Determinants of diarrhoeal diseases: a community based study in urban south western Ethiopia.

OBJECTIVES To identify the determinants and describe the extent of diarrhoeal diseases among under-five children in urban Ethiopia. DESIGN Community based, cross-sectional study. SETTING Jimma, a town in south western Ethiopia, is an urban area with multi-ethnic population. The town is divided into 20 kebelles. Each kebelle has a population of about 5000 people. SUBJECTS Six hundred and five children under the age of five years were selected by random sampling. There were 142 children with diarrhoeal diseases in selected households. All those without diarrhoea were taken as controls. RESULTS The incidence at diarrhoeal diseases was 5.48 episodes per child per year. The incidence of persistent diarrhoea was 7.75%. About 24.5% of the acute diarrhoeal diseases (ADD) culminated to persistent diarrhoea. Well source of water, lack of complete immunization, attack of measles and acute respiratory infecions (ARI) in the previous two weeks were found to be significantly associated with occurrence of diarrhoeal disease; however, only ARI and well water were retained in the logistic regression analysis. CONCLUSION The incidence of diarrhoeal diseases and the progression to persistent diarrhoea are very high. Many of the socio-environmental factors did not appear as significant determinants independently. The implication of this is that in a homogenous and economically deprived society improvement in a single factor does not reduce the problem of diarrhoeal diseases. Hence, an inter-sectoral approach is recommended to control diarrhoeal diseases.