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Incidence and Determinants of Diarrheal Cases in Children Under Five Admitted at Kampala International University Teaching Hospital, Ishaka-Bushenyi District, Western Uganda

Halongo Denis

Faculty of Clinical Medicine and Dentistry at Kampala International University Western Campus Uganda.

ABSTRACT

Diarrhoea stands as a significant global public health issue, with the WHO reporting approximately 2.5 billion cases annually among children below five years old. This study aimed to ascertain the prevalence of diarrhoea and its influencing factors in children under five admitted to Kampala International University Teaching Hospital (KIU-TH). Employing a cross-sectional and descriptive approach, quantitative data was gathered through self-administered and investigator-led questionnaires, utilizing digital tools such as Google Sheets for data collection. A total of 238 mothers, randomly selected using convenience sampling, whose children were admitted at KIU-TH constituted the study’s sample. The results, presented through 95% Confidence Intervals (C.I), Odd Ratios (OR), and P-values, were computed using Binary Logistic Regression with Pearson’s correlation in SPSS Version 26, and graphically represented using Microsoft Excel Software. At the time of data collection, the prevalence of diarrhoea among children under five admitted at KIU-TH stood at 24.4% based on maternal responses. This high prevalence was found to be influenced by several factors, including the child’s vaccination status, the early introduction of supplementary foods, premature weaning practices, and the child’s age. Notably, exclusive breastfeeding practices were not adhered to, with mothers introducing other foods at a young age and initiating early weaning practices.

Keywords: Diarrhoea, Children under five years of age, Vaccination status, early weaning.

INTRODUCTION

Diarrhoea is one of the major public health concerns worldwide. The World Health Organization estimates that 2.5 billion cases of diarrhoea occur yearly among children under five years of age. The same report further indicates that nearly three-quarters of child deaths are due to diarrhoea [1]. In 2015, it was reported that 16,000 children under five die every day from mostly preventable causes such as pneumonia, diarrhea, and malaria. 80% of these cases are in Africa and South Asia (46% and 38% respectively) [2]. In Africa, a study done by the Center for Infectious Disease Research and Policy (CIDRAP) in 2015 showed that Nigeria had the most variance of disease rates among African countries, with estimates ranging from 1.6 deaths per 1000 children to 9.5 deaths per 1000 children and according to this study all the severe cases of diarrhea occurred in Ethiopia and democratic republic of Congo [3]. Uganda was ranked number 9 among the countries with the highest number of diarrhea cases under five with 29,000 deaths due to diarrhea [2]. According to the annual Health Sector Performance Report AHSPR (2013), diarrhea is number six among the top ten causes of under-five years of morbidity and mortality in Uganda [4]. It accounts for 3.4% of under-five-year mortality. AH- SPR 2013 report further shows an increase in the trend from 1.84% in 2011 to 3.4% in 2013. Overall, these children experience an average of 3.2 episodes of diarrhea per child per year [4]. Demographic and Health Survey (UDHS 2011) conducted by the Uganda Bureau of Statistics (UBOS) indicates that in Uganda the prevalence was 20% in 2011 and 23% in 2016. This shows an increase in the trend of diarrhea cases in the country [5]. Globally, in 2015, 5.9 million children under the age of 5 years died, and the majority of these children were in the African region [6]. Most of these mortalities occurred as a consequence of diarrhea and acute respiratory infections [2]. Uganda is among the countries where the burden of childhood diarrhea is heavily Concentrated (IVAC, 2014). The incidence varies greatly with seasons and children’s age, highest in the rainy season and among children aged 6-11 months [5]. Some of the risk factors include nutrition, environmental pollution, population increase, and climate change [7, 8]. Poor sanitation, lack of access to clean water supply, and inadequate personal hygiene are responsible for 90% of diarrheal disease occurrence [9-12]. Diarrhea prevalence increases with age and peaks at 12-23 months (33%), then declines at older ages [13]. It is therefore necessary to identify associated factors leading to the increase of diarrhea using Kampala International University Teaching Hospital. More so, there is no documented data about Ishaka, Bushenyi district that explains associated factors leading to an increase in the number of diarrhea cases in children under five years, which is also the same case at Kampala International University Teaching Hospital. These factors have not been well understood and this remains a problem. This study will help to identify maternal and child factors associated with the increasing cases of diarrhea among children under five years of age admitted at Kampala International University Teaching Hospital.

Recommendations

Intensive health education and awareness campaigns on the importance of breastfeeding to children should be done to equip mothers with tactical knowledge. This will reduce the burden of diarrhoea in children under five. Breastfeeding health education services should be integrated into health facilities for all breastfeeding mothers and expectant mothers. More effort must be applied to spread awareness about proper health services by mothers to seek specialized healthcare from properly equipped health facilities with trained health workers.

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CITE AS: Halongo Denis 2023. Incidence and Determinants of Diarrheal Cases in Children Under Five Admitted at Kampala International University Teaching Hospital, Ishaka-Bushenyi District, Western Uganda. IAA Journal of Applied Sciences 10(2):1-12. https://doi.org/10.59298/IAAJAS/2023/1.2.1100

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