Environmental and Behavioral Factors Associated with Childhood Diarrhea in the Rural Health Zone of Maluku I, Kinshasa, DR Congo

Abstract

Background: Diarrhea accounts for nearly one in five child deaths, with approximately 1.5 million annual fatalities, mainly in peri-urban and rural settings with poor living conditions. This study assessed environmental and household Behavioral factors associated with childhood diarrhea in Maluku I. Methods: A cross-sectional study was conducted in 239 households with children aged 0–59 months. Data were collected using structured questionnaires and analyzed using logistic regression, with associations expressed as odds ratios (ORs) and p-values (<0.05). Results: The prevalence of childhood diarrhea was 21.3%. Households with clean yards showed an 11-fold lower risk (OR = 0.09; 95% CI: 0.01–0.88; p = 0.039), whereas access to improved water reduced the risk by 7.7-fold (OR = 0.13; 95% CI: 0.11–0.29; p < 0.001). Lack of handwashing at critical times emerged as the strongest risk factor, increasing the likelihood of diarrhea approximately six-fold (OR = 6.13; 95% CI: 2.09–18.00; p < 0.001). Conclusion: Childhood diarrhea in Maluku I remains highly prevalent and is strongly influenced by modifiable environmental and behavioral factors, highlighting the need for targeted interventions.