Prevalence of diarrhoea and associated risk factors among children under five years old in Pader district, Northern Uganda

Abstract Background: Diarrhoea remains a major cause of morbidity and mortality in children < 5 years in sub-Saharan Africa. Uganda has the worst mortality rate in children < 5 years among the three East African countries, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control interventions, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children aged < 5 years in Pajule sub-county in Pader district in northern Uganda. Methods: A cross-sectional survey was conducted covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last two weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Descriptive statistics was used to summarize the risk factors whereas bivariate and multivariate logistic regression analyses (95% confidence interval and p < 0.05) were used to identify the risk factors associated with childhood diarrhoea.Results: We found a prevalence of diarrhoea of 29.1% among children < 5 years of age in Pajule sub-county during the two weeks preceding the survey. Multivariate logistic regression revealed significant associations between diarrhoeal prevalence and use of unprotected water sources (adjusted Odd Ratio, aOR=2.866, 95% CI: [1.431 – 5.741]), presence of animals in respondents’ homes (aOR=3.950, 95%CI: [1.399 – 11.156]) and infrequent hand washing practices (aOR=2.737, 95% CI: [1.304 – 5.743]). Conclusion: The present study identified a high prevalence of diarrhoea among children < 5 years of age in Pajule sub-county, higher than the Ugandan national average. Extensive use of unprotected water sources, animals’ presence in homes and poor hand washing practices had significant associations with diarrhoeal occurrence. These findings underscore the need for continuous community health promotion emphasizing good hand washing practices and interventions that target improvement of hygiene practices at homes as the best methods for fighting childhood diarrhoea in the study area.