A Study On Diarrhea Among Children In Health Clinic

ABSTRACT

Diarrhea is the second leading cause of under five child mortality worldwide after pneumonia. Daily, Nigeria loses about 2,300 under-fives ranking the country as the second largest contributor to the under five mortality rate from diarrhea. The absence of clean water, essential sanitation and hygiene is responsible for almost 88% of the disease burden in the country.

This study aimed to identify the prevalence diarrhea among children aged between 0-5 years in northern Nigeria regions.

A cross-sectional survey was conducted in Kalahari Health Clinic Yamaltu Deba LGA Gombe State to estimate the burden of diarrhoea diseases (i.e. diarrhoea episodes in the 2 weeks preceding the survey) and associated risk factors. Overall, 596 households were surveyed by a questionnaire, yielding information on socio-demographic, environmental and hygiene behavioural factors. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.

The reported prevalence of diarrhea among children under the age of five during the 2 weeks preceding the survey was 26%. Without adjustment, the highest diarrhoea prevalence rates were observed in the peri-central (44.8%) and urban central zones (36.3%). Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers (adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI]: 1.18–2.23), use of open bags for storing household waste (aOR = 1.75, 95% CI: 1.00–3.02), evacuation of household waste in public streets (aOR = 2.07, 95% CI: 1.20–3.55), no treatment of stored drinking water (aOR = 1.69, 95% CI: 1.11–2.56) and use of shared toilets (aOR = 1.69, 95% CI: 1.11–2.56).

We found a high prevalence of diarrhea in children under the age of five of  Yamaltu Deba LGA Gombe State, with the highest prevalence occurring in the central and peri-central areas. These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups. Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay.

TABLE OF CONTENT

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWLEDGEMENT

ABSTRACT.

TABLE OF CONTENT

LIST OF ABBREVIATIONS

CHAPTER ONE

INTRODUCTION

• Background of the study
• Problem statement
• Research question
• aim and objective of the study
• significance of the study
• Scope/Delimitation of The Study
• Operational Definition Of Terms

CHAPTER TWO

REVIEW OF RELATED LITERATURE

• Review of the study
• Overview of Diarrhoeal disease
• Overview of Diarrhoea disease
• Occurrence of diarrhoeal disease
• Causes Of Diarrhoea
• Sanitation, Hygiene and Diarrhea
• Health Systems in Nigeria

CHAPTER THREE

METHODOLOGY

• Introduction
• Study area
• Research design
• study population
• Sample and sampling method
• Data collection method
• Statistical analysis

CHAPTER FOUR

RESULT ANALYSIS

4.1.     Result analysis

4.2      Discussion

CHPATER FIVE

CONCLUSION AND REFERENCES

• Conclusion
• References

CHAPTER ONE

1.0                                             Introduction

1.1                                   Background of the study

Diarrhoeal diseases remain among the most common causes of mortality and morbidity in children, particularly in low- and middle-income countries (LMICs). In 2013, of the 6.3 million children worldwide who died before they reached their fifth birthday, about half (3.2 million) died from infectious diseases, with diarrhoea killing more than 500,000 children [Liu et al, 2015]. By 2030, it is estimated that 4.4 million children under the age of five will die from infectious diseases annually and that 60% of those deaths will occur in sub-Saharan Africa [Liu et al, 2015]. Diarrhoea accounts for an estimated 3.6% of the global burden of disease, as expressed in disability-adjusted life years (DALYs) [Murray et al, 2012]. Although mortality from diarrhea has declined considerably over the past 25 years globally, morbidity from diarrhoea in sub-Saharan Africa has not, as risk factors related to inadequate water, sanitation and hygiene (WASH), insufficient promotion of breastfeeding and malnutrition remain unacceptably high [Murray et al, 2012]. The rapid growth of African cities and associated overcrowding has been linked to outbreaks of diarrhoea, with children under the age of five among the most affected [Sire et al, 2013].

In Nigeria, the Ministry of Health (MoH) lists diarrhea as the third leading cause of mortality and the second leading cause driving caregivers of children under 5 years old to seek medical consultation [MSAS, 2013]. In 2013, according to Liu and colleagues, the total number of deaths among children under the age of five in the country was 28,648, with 1866 deaths (15%) due to diarrhoeal diseases [PATH, 2014]. In 2011, the Nigerian Demographic and Health Survey (DHS) reported that one in five children under the age of five suffered from diarrhoea during the 2 weeks preceding the survey (21%) [ANSD, 2012]. The 2014 DHS showed that prevalence of diarrhoea in this age group remained at the same level (19%) [ANSD, 2015].

Lack of access to clean water and improved sanitation is a major issue in the northern part of Nigeria, where 13.5 million people reside, accounting for 45% of the national population. Rapid urbanisation in Africa (including Nigeria) over the past few decades has resulted in disorganised urban landscapes, where populations live in crowded conditions. Urbanisation not only occurs in capital cities of LMICs, but also in secondary cities. Indeed, half of the anticipated urban population increase in the coming years is expected to occur in secondary African cities and in smaller cities that connect the rural hinterlands of the sub-region [Costello et al, 2009]. The urbanisation trends in secondary cities merit focused attention due to the particular weaknesses and vulnerabilities of those contexts.

Here, we provide an overview of diarrhoea prevalence among children under 5 years old in Kachallari Health Clinic Yamaltu Deba LGA Gombe State. Specifically, we determined the prevalence of self-reported diarrhoea and identified key risk factors among young children in the area.

1.2     Problem statement

Since the year 2000, Nigeria has consistently encountered the highest number of diarrhea deaths globally (14). However, Nigeria’s efforts toward decreasing preventable child deaths have been met with steady and constant progress toward MDG4 (25). The under-five mortality rate (U5MR) has decreased from 191 deaths per 1000 live births in 2000 to 89 deaths per 1000 live births in 2014 as the end-point status of U5MR. Nigeria was close to achieve the 2015 target of 64 deaths per 1000 live births by 28%, yet deaths from diarrheal diseases are still the highest despite all the progress made (25).

Each day, Nigeria loses about 2,300 under-fives which reflects the country’s rank as the second largest contributor to the U5MR from diarrhea in the global ranking and its low Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) intervention score of 31% (26). A country’s “GAPPD score” measures the usage of interventions that protect against, prevent and treat pneumonia and diarrhea. The higher the score, the more interventions are being used (26). Absence of clean water, essential sanitation and hygiene is responsible for almost 88% of the disease burden due to diarrhea (26). Although diarrheal mortality continues to be improperly high, it is steadily decreasing by 4% per year, while disease rate is decreasing more modestly (14). Interventions that focus on the major causes and on the most vulnerable children must further increase these declines (7). To direct these attempts, strong data describing the burden, risk factors and case mortality of extremely life-threatening and disabling episodes are crucial, however such data have been inadequate in regions with the highest child mortality; Nigeria in specific. Therefore, this study sought to address these knowledge gaps through assessing the prevalence of child diarrhea in northern Nigeria regions and the associated behavioural, environmental and socioeconomic risk factors among children under the age of five.

1.3                             Research question

1. Is diarrheal a common disease in Yamaltu Deba LGA Gombe State?
2. What are the diarrheal diseases risk factors leading to children under five years of age mortality in northern Nigeria regions?

1.4                       Aim and objectives of the study

Aim

To identify the prevalence and the risk factors for the occurrence of childhood diarrhea among children aged 0-5 year in Yamaltu Deba LGA Gombe State Nigeria.

Specific Objectives

1. To assess the prevalence of childhood diarrhea in Yamaltu Deba LGA Gombe State
2. To determine the behavioral, environmental and socioeconomic risk factors for the occurrence of diarrhoea among children aged under 5 years in Yamaltu Deba LGA Gombe State.

• To determine if diarrhea is common in Yamaltu Deba LGA Gombe State

1.5   Significance of the Study

The research work is important in several ways both to the Health personnel and the individuals within the society. Firstly, this study will expose to us some of the causes of diarrhoea in Yamaltu Deba LGA Gombe State and also proffer ways of preventing diarrhoea outbreak within our community.

This study will also be of importance to the health personnel and our community health workers in the sense that it will expose to them the various preventive measures to put in place to avoid diarrhoea outbreak in our community and Yamaltu Deba LGA Gombe State at large.

This study is also to be relevant to the government by providing the number of diarrhoea outbreak within the Nigeria economy and also presenting the figures of victims who dies as a result of this disease, by this the government will swing into action by providing various measures in other to prevent further outbreak of the disease.

1.6     Scope/Delimitation of The Study:

The study will beset out to determine the occurrence of diarrhea outbreak in Yamaltu Deba LGA Gombe State. Therefore, the study is restricted to only community health workers, and other health related personnel in Yamaltu Deba LGA Gombe State. Respondents may include students, teachers, civil servants, youths, and drivers.

1.7     Operational Definition Of Terms:

Diarrhea: – is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual)

Outbreak: –. A sudden, violent, or spontaneous occurrence, especially of disease or strife

WHO: –World Health Organization.

Contamination: Is the term describing the state of a person or material on coming in contact with the disease pathogen.

Disease: Can be seen as a depart from the normal healthy state of the body soul and mind of a human being, which manifests itself in an abnormal development of the physical, physiological and mental state of the human being concerned.