Nexus of water quantity, microbiological quality and diarrheal diseases in children under five: a case of Hosanna town, Central Ethiopia
| dc.contributor.advisor | Sirak Robele (PhD) | |
| dc.contributor.advisor | Seid Tiku (Prof) | |
| dc.contributor.author | Abiot Abera | |
| dc.date.accessioned | 2025-08-16T11:13:20Z | |
| dc.date.available | 2025-08-16T11:13:20Z | |
| dc.date.issued | 2025-03 | |
| dc.description.abstract | While various studies worldwide have examined the impact of water quantity and quality on childhood diarrhea, there is limited evidence available on how seasonal changes in domestic water use and microbial water quality affect childhood diarrhea. Additionally, limited longitudinal studies have tracked diarrhea incidence, and those that measured domestic water use often miss the daily and seasonal variations. Hence, this study aimed to investigate seasonal variations in household water use, microbiological water quality, and their implications on the incidence of diarrheal disease among under-five children in the peri-urban and informal settlements in Hosanna town. The study employed a mixed-method approach. The study incorporated a prospective cohort study with a one-year follow-up period, along with cross-sectional and qualitative study, to fulfill all its objectives. The study was conducted in three Kebeles of Hosanna town, namely Bobicho, Sech-Duna, and Jelo-Naremo Kebeles. The sample size for the prospective cohort study and cross-sectional study was limited to 292 and 424 households, respectively. The original data was obtained through a structured questionnaire, observational checklist, observational spot-check method, storage container inventories, interviews, laboratory analysis, FGDs, KIIs, and HWISE Scale. The data was analyzed using bivariate and multivariable logistic regression, stepwise-multiple linear regression, GEE model, thematic analysis, non-parametric tests, and t-tests. All households had access to piped water, either on or off-premises. However, the reliability of these water sources was a significant issue, with only 8.9% of households having access to reliable water services. A total of 440 stored water samples were analyzed for E. coli presence during dry and rainy seasons. The prevalence of stored water contamination with E. coli was 43.2% (95% CI = 36.6% - 49.8%) and 34.5% (95% CI = 28.2% - 40.9%) during the dry and rainy seasons, respectively. The daily per capita water consumption was 19.4 liters (95% CI = 18.81 - 20.05) in the dry season and 20.3 liters (95% CI = 19.69 - 20.94) in the rainy season. The study found that 68.6% of the households experienced water insecurity, and 16% of children under the age of five suffered from diarrhea. Only 42.2% of the mothers practiced good handwashing. The incidence of diarrhea was 1.6 episodes per child-year, with high rates in exposed groups. Households without piped water on premises had 2.2 episodes per child-year, while those with piped water on premises had 1.0 episodes. Piped water off premises, unsafe disposal of child’s stool, eating unheated food, and poor handwashing practices at critical times also contributed to the increased incidence of diarrheal diseases. Consuming water contaminated with E. coli during the dry and rainy seasons has significantly increased diarrhea risk. Additionally, consuming less than 20 liters of water per capita per day during the dry season has also significantly increased the risk of diarrhea. The study found that most households had access to unreliable drinking water sources and lacked basic sanitation and handwashing facilities. Seasonal changes significantly affected household water use and microbiological water quality. Diarrhea incidence and prevalence and household water insecurity were notably high, creating public health concerns. Most mothers exhibited poor handwashing practices. Therefore, the study emphasizes the need to enhance on-premises water access and improve the reliability of the drinking water sources to reduce diarrhea risk. Seasonal monitoring of drinking water safety is also recommended to maintain its health standards. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6808 | |
| dc.language.iso | en | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Diarrhea incidence | |
| dc.subject | E. coli | |
| dc.subject | household water use | |
| dc.subject | peri-urban | |
| dc.subject | seasonal variations | |
| dc.subject | offpremises water access | |
| dc.title | Nexus of water quantity, microbiological quality and diarrheal diseases in children under five: a case of Hosanna town, Central Ethiopia | |
| dc.type | Thesis |