Academic journal article Journal of Health Population and Nutrition

Diarrhoeal Morbidity among Young Children in Eritrea: Environmental and Socioeconomic Determinants

Academic journal article Journal of Health Population and Nutrition

Diarrhoeal Morbidity among Young Children in Eritrea: Environmental and Socioeconomic Determinants

Article excerpt


Diarrhoeal diseases are still one of the most important causes of morbidity and mortality in developing countries, especially in African countries. Diarrhoea, characterized by an increase in the number of watery evacuations relative to the usual pattern of each individual, has been a major contributor to illness and death, particularly among children, in sub-Saharan Africa (1,2). According to the WHO report, diarrhoeal diseases are still the leading cause of mortality and morbidity in children aged less than five years in the African region (3). The report indicates that each child in the region has five episodes of diarrhoea per year and that 800,000 children die each year from diarrhoea and dehydration.

It is widely recognized that exposure to diarrhoeal pathogens in developing countries is conditioned by such factors as age of children, quality and quantity of water, availability of toilet facilities, housing conditions, level of education, economic status of households, place of residence, feeding practices, and general sanitary conditions (personal or domestic hygiene) surrounding houses (1,4,5). In Ethiopia, the incidence of diarrhoea is higher in the second half of an infant's life, when inborn immunity is weaker and exposure to contaminated weaning foods is increased (6). Results of this study also showed that children living in households with some kind of toilet facility are less likely to be sick than children in households without any toilet facility. In Ghana, the risk of having diarrhoea is significantly associated with toilet facility, where children living in houses with toilet facilities are about 50% less likely to contact diarrhoea than children living in houses without such facilities (7). The same study indicates that the prevalence of diarrhoea varies according to education of mothers, being significantly lower among children of more educated mothers (secondary or higher) than among children of mothers with primary or no education. This is probably because more education provides knowledge of the rules of hygiene, feeding and weaning practices, and interpretation of symptoms, and enhances timely action to childhood illness (2,4).

Results of a comparative study, carried out in urban areas of Ghana, Egypt, Brazil, and Thailand by Timaeus and Lush, clearly indicate that children's health is affected by environmental conditions and economic status of households (5). According to these authors, children from better-off households have lower diarrhoeal morbidity and mortality in Egypt, Thailand, and Brazil. Such differentials in diarrhoeal diseases by household economic status are probably due to the differences in childcare practices, for instance, preparation of weaning foods and personal hygiene (5).

In Eritrea, the health planners are, at present, greatly concerned about morbidity and mortality, especially among young children. The Ministry of Health has introduced a programme known as Participatory Hygiene and Sanitation Transformation (PHAST) by constructing community and school latrines and has undertaken national clean-up days yearly to reduce the prevalence of sanitary and hygiene-related diseases.

The success of any health policy or healthcare intervention depends on a correct understanding of the socioeconomic, environmental and cultural factors that determine the occurrence of diseases and deaths. Until 1995, any morbidity information available was derived from clinics and hospitals. Information on the incidence of diarrhoea obtained from hospitals represents only a small proportion of all illnesses, because many cases do not seek medical attention (8). Thus, the hospital records may not be appropriate for estimating the incidence of diarrhoea and are too sketchy to be used for programme developments.

The first attempt to obtain population-based morbidity data was the Eritrea Demographic and Health Survey (DHS) conducted in 1995. …

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