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.
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% , Yaya Gulele district, Ethiopia 13.5% , Serbo town, Southwest, Ethiopia, 14.9% , Bahr Dar city, 14.5% , and Farta Wereda, Northwest Ethiopia, 16.7% . However, result of this study was lower than the study conducted in Sena’a, Yemen, 29.07% , Senegal, 26% , Cameroon, 26.1% , Sheka zone, southwest Ethiopia, 21.8% , Jig-Jiga city, Eastern Ethiopia, 27.3% , Bahir Dar Zuria district, Northwest Ethiopia, 20% , North Gondar zone, 21.1%  and Harena Buluk district, Southeast Ethiopia, 28.4% . In contrast, it was higher than the study conducted in Wolayta Sodo town, Southern Ethiopia, 11.0% . This difference may be due to seasonal trends in diarrhea disease or differences in year and age of the study participants as well as the differences in the study design and data collection.
Children aged between 7-11 months were at high risk of developing diarrhea compared with children aged was less than seven months. This result was in line with the results of the study conducted in Farta Wereda, Northwest Ethiopia . The increased risk might be due to the decline/loss in maternal antibodies and at this age child start complementary feeding that might increase their exposure to contaminated foods and water. In addition, crawling begins at this age further increasing potential exposure to fecally contaminated environments.
This study found that diarrhea was more common among second-born children 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 borne . This may be due to quality of care and attention from parents decreases as mothers become incapable of caring for children .
According 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 suggests 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 .
In this study, the following limitations were noted. The major limitation of the study was the limited time period over which the study was conducted, that may create over or under reporting of diarrhea since diarrheal diseases have some seasonal variations.
The two week prevalence of diarrhea among children under-five years in Debre Berhan town was 16.4%. Childhood diarrheal disease was significantly associated with the age of children, birth order and hand feeding practice of mother. So, education program on the importance of vaccination against rotavirus, increase breast feeding frequency with complementary food after six months and the critical points of hand washing are recommended.