Spatio-temporal distributions and determinants of diarrhea among under-five children in Ethiopia

The purpose of this study was to evaluate the spatio-temporal pattern of Ethiopia's childhood diarrheal disease and identify its contributing factors.

We conducted analyses on secondary data from four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. Moran's I was used to determine spatial dependence and spatial models were used to evaluate variables associated with diarrhea in under-five children at the zonal level.

Childhood diarrhea showed spatial clustering in Ethiopia (Moran's I; p < 0.05). The spatial regression model revealed significant factors at the zonal level: children born at home ($e^{\theta }$ = 1.355, 95% CI: 1.052-1.544, p < 0.001), low birth weight ($e^{\theta }$ = 1.18, 95% CI: 1.017-1.691, p < 0.05), and unimproved source of water ($e^{\theta }$ = 0.8568, 95% CI: 0.671-1.086, p < 0.01).

The prevalence of diarrhea among under-five children varied over time by zone, with the Assosa, Hundene, and Dire Diwa zones having the highest rates. Home births and low birth weight contributed to the prevalence of childhood diarrhea. In high-risk zones of Ethiopia, reducing childhood diarrhea requires integrated child health interventions and raising awareness about the potential hazards associated with unimproved water sources.