Epidemiology and factors associated with diarrhoea among children under five years of age in the Engela District in the Ohangwena Region, Namibia

Background: Diarrhoea remains a public health problem and an important cause of morbidity and mortality amongst children, mainly in low- and middle-income countries. In Namibia, the national prevalence of diarrhoea was 17%; it was responsible for 5% of all deaths in children under 5 years old and is the second leading cause of death. Aim: The purpose of this study was to assess the epidemiology and factors associated with acute diarrhoea amongst children less than 5 years of age in Engela district in the Ohangwena region, Namibia. Setting: The study was conducted in Ohangwena Region in Namibia which extends east to west along the borders of the southern part of Angola. Methods: A cross-sectional study was conducted. A structured questionnaire was administered through face-to-face interviews. Descriptive statistics were used to describe the socio-demographic and epidemiological data of diarrhoea and logistic regression analysis was used to determine the factors associated with the prevalence of diarrhoea. Results: The study found a prevalence of 23.8% for diarrhoea in the 2 weeks period preceding the survey amongst children aged under 5 years. The prevalence of diarrhoea was statistically significantly associated with children (p < 0.05). The strongest predictor of the prevalence of diarrhoea was the residential area 'informal settlement', with an odds ratio of 36.42. This implies that children living in the informal settlement are 36.42 times at risk of contracting diarrhoea as compared to those living in other residential areas. Conclusion: epidemiology; factors; diarrhoea; under-5 years children; Engela district; Ohangwena region; Namibia

Enteropathogens in under-five children with diarrhea in health facilities of Debre Berhan Town, North Shoa, Ethiopia

BACKGROUND: Diarrheal disease is a major cause of mortality and morbidity for under-five children in Ethiopia. The purpose of this study was to investigate the behavioral and socioeconomic risk factors, etiology, and drug susceptibility of bacteria isolated from under-five children with acute diarrhea who were treated at Debre Berhan Referral Hospital or Health Center in Ethiopia. METHODS: A health facility based cross-sectional study design was used to investigate enteropathogens from 163 under-five children with acute diarrhea. After obtaining written consent from parents or guardians, data were collected using a standardized questionnaire. Freshly passed stool samples were collected for microbiological tests for bacteria and parasites. The chi-square test was used for assessing the relationships of variables. RESULTS: Enteropathogens were detected among 55.8% (91/163) participants. There was a 46%(75/163) bacterial culture positivity rate and a 9.8%(16/163) prevalence of parasites. The isolated enteropathogens were Escherchia coli, Klebsiella specie, Proteus species, Salmonella species, Shigella species, Enterobacter species, Giardia lamblia, Enteameba histolytica, Ascaris lumbricoides, Trichuris trichiura and Hymnoleps nana. Level of antimicrobial resistance of bacterial isolates ranged from 0 to 87.2%. Poor hand washing and poor cleaning of feeding utensils showed significant association with the presence of enteropathogens. CONCLUSION: Bacterial enteropathogens with drug resistance were observed in this study. Continuous health education and promotion about diarrheal disease for mothers/caretakers and regular surveillance of entropathogenes are recommended to reduce under-five mortality

Clinico-demographic factors associated with diarrhoeal disease outcome in under-five children: A Nigerian tertiary hospital experience

Objectives: To determine the proportion of under-5 children presenting with diarrhoeal disease, and the clinico demographic variables associated with the outcome at the emergency paediatric ward (CHER) of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, South- East Nigeria.Methods: Clinical and demographic details of patients with diarrhoeal disease as obtained from the Paediatrics emergency ward log book over an 18month period were analyzed using SPSS and Microsoft excel software packages. The clinical variables (non-parametric) were tested for degree of association with mortality using Spearman's rank correlation. Chi square and Fischer exact test were used to determine presence of significant differences between certain variables. A p value <0.05 was deemed significant. Results: One thousand, one hundred and sixty three out of 1,513 children admitted within the period were aged below 5 years. Acute diarrheal disease accounted for 32% and 38% respectively of morbidity and mortality in these under-five children, with a case fatality rate of 18.3%. The mean age at presentation was 11.96 months with a male to female ratio of 1.4:1. Presentation with fast breathing (Odds Ratio {OR} 2.6), convulsion (OR 2.5), loss of consciousness (OR 4.3), increased severity of dehydration, presence of one or more comorbidities (OR 4.68) and a co-diagnosis of sepsis (OR 3.23) significantly affected the outcome. (p< 0.05 in all these). Educational status of the mothers also significantly affected the outcome. (F=9.08, p=0.023)Conclusion: Intensified effort should be made to sensitize the public about dangers of inappropriate therapy and late hospital presentation of children with diarrhoeal disease. These will reduce mortality-heralding complications