Factors Associated with Diarrhea among Children Less Than 5 Years Old in Sudan

a Secondary Analysis of Sudan Multiple Indicator Cluster Survey 2014

Abstract

Background: Diarrhea is the passage of three or more loose or liquid stools per day (or feces are discharged frequently from the bowl than the normal for the person).  It is a leading cause of mortality and morbidity in children under the age of five in developing countries especially in the Sub-Sahara Africa including Sudan. The aim of the study was to explore the factors associated with diarrhea among children aged under 5 years in Sudan using the 2014 Multiple Indicator Cluster Survey (MICS).

Methods: A total of 14081 children under 5 years who had completed the survey questionnaire were considered for this study. Data was entered and cleaned using SPSS version 17. Bivariate analysis was done using Pearson’s Chi square test while multivariate analysis was done using binary logistic regression with 95% CI to examine the association between the dependent and independent variables. All variables with p-value <0.2 using the bivariate analysis was included in multivariate analysis.

Results: The prevalence of diarrhea among children was 26.9% (3785 children with diarrhea out of 14081). Factors associated with diarrhea were weight for height z-score, weight for age z-score, wealth index quintile and child age in months. In multivariate analysis, children from the fourth wealth index quintile were 1.21 times more likely to develop diarrhea, (OR: 1.21, p=0.016) than those children from the richest wealth index quintile. Children who were severely underweighted were 1.59 times more likely to develop diarrhea (OR: 1.59, p<0.001) than children who were normal. The risk of diarrhea was 32% lower in severely wasted children (OR: 0.68, p=0.047) than those children who were obese. Children aged 6-11 and 12-23 months were about 2.5 times more at risk of getting diarrhea (OR: 2.49, p<0.001; OR: 2.45, p<0.001 respectively) in comparison to children aged 48-59 months.

Conclusions: Nutritional factors were found to be associated with diarrhea. Continuous governmental efforts to eradicate malnutrition and hunger are recommended. The MICS 2014 of Sudan has produced much of great value; but there are some questions about certain kinds of information. Unexpected results were found regarding main source, treatment of drinking water and toilet facilities. Further studies in the form of longitudinal studies are needed as one cannot infer causality using this kind of study.