Prevalence of Diarrhea and Associated Risk Factors Among Children Under-Five Years of Age in Nigeria

Diarrhea is the second leading cause of under-five child mortality after pneumonia. The absence of clean water source, essential sanitation and hygiene is responsible for almost 88% of the disease burden in the Nigeria. This study aimed to identify the risk factors for the occurrence of childhood diarrhea among children aged between 0-5 years in Nigeria. Nigeria Demographic and health survey (NDHS) data for year 2013 was used for the purpose of this study. Descriptive Statistics was used to identify the mean age of the mother, children and also the frequencies and percentage of the independent factors. Multilevel Probit Regression was computed to assess the independent factors of childhood diarrhea. Two-way table with measures of association was used to test the association of the predictor variables. The prevalence of diarrhea in the two weeks period among under- five children in Nigeria is 9.52%. The result showed that maternal/mother’s education attainment, region, sex of children, maternal/mother’s age, children’s age, source of water, place of residence, breast feeding status, family Income and mass media were found to be positively associated risk factors for childhood diarrhea.


Association of children's socio-economic factors and diarrhea
From the analysis, the child's age group and breast feeding status were significant at 95% CI, while sex male was not significant (p-0.651) at 95% CI. It indicated that there is a strong association between the occurrence of childhood diarrhea to age and currently breast feeding while, we conclude that there is no association between occurrence of childhood diarrhea and sex of the child. From the analysis in above variables such as water source (p-value 0.000), place of residence (p-value 0.001), mass media (p-value 0.000) were significant at 95% CI which indicated that there is a strong association between the occurrence of childhood diarrhea and mass media. While, toilet facility (p-value 0.905) is not significant at 95% CI and conclude that there is no association between the occurrence of childhood diarrhea and toilet facility.

Environmental factors associated with diarrhea
For Table 1.2, All the variables (age, region, education attainment, wealth index) in this category were found to be significant at 95% during the analysis, age (p-value 0.000), wealth index (p-value 0.000), region (p-value 0.000) and mother's education attainment (p-value 0.000). It indicated that there is a strong association between the occurrence of childhood diarrhea and each of the selected factors for the mother.

Result & Discussion:
This study reveals that overall prevalence of diarrhea in Nigeria is about 9.56%. In the north central region, the two weeks period prevalence of diarrhea was 6.36%, diarrhea was prevalent in north east with 19.59%. Diarrhea was prevalent among children aged (12-23) months with 16.52%. it showed that children aged 12-23 months are more likely a risk factor of childhood diarrhea in Nigeria. Prevalence of diarrhea showed no much difference between male and female children (9.65% in males and 9.47% in females). Diarrhea was noted to be 10.69% in currently breastfed children. Currently breast feeding children were less likely to have diarrhea.
Mothers who were in the urban areas with prevalence 8.67% was significantly different with (p-value < 0.05) having diarrhea compared to those in the rural areas with prevalence 9.99%. Mother's educational level was found to have a strong association with diarrhea with highest prevalence rate of 16.18% among no education category. Mother's educational level was found to have a strong association with diarrhea with highest prevalence rate of 16.18% among no education category. Also rural areas had higher prevalence of diarrhea 9.96% compared to those in the urban area with prevalence rate 8.67% because water sources, droughts and sanitation in the rural were worse than in the urban areas. Wealth index was significant at chi-square test (p-value 0.000). However, childhood diarrhea was most prevalent among the category of wealth index poorest with 12.01%. The study revealed that maternal age groups had strong association with diarrhea in children using chi-square analysis (p-value 0.000).

Conclusion:
This study has identified some important risk factors that showed strong association with diarrhea among children under the age of five which include socio-economic factors for mothers and children as well as environmental factors. The factors associated with diarrhea among under-five children were found to be children's age, mother's age, region, educational attainment, place of residence, wealth index, breastfeeding status, water source and mass media.