GEOSPATIAL EVALUATION OF DIARRHOEA PREVALENCE, RISK FACTORS, PREVENTION AND HANDLING PRACTICES AMONG CHILDREN UNDER FIVE YEARS IN MACHAKOS COUNTY, KENYA

Abstract

Childhood diarrhoea remains a major cause of mortality and morbidity worldwide. Although the World Health Organization and the Government of Kenya have established guidelines to control and prevent it, cases persist, necessitating further study. This study aimed to determine prevalence and spatial distribution of diarrhoea among children aged under 5 years, determine seasonal patterns in diarrhoea incidence amongst households, identify risk factors that influence the occurrence of childhood diarrhoea, determine the spatial association between the main factors and the occurrence of childhood diarrhoea and examine the household and community prevention practices employed to prevent the occurrence of childhood diarrhoea in Mavoko and Matungulu sub-Counties. Using a mixed-methods approach, the research collected data through a cross-sectional household survey, key informant interviews, and secondary data review. Analysis was conducted using Global Moran’s I, Hotspot Analysis (Getis-Ord Gi*), Multivariate Logistic Regression, Geographically Weighted Logistic Regression (GWLR), percentages, and chi-square test methods. The study revealed a high 2- week prevalence of childhood diarrhoea, affecting 34% of children under five years old in Mavoko and Matungulu sub-Counties. Mavoko Sub-County had a higher prevalence rate of 37%, compared to 27% in Matungulu sub-County. Multivariable regression revealed significant associations between childhood diarrhoeal disease and the mothers/caregivers education level in Matungulu (OR = 0.732, 95% CI = 0.217–2.204, p = 0.011), employment status of mothers/caregivers in Mavoko (OR = 1.87, 95% CI = 0.94–3.76, p = 0.004), among child’s age groups, children aged 7-36 months in both regions had significantly higher odds of diarrhoea (Matungulu: OR = 1.704, 95% CI: 1.321-3.468, p = 0.012; Mavoko: OR = 1.730, 95% CI: 1.221–2.468, p = 0.023), drinking surface water significantly increased childhood diarrhoea odds in both Matungulu (OR = 5.344, 95% CI = 0.472–1.667, p = 0.002) and in Mavoko (OR = 1.34, p = 0.009), the number of children in the household in Matungulu (OR=1.625, 95% CI=0.762–2.306, p=0.019) and improper disposal of child faeces and other wastes significantly increased the odds of diarrhoea in Mavoko sub-County (OR = 1.342, 95% CI = 0.874–3.123, p = 0.0023). The study found diarrhoea prevention practices more effective in Mavoko than Matungulu sub-Counties, highlighting spatial differences in childhood diarrhoea distribution and factors. The study recommends enhancing water treatment, healthcare access, educational programs for caregivers, and waste management practices. The study suggests further longitudinal research to track diarrhoea trends and improve child health strategies in Machakos County