Risk Factors Associated with Diarrhea among Hospitalized Children in Gaza Governorates: Case Control Study
Ghadeer Abdo Bakry
غدير عبدو بكري
Globally, Diarrhea is the leading cause of burden of disease in children worldwide, it is one of the leading causes of childhood morbidity and mortality in developing countries. This study aimed to know the main risk factors which are associated with diarrhea among hospitalized children in Gaza governorates. The design of this study is case-control, the study sample consisted of 140 children (70 cases and 70 controls). Seventy cases were taken as a stratified cluster sample from Naser Medical Complex and Alnasser Pediatric Hospital, 70 controls were taken from Khanyounis primary health care center and Sheikh Radwan primary health care center. The researcher used an interview questionnaire, face, content validity were done. Different statistical procedures were used for data analysis including cross tabulation, percentages, mean, Chi square test and multiple regression. By bivariate analysis using Chi-square test was used, the results revealed that there was a significant association between diarrhea and household environmental factors such as (residence, family income per month, source of drinking water, type of toilet facility, p value < 0.05). On the other hand; the results showed that there was no significant association between diarrhea and (main source of water, fuel used for cocking, child’s feces disposal method, household animals, number of children less than 5 years at home and number of rooms in the home, p value > 0.05). Among socio-demographic factors; bivariate analysis using Chi-square test showed that there was a significant association between diarrhea and father age, p value < 0.05 and there was no significant association between diarrhea and (child gender, age of the child, orphaned and vulnerable status, type of family, mother's education level, father's education level, mother age and mother work, p value > 0.05). Also there was a significant association between (Exclusive breast feeding, complementary feeding, number of meals per day and the age of weaning) and diarrhea as p value < 0.05 and there was no significant association between diarrhea and (Immediate breast feeding and replacement feeding) as p value > 0.05. Bivariate analysis using person’s chi-square revealed that there was a significant association between diarrhea and (weight for age z score and height for age z score) as p value < 0.01 and there was no significant association between diarrhea and (head circumference and body mass index) as p value > 0.05. Multivariate analysis of risk factors of diarrhea in children aged less than 5 years using multiple logistic regression by binary logistic regression, results showed that there was a significant association between diarrhea and (family income, residence, complementary feeding and age of weaning) as p value < 0.05. The results showed that the children who are living in villages have decreased the odds of having diarrhea by 53.2% than children who are living in cities and the children who have families with income of (1800 – 2300 NIS) have decreased odds of having diarrhea by 80.8% than children who have families with income less than 1800 NIS. Also children who didn’t take complementary feeding have decreased odds of having diarrhea by 59.0% and children with increase in one month of weaning age, will have a decrease 1.058 times the odds to have diarrhea The study concluded that the residence, family income, complementary feeding and age of weaning are risk factors for diarrhea among children less than 5 years in Gaza Strip. The results of the study imply the need for paying the attention for whom who have low income families and for whom who weren’t naturally breast fed.