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Prevalence, trend analysis and factor associated with diarrheal diseases among under 5 children in Nigeria: Evidence from 2008 to 2018 Demographic Health Surveys

Afape Ayobami1*, Precious Chidozie Azubuike2, Temidayo Akinreni3, Dalanda Cham4, Amadou Barrow5

Background: Diarrhea is the second most common propagator of childhood mortality in most developing countries, including Nigeria. Diarrheal infection is majorly transmitted through fecal-contaminated food and water and can also be transmitted from one person to another due to poor hygienic practices, This study aimed to estimate the prevalence, trend analysis, and factors associated with diarrhoeal diseases among under-five children in Nigeria over the last ten years.

Method: Data from 2008, 2013 and 2018 Nigeria Demographic and Health Survey (NDHS) were pooled for the analysis used in this study. Data were obtained from a total weighted sample of 94,121 children under-5 years through a stratified two-stage cluster sampling approach. A multivariable logistic regression model was used to assess the predictors of diarrheal disease at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs).

Results: The weighted prevalence of diarrheal diseases among under-5 children in Nigeria were 10% for 2008 and 2013 increased to 13% in 2018. Associated factors with under-5 children’s diarrheal diseases includes children aged 12-23 months [aOR=1.79, 95% CI= 1.66-1.94], 24-35 months [aOR=1.19, 95% CI= 1.09-1.31], 36-47 months [aOR=0.67, 95% CI= 0.60-0.75] and 48-59 months [aOR=0.51, 95% CI= 0.45-0.57] of having diarrhea disease compared to children 0-11 months. Furthermore, children under five who had not received measles vaccination [aOR=1.62, 95% CI= 1.51-1.75] and those who had not received DPT3 vaccination [aOR=0.82, 95% CI= 0.76- 0.88] were found to be associated with diarrheal diseases among under-5 children. Other associated factors includes mothers age, mothers’ education level, fathers’ educational level, types of house’s floor used, household size, number of under-5 children, region and household wealth index after controlling for confounders.

Conclusion: The prevalence of diarrheal diseases among under-5 years in Nigeria was low and had increased in 2018 by 3%. There is a need to design and promote household and community-level water, sanitation and hygiene programs, especially in the country's northern region. Government should design robust, community-based social and behavioural change communication strategies and programs with solid elements of awareness rising at household and community levels.