Prevalence of Diarrhea and Its Associated Factors among Under-Five Children in Open Defecation Free and Non-Open Defecation Free Households in Goba District Southeast Ethiopia: A Comparative Cross-Sectional Study

Background: In Ethiopia, diarrhea kills half a million under-five children every year and most cases of diarrhea spread in settings with lack of sanitation facilities. In effect, Ethiopia began to adopt a Community-Led Total Sanitation (CLTS) approach which aimed at generating a collective sense of intolerance towards open defecation through empowering local communities to find solutions for sanitation related problems such as diarrhea. Therefore, this study aimed to assess the prevalence of diarrhea and its associated factors among under-five children in open defecation free (ODF) and non-ODF households in Goba district, southeast Ethiopia. Methods: A community-based comparative cross-sectional study was employed from March 1 to April 30, 2017, in Goba district. A total of 732 households (366 ODF and 366 non-ODF households) that had at least one under-five children were included in the study. Descriptive statistics and logistic regression analyses were computed. Results: The two weeks diarrheal prevalence in under-five children among ODF and non-ODF households were 17.2% and 23.2%, respectively. A significant difference in the occurrence of diarrhea was observed between ODF and non-ODF households [x2(df)=3.93(1), p=0.04]. Unsanitary disposal of children`s faeces [AOR: 2.68; 95% CI: 1.66, 4.30], exclusive breastfeeding [AOR: 0.43; 95%CI: 0.26, 0.71], mother not attend formal education [AOR: 1.93; 95% CI:1.18, 3.15] were factors associated with diarrhoea in ODF households. On the other hand, latrine cleanliness [AOR: 0.41; 95% CI: 0.20, 0.82], presence of faces in the compound [AOR: 2.10; 95% CI: 1.05, 4.17], and child age [AOR: 1.93; 95%CI: 1.04. 3.57] were factors associated with diarrhea in non-ODF households. Conclusion: The prevalence of diarrhea slightly higher in non-ODF households than ODF households. Therefore, intensifying Community-Led Total Sanitation and hygiene approach strongly recommended.