This study was conducted to assess the prevalence and associated factors of diarrhea among children under-five in Debre Berhan town, Ethiopia. The Ethiopian Demographic and Health Surveys of 2016, showed that diarrheal disease was the leading cause of illness among children under-five years old.
The result of this study showed that prevalence of diarrhea among children under-five was 16.4% (95%CI: 12.7 – 20.0). This finding was congruent with the study done in Dale District, Sidama zone, Southern Ethiopia, 13.9% [11], Yaya Gulele district, Ethiopia 13.5% [15], Serbo town, Southwest, Ethiopia, 14.9% [16], Bahr Dar city, 14.5% [17], and Farta Wereda, Northwest Ethiopia, 16.7% [7]. However, result of this study was lower than the study conducted in Sena’a, Yemen, 29.07% [18], Senegal, 26% [19], Cameroon, 26.1% [20], Sheka zone, southwest Ethiopia, 21.8% [12], Jig-Jiga city, Eastern Ethiopia, 27.3% [21], Bahir Dar Zuria district, Northwest Ethiopia, 20% [22], North Gondar zone, 21.1% [10] and Harena Buluk district, Southeast Ethiopia, 28.4% [23]. In contrary, it was higher than the study conducted in Wolayta Sodo town, Southern Ethiopia, 11.0% [24]. This difference may be due to; diarrhea disease tend to be seasonal, and may differ by year and age groups of the study participants and may also have some difference in methods of data collection.
Children whose age between 7-11 months were at high risk of developing diarrhea when compared with children whose age was less than seven months. This result was in line with the result of the study conducted in Farta Wereda, Northwest Ethiopia [7]. This might be due to the decline/loss in maternal antibodies and children start complementary feeding this may increase their exposure to infection through contaminated foods and water. In addition, crawling usually begins at this age and they have the risk of getting contaminated materials by fecal matters if considerable care and attention are not taken.
This study found that diarrhea was more common among second-born children when compared with first-born children (AOR: 3.9, 95%CI: 1.7 – 8.5). Similarly, a cross-sectional study conducted in Jig-Jiga district, Somali region, Ethiopia showed that fourth-born children and above were more affected by diarrhea compared with first-born [21]. This can be justified by the fact that when the number of children in the household increases, it is expected that children could be more vulnerable to contamination because the quality of care and attention from parents decreases as mothers become incapable of caring for children [25].
According to the findings of this study, children who didn’t receive rotavirus vaccination were 10.3 times more likely to have diarrhea compared with children who received rotavirus vaccination (AOR: 10.3, 95%CI: 1.2 – 91.2). The result suggest that a major contributor to the diarrheal burden in children less than five years in the town is in fact rotavirus. This result was in agreement with study done in Farta Woreda, Northwest Ethiopia [7].
In this study, we have limitations that would be noted. The major limitation of the study was the limited time period over which it was conducted that may create over or under reporting of the problem since diarrheal disease have some seasonal variations. Use of cross-sectional study may not create true causal relationship between under-five diarrheal diseases and its risk factors.