Mothers Knowledge of the Prevalence, Causes, Effects, Prevention and Control of Diarrhoea among Children in Ife East Local Government Area, Ile Ife, Osun State, Nigeria

Introduction

Childhood diarrhoea is one of the leading causes of morbidity and mortality in children under 5 years of age and it is the second leading cause of death among children under five years of age worldwide (BBS, Bangladesh Bureau of Statistics UNICEF, United Nations Children’s Fund, 2007). Of the 6.3 million deaths that occurred in children under the age of 5 worldwide in 2013, 10% were attributed to diarrhea. In effect, 2,195 children die from diarrhoea every day, which is more deaths than AIDS, malaria, and measles combined. Seventy percent of these deaths are concentrated in 15 developing countries. Nigeria is one of these 15 countries and diarrhoea is responsible for sixty-nine thousand diarrheal deaths [1]. In Nigeria, diarrhoea is the second leading cause of death in under-five children (after malaria) with a prevalence rate of 18.8% making it one of the worst diseases in sub-Sahara Africa. In 2009, the WHO reported that Nigeria records at least 151700 child’s death per year (WHO). Such high incidences of diarrhoea might be associated with poor hygiene, standard of living, poverty, illiteracy, ingestion of contaminated water and foods [2].

Diarrhoea was listed as one of the three most prevalent waterborne diseases in southwest Nigeria after typhoid fever and cholera. Also, the molecular epidemiology of diarrheal pathogens, anti-diarrheal activities of indigenous medicinal plants, and the risk factors of childhood diarrhoea have been highlighted [3]. There seems to be uneven distribution or existence of discrepancy in the epidemiology of diarrhoea in Nigeria with more incidences occurring in northern Nigeria than in the southern Nigeria [4]. In northern Nigeria, the prevalence and determinants of diarrhoea among infants in primary health centers in Kaduna have been reported in which the authors highlighted proper hygiene, nutrition education for nursing mothers, meticulous hand washing practices and child immunization as pre-requisites in disease burden reduction [5].

The transmission of infection occurs by direct contact with the agent, through oral–faecal transmission routes due to poor water quality, unhygienic behaviours, improper storage of food and inadequate sanitation practices [6]. This may be because mothers lack of awareness about safe drinking water, hygiene practice, feeding children with hygienic food and defecation practices [7]. Diarrhoea can be prevented by avoiding contacting with causative agents, but children under 5 years of age are unable to protect themselves from these agents. They are under the care of their mothers; therefore, the maternal preventive behaviours for children are very important. There are many studies showings the incidence of diarrhoea related to maternal behaviours including hygiene practices, child feeding practices, safe water and defecation practices, therefore, the aim of this Study was to determine the Prevalence, causes, effect prevention and control of diarrhoea among children in Ife East Local Government Area, Ile Ife, Osun State, Nigeria [8, 9, 10]. Materials and Methods

Data Analysis

Analysis of the data was done using Statistical Package for the Social Sciences tool (SPSS) version 27.0. The descriptive statistic such as frequency in percentage was used to analyze the data form the respondents.

Results

A total of 200 samples; Majority of the area where questionnaire were administered are Itafaji and Safejo (8.5%) each (Table 1).

Majority of aged 26-30 years (33.0%) had participated in this study. Majority of the women that participated were 33.0% (66/ 200), 86.0% (172/400) were married, 78.0% (156/400) were Christians, 32.0% (64400) were artisans, and 44.5% (89/400) had secondary school education and 86,5% were Yoruba (Table 2).

Table 3 shows the Socio- demographic Characteristics of the Children used in the study on Diarrhoea among Children in Ife East Local Government Area, Osun State, majority of aged 5-7 years (37.0%), 113/200 (43.5%) males and

112 /200 (56.0% ) with secondary school education had participated in this study.

Table 4 show mothers knowledge of the Prevalence and Management of Diarrhoea among Children in Ife East L.G.A. Osun state. 27.0% of the children have had diarrhea before, while 20.0% had diarrhea this year. Only 66.0% has heard about diarrhea infection, 10.5% had in the past month and

11.5% has been hospitalized due to diarrhea. 16.0 % live in area with poor access to clean water, 8.0% had taken medication that may cause diarrhea as side effect. The recurrence of diarrhea occurs among 8.0% children and only 8.0% had travelled to an area with poor sanitation.

Table 5 show mothers knowledge of the cause of diarrhoea among children in Ife East L.G.A, Osun. 9.8% of the children had eaten food that was spoiled diarrhea before while 71.0% knows that fly infestation to food is not good for child’s health. Undercooked meat, sea food or egg were eaten

23.5%, 50.5% of the children had experienced vomiting while, watery, bloody or mucus stools are common among 31.5% children. Fever (53.0%), abdominal pain or cramps (49.0%) and 32.5% had eaten raw fruit or vegetable recently.

Table 6 show mothers knowledge of the effects of diarrhoea among children in Ife East L.G.A, Osun State. 67.0% know that malnutrition can trigger diarrhea, 79.0% know that diarrhea can trigger dehydration and loss of mineral salt while 75.5% knows that diarrhea can lead to fever among children. 72.0% agreed that poor sanitary condition leads to diarrhea. 67.0% agreed that lack of health education can lead to the spread of diarrhea while only 44.5% sought medical attention for their children diarrhea. Underlying conditions were seen among 33.5% children and 32.5 had experienced previous episode of diarrhea. Only 42.5% experienced weight loss when having diarrhea.

Table 7 show mothers knowledge of the prevention of diarrhoea among children in Ife East L.G.A, Osun State. 88.0% knows that washing hand before handling of food is good for the child, 95.5% know that covering food prevent flies and 96.5% knows that washing hand after going to toilet protect child from diarrhea. Washing of hand with soap and water before eating was seen among 92.0%, 84.0% drink water from safe source and 80.0% practice good hygiene during food Preparation. 78.0% make use of toilet or latrine for bowel movement and 81.5% store food at the correct temperature.

Table 8 show mothers knowledge of the control of diarrhoea among children in Ife East L.G.A, Osun State. 82.0% knows that poor personal hygiene can cause/ trigger the transmission of diarrhea, 81.0% know that lack of good food and drinking water can cause or trigger the transmission of diarrhea and 82.5% give their children medication prescribed by healthcare provider. Only 86.0% drink enough fluids to stay hydrated, 80.5% monitor their children stool output and frequency while only 52.5% seek medical attention when the mother and children has the symptoms or persistence diarrhea.

Table 9 shows immunization records of children in Ife East L.G.A, Osun State. 93.0% of the children were vaccinated with BCG, 89.5% with HBV, 91.0% PENTA, 90.5% OPV, 90.0% PCV, 89.5% IPV and the least was 12.5% with ROTA.

Discussion

The findings from the study revealed that majority of the correspondence were between aged 26-30 years, married, educated and had means of livelihood. Majority of the women that participated had secondary school education. This is similar to a study conducted in Odeda in Ogun State by Agbon et al, where majority of respondents were between 20-40 years, 79.1% were educated and that of Turyare in Somalia where respondence were between aged 25-34 years [11, 12]. This study also revealed that majority of children was between 5-7years and males. This is in contrast to a study conducted in Tanzania by Masuke, et al. where majority of children used for the study were 2years old and 46% were females [13]. It also revealed that most of children had primary education. This study also shows the mothers’ perceived knowledge of the prevalence of diarrhoea, where only 66.0% have heard about diarrhea infection, 10.5% had diarrhoea in the past month and 11.5% has been hospitalized due to diarrhoea. This is in agreement with Olaniyi and Oyerinde, where majority of mother had knowledge of diarrhoea in children. According to this study, considerable number of children had diarrhoea before (27.0%) and this year (20.0%). A significant proportion of children lived in areas with limited access to clean water, increasing their risk of exposure to waterborne pathogens. While less prevalent (8.0%) in this study, travel to areas with poor sanitation can still contribute to diarrhoea outbreaks.

In this study, consuming undercooked or spoiled food, particularly meat, seafood, and eggs, was associated with increased diarrhea risk. While not a major factor in this study, it is important to note that raw produce can harbour harmful bacteria if not properly washed.

A small percentage of children were taking medications that could cause diarrhea as a side effect. The study revealed a mixed picture of knowledge and practices, majority of mothers were aware of the importance of hand washing, food hygiene, and vaccination. However, some misconceptions persisted, such as the belief that only poor sanitary conditions lead to diarrhoea.

Most mothers practiced good hygiene, such as hand washing and food storage in this study, This was similar to the study conducted in Nepal by Ansari et al., where majority of mothers claimed that the occurrence of diarrhoea in children was preventable through preventive approach such as maintaining cleanliness and making a habit of hand washing before feeding the child and Mubarak et al, where most mothers prefer washing their hands before preparing food and eating [14, 15, 16].

There were gaps in other areas, including seeking medical attention for diarrhea and ensuring adequate fluid intake. Vaccination coverage was generally high for most vaccines, but the low coverage for rotavirus vaccine was a concern.