Prevalence of diarrheal disease
A significantly high proportion of the study population 154 (37%), complained of having had diarrhea (defined as watery stools for more than three times in 24hrs).This high prevalence of diarrhea as observed in the results, is in agreement with the results from a study to evaluate prevalence of diarrhea and associated risk factors among children under five years old in Pader District, northern Uganda that concluded that 29.1%, of the children under five years, had diarrhea [5, 16]. The high prevalence in addition could be attributed to consumption of contaminated water and food resulting from poor disposal of solid waste and probably the contamination of water sources by fecal matter from the pit latrines.
A study in Juba, South Sudan concluded that, “the River Nile is highly contaminated with solid waste to the extent that it is unfit to be used as drinking water except for other purposes”. Water- borne diseases such typhoid, diarrhea, dysentery, hepatitis A and occasionally cholera are currently a serious public health problem in Juba contributing to about 38.3% of health facility Attendances [15].
The findings in the study above are in agreement with the findings in a study conducted to determine the association between poor sanitation practices with diarrheal disease occurrence in Namatala slum, Mbale district that conclude that, the prevalence of diarrhea in children less than five years was 45.73% [29].
Solid waste management practices
Findings from the study indicated that overall, SWMPs were good, on average (65%) implying that residents in industrial division practiced good solid waste management.
Solid waste storage as a component on the independent variable was rated good (62,5%), implying that the SW storage practices in industrial division were good. The findings in the study above were in agreement with findings from a study conducted in Dakarto determine Solid Waste Management practices and Risks to Health in Urban Africa showed that,”Overall,26.9% of the HHs used a closed container, while 47.1% used an open container and 22.3%used plastic bags (22.3%) to store waste. Other households that did not have a storage system used either a pile in the yard (3.0%) or a common collection point outside the household (0.7%) which in itself was a good practice [20]. The good storage practice as observed could be attributed to the availability of adequate storage facilities and information on the dangers associated with poor solid waste management
Solid waste collection as a component was also rated as good (67.3%).The findings from this study are in agreement with the findings from a study by Okumu et al on supply and frequency of SW collection concluded that, “Most households (97%) included in the study received waste collection services with significant variations i.e. the closer the site to disposal ground, the more frequent was the service. The study also concluded that the two main methods of waste collection in Dakar include formal (e.g. public service) and informal services (e.g. Cart handlers) which was also the case with Industrial division, Mbale City [30]. The good collection services could be attribute to the availability of private waste collectors who collect waste at a low cost and probably availability of alternative uses. In that, waste collection was done mainly by private waste collectors which accounted for 75.7%, hence a good practice [22, 23, 28].
Findings also show that, SW disposal was good in Mbale industrial division. Agreement with the findings in a study to evaluate SWM in Kawempe, Uganda that concluded that, “the following solid waste management approaches employed in Bwaise II which included, waste reduction, dumping, and recycling and re-use compositing and incineration/burning were important in managing solid waste”.
Other factors associated with prevalence of diarrheal disease
Household size
Results from the study showed that Household size was another factor associated with diarrhea disease. Households with size (4–7) members’ were 1.85 times more likely to suffer from diarrhea as compared to HHs of size 1–3 members. These results are closely related to a study in Lagos- Nigeria that concluded that “the city being a nerve center of Nigeria economy, with 60 to70% of Nigeria industries, is one of the most highly and the increase in economic activities has led to population explosion in Lagos which the volume of Solid waste generated with no clear storage system hence increase diarrheal Disease prevalence” [2].
The findings were also in agreement with the results from a cohort study on the association between household conditions and diarrheal disease among children in Turkey concluded that house hold size, conditions, individual status, age education level of fathers and parents habit of washing hands before taking care if the child were the major factors affecting the incidence of diarrhea [4].
Additionally the findings in this study were in line with the results in another study that evaluated socio-economic factors associated with diarrheal disease among under-five children of the nomadic population in north east Ethiopia that observed that diarrhea was prevalent among children and that the number of children in a household was one of the factors that were significantly associated with childhood diarrhea [39].
Source of drinking water
Results indicated that Households that reported regularly drinking surface water were 16.6 times more likely to suffer from diarrhea disease as compared to HHs from local sellers. The above findings are in agreement with the findings from the study by” done in Juba, Southern Sudan [15]. The study concluded that “River Nile is highly contaminated with solid waste to the extent that it is unfit to be used and that Water-borne diseases such typhoid, diarrhea, dysentery, hepatitis A and occasionally cholera are currently a serious public health problem in Juba contributing to about 86.3% of health facility attendances. The high prevalence of diarrhea among those who consumed surface water could beat tribute to high exposure to contaminants such as solid waste, storm water and other pollutant gases that contaminate water and hence diarrheal disease outbreak.
Additionally, the findings were also in agreement with the findings in a study conducted to evaluate determinants of diarrhea among young children under the age of five years in Kenya concluded that “HHs using well as a source of water reported high episodes of diarrhea of childhood diarrhea as a result of source contamination, storage and handling problems [8].
The findings in the study above were in agreement with the findings in a study on Childhood
Diarrhea Determinants in sub Saharan Africa concluded that” higher rates of diarrhea prevalence were seen in children from HHs whose mother/caregivers never had knowledge of safe sources of drinking water [12].
Toilet facility ownership
Results also indicated that Households that didn’t own a toilet facility were 4 times more likely to suffer from diarrhea disease as compared hose with toilet facilities. The above findings are in agreement with the findings from a study on Environmental Impacts of Waste Management [14] a Case Study in the City of Kaya, Burkina Faso that showed “lack of maintenance and failures of sanitation facilities has caused more pollution and prolife ration of disease vectors that cause diarrhea and cholera”.
The above findings were in agreement with the findings in a study to examine the association between improved water supply and sanitation usage and childhood Diarrhea in Ethiopia concluded that poor disposal of human excrete was significantly associated with diarrhea report from world Health Organization.
The findings in the study were also in agreement with the study conducted to determine the association between poor sanitation practices with diarrheal disease occurrence in Namatala slum, Mbale district which concluded that, the prevalence of diarrhea in children less than five years concluded that type of toilet/latrine used by the household and location of toilet/latrine within or outside the household were among the factors that were significantly associated with occurrence of diarrhea in children less than five years [29].
Type of solid waste generated
In this study, type of solid waste generated by a house hold was the only SWM related factor that was associated with presence of diarrhea. This findings are in line with study on solid waste management in Africa [30]. Indicated that “waste was predominantly biodegradable (78%) with generation rate of 0.55(0.3–0.66) kg/capita/day and collection coverage of 43.7% and that Urban Councils were in capacitated to handle waste management demands and where services are poor or nonexistent, the community developed on site waste management methods such as waste recovery, recycling, re-use, and composting “Waste collection across the three sites was mainly provided through free municipal service