| dc.description.abstract | Background:
A serious worldwide health concern, diarrheal disease kills approximately 443,832 people each year and causes 1.7 billion cases, especially in children under five (World Health Organization, 2024). In countries with low or middle incomes, diarrhea continues to be a major cause of child mortality (UNICEF, 2024). Due to inadequate sanitation, contaminated water, hygiene practices and a lack of access to healthcare, slum people in Bangladesh are particularly vulnerable to diarrhea, which causes more than two-thirds of child deaths (Mitra et al., 2001). In order to reduce childhood morbidity and death rates, it is critical to address the factors that contribute to childhood diarrhea in these slums, given the prevalence of the disease, particularly among this vulnerable population. Thus, the purpose of this study is to determine the prevalence of diarrhea and its determinants among under five living in urban slums in Chattogram, Bangladesh.
Methodology:
A cross-sectional study with a quantitative research design was conducted using a semi-structured questionnaire. Cluster sampling was used to choose 385 mothers of children under five from four distinct Chattogram slum regions. To guarantee intelligibility and cultural relevance of the study, pretesting was done. Participants gave their informed consent and were free to withdraw from the study at any time. One to one, in- person interviews were done to gather data, which was then entered into SPSS version 20 for analysis. To investigate associations between diarrheal illness and other determinants, frequency and crosstab analyses were conducted. Data dependability and accuracy were guaranteed by quality control procedures.
Results:
Among all 385 participants surveyed, it was found that diarrhea affected 48.8% of children living in urban slums during the previous eight months, with the largest prevalence occurring in children between the ages of 2 and 31 months. Moreover, younger mothers had a higher prevalence of child diarrhea compared to older mothers. Additionally, low maternal education was also noted with 42.6% of mothers having only a primary education, and the highest prevalence of diarrhea, 39.4%, was found among this category. Furthermore, children from lower-income households had a significantly higher prevalence of diarrhea. The rotavirus vaccine was taken only by 6.8% of children, indicating a very low level of immunization coverage. Additionally, postnatal care (PNC) coverage was extremely low with only 2.1% mothers getting recommended 8+ PNCs, limiting opportunities for early health interventions and education on hygiene practices Unsafe drinking water, where 73.8% reported not treating it before drinking and inadequate sanitation where 90.9% reported using shared toilets and 51.2% reported open defecation, were important risk factors. Moreover, 67.8% of mothers did not wash their hands with soap before feeding their children, indicating inadequate handwashing practices. Majority 62.3% of children showed symptoms of malnutrition prior to acquiring diarrhea. Therefore, to reduce the burden of diarrheal disease among under five children of slums, these findings emphasize the critical need for improved water, sanitation, hygiene, education, income, focused healthcare access and awareness.
Conclusion:
The significant prevalence of diarrheal illness which was 48.8% among children under five in Chattogram's urban slums was highlighted by this study. It emphasizes factors such as low maternal education, low household income, poor sanitation, and restricted access to healthcare. The risk was further enhanced by inadequate postnatal care, poor hand hygiene, and low rotavirus vaccination. Diarrhea and child malnutrition were found to be correlated, which furthers the cycle of malnutrition and increased susceptibility to the disease. To lessen the burden in these vulnerable communities, the findings recommend integrated policies that prioritize better access to healthcare, community led total sanitation approaches, and more maternal and health education. | en_US |
