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article · PLoS ONE

Risk factors for diarrhoea and malnutrition among children under the age of 5 years in the Tigray Region of Northern Ethiopia

2018102 citationsOpen accessMekelle University

In plain language

In the Tigray Region of Northern Ethiopia, diarrhoeal diseases and undernutrition represent significant health burdens for young children. A community-based investigation of 610 mother-child pairs found that over a quarter of children aged between six and fifty-nine months experienced diarrhoea during a two-week period. In addition, over a third of the children suffered from stunting and underweight conditions, alongside measurable rates of wasting and acute undernutrition. Diarrhoeal risk was heavily driven by the type of drinking water source, improper solid waste disposal, and mothers not washing their hands at critical times. Nutritional vulnerability varied significantly across child age groups, with children between 12 and 47 months facing the highest risks of wasting, stunting, and being underweight, whereas smaller family size reduced wasting risks.

Key takeaways

  • Over 27 percent of surveyed children aged 6 to 59 months experienced diarrhoea in the two weeks preceding the study.
  • Child malnutrition was prevalent, with 36.1 percent of children affected by stunting and 37 percent classified as underweight.
  • Unsafe drinking water sources, improper solid waste disposal, and poor maternal hand washing at critical times were strong predictors of diarrhoea.
  • Child age strongly influenced malnutrition risk, with ages between 12 and 47 months being particularly vulnerable to wasting and stunting.

Why it matters

Diarrhoea and malnutrition remain major causes of childhood illness and death in areas lacking basic infrastructure. Identifying specific environmental and behavioural triggers helps public health authorities and community organisations target resources where they matter most. The findings show that expanding clean water access, promoting essential hygiene practices, and delivering age-specific nutritional support are vital steps to protecting vulnerable children in developing regions.

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Abstract

BACKGROUND: Diarrhoea and malnutrition are the leading cause of morbidity and mortality among children in areas with poor access to clean water, improved sanitation, and with low socioeconomic status. This study was designed to determine the prevalence of diarrhoea, malnutrition and risk factors among children aged 6-59 months in the Tigray Region of Northern Ethiopia. METHODS: A community based cross-sectional study design was conducted from June to August 2017 to assess the magnitude and factors associated with diarrhoea and malnutrition among children. A standardized questionnaire was used to collect data on diarrhoea, environmental, demographic and behavioural factors from 610 mother-child pairs. Anthropometric measurements were collected from the children. SPSS ver.21 statistical software was used for analysis. Factors associated with diarrhoea and nutritional status were identified using bivariate and multivariate logistic regression. A p-value ≤ 0.05 was considered statistically significant. RESULTS: Of the 610 children monitored in this study, the incidence of diarrhoea among 6-59 month-old children in the two weeks preceding the day of the interview day was 27.2% (95% CI: 23.6-31%). Specifically, 35.9%, 9.7%, and 1.8% had 1-2, 3-4 and 5-6 times of diarrhoea episodes in a one year of time, respectively. The prevalence of stunting, underweight, wasting, and acute under-nutrition were 36.1% (95% CI: 31-38.6%), 37% (95% CI: 32-39.6%), 7.9% (95% CI: 5.5-9.7%), and 5.4% (95% CI: 3.8-7.4%), respectively. In a multivariate logistic regression analysis, type of drinking water source [AOR = 3.69; 95% CI: 2.03-6.71], mothers not hand washing at critical times [AOR = 15.42; 95% CI: 2.02-117.78], improper solid waste disposal [AOR = 12.81; 95% CI: 2.50-65.62], and child age (36-47 months) [AOR = 2.57; 95% CI: 1.45-4.55] were found to be predictors of diarrhoea. Being within the age range of 12-23 months was a predictor for wasting [AOR = 4.38; 95% CI: 1.61-11.90] and being underweight [AOR = 4.4; 95% CI: 1.7-11.2]. Similarly, the age range of 36-47 months was associated with wasting [AOR = 2.3; 95% CI: 1.45-3.85] and stunting [AOR = 1.7; 95% CI: 1.03-2.67]. Family size (less than 4) [AOR = 0.56; 95% CI: 0.368-0.959] was inversely associated for wasting. CONCLUSIONS: Our study revealed that the problem of diarrhoea and malnutrition amongst 6-59 months children in the study area was significant. Access to clean water was the main problem in the study area. Hence, improving access to clean water and providing health education to mothers on personal and environmental hygiene, and proper waste disposal could improve diarrhoea in the study area. Intervention on children's nutrition should also be implemented to minimize the problem of malnutrition.

Research topics

  • Child Nutrition and Water Access
  • Congenital gastrointestinal and neural anomalies
  • Dental Health and Care Utilization

Sustainable Development Goals

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DOI: 10.1371/journal.pone.0207743

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