Environmental health and socio-demographic risk factors for diarrheal disease among under-five children in Rwanda: secondary data analysis of the Rwanda Demographic and Health Survey 2014-15

Abstract

Diarrhea is a worldwide public health issue as it is among the first top ten leading causes of global mortality and morbidity. Globally, it accounts for one in nine deaths in children under five years killing 2195 children every day worldwide making diarrhea the second leading cause of death in children under five years. Low and middle income countries of Africa and part of Asia are more affected by diarrheal diseases. However, effective practice of hygiene measures accompanied by provision of water and sanitation can reduce the burden caused by diarrheal diseases. These risk factors vary from one community to another. The present study was to ascertain the prevalence pattern of diarrhea in line of environmental health risk factors contributing to diarrhea disease. Methods A cross-sectional study was conducted by the Demographic and Health Survey in 2015 (n= 7,856) in Rwanda. Diarrhea prevalence rate and environmental health risk factors from this survey were analyzed using the STATA version 13.0. For the statistical analysis univariate was performed for all variables, the dependent variable and independent variables. On bivariate analysis, cross tabulations between the dependent variable and risk factors variables were used to interpret the p-value to see if the relationship was statistically significant. Chisquare test was used to assess whether there was statistical significance between the categorical variables associated with the outcome variable. Approval to access the database was thought and secured through online registration. Results The study revealed that prevalence of diarrhea in Rwanda is 12.25%. The factors associated with diarrhea among under-five children were found to be child‟s age (p-value<0.001), mothers‟ education level (p-value<0.003), place of residence (p-value=0.048), wealth index (p-value=0.001), drinking water source (p-value<0.001), type of sanitation facility (pvalue=0.021), frequency of washing water containers (p-value=0.01) and handwashing (pvalue=0.043). Conclusion Findings from this study have shown that women need to be encouraged to get formal education to help them understand the importance of health promotion and disease prevention. This requires also supply of improved water and sanitation to households in order to reduce diarrhea prevalence and achieve SDGs targets especially end of poverty for all, ensure health and well-being for all at all ages, ensure available and sustainable management of water and sanitation for all.