under the age of 5 years in Uganda in 2021.
Methods: A cross-sectional study was employed that used secondary data for analysis from the 2021 Uganda Demography and Health Surveys. Frequency and percentages were used to describe the study populations’ baseline characteristics. Chi-square test was used to assess the significant differences in those participants with and without diarrhoea. Logistic regression with Odds Ratios (OR) was used in bivariate and multivariate analysis to determine the relationship between diarrheal illness and other factors (sociodemographic and environmental). The crude OR was determined and variables with a P<0.01 were included in the final model. A backward stepwise regression was used to get variables in the final model. The P value <0.05 was used as the level of significance in the final model.
Results: The number of children included in the study was 13,573 children. The prevalence of childhood diarrheal illness in past 2 weeks was 20.9% (n = 2838) for children below the age of 5 years in Uganda. Multivariate analysis showed that caregiver’s age (15-24 years: aOR;0.84; 95%CI:0.77-0.92 & 25-34: aOR;0.71; 95%CI:0.62-0.83), region (East: aOR;0.65; 95% CI:0.56-0.75 & West: aOR;072; 95%CI:0.65-0.81), Age of child (2 years: aOR;0.60; 95% CI:0.49-0.75), own radio (aOR;0.83; 95% CI:0.76-0.91) were significant and showed decreased risk of suffering from childhood diarrheal illness. Child’s sex (Male: aOR;1.13; 95% CI:1.06-1.21) was significant but showed increased risk of suffering from diarrheal illness. The environmental factors such as source of water (springs: aOR;0.85; 95% CI:0.73-1.00) were significant to the study and showed a decreased risk of suffering from diarrheal illness, and visitation of health facility (aOR;1.20; 95% CI:1.30-1.35) with vitamin A dose (aOR;1.42; 95% CI:1.30-1.57) showed an increased risk of suffering from diarrheal illness.
Conclusion: Diarrhoeal disease is still a problematic health issue in Uganda, especially among children that are raised by caregivers aged between 35 and 49 years, children from either the North or South region, and male children below the age of 2 years. In relation to environmental factors, families that got their drinking water from piped water, wells, containers, received a vitamin A dose, regularly visited hospitals were susceptible to high risk of suffering from diarrhoeal disease. A targeted approach of interventions can be suggested to assist in the elimination or reduction of the severity of diarrhoeal disease among children. Individuals, organisations, and governments should allocate adequate diarrhoeal-related resources in regions with a high prevalence of the disease.
Keywords: Diarrhoea, sociodemographic factors, environmental factors, children under five, Uganda