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. 2022 Apr 25;17(4):e0265804.
doi: 10.1371/journal.pone.0265804. eCollection 2022.

Effects of community-led total sanitation and hygiene implementation on diarrheal diseases prevention in children less than five years of age in South Western Ethiopia: A quasi- experimental study

Gedamu Bushen  1 , Hailu Merga  2 , Fasil Tessema  2
Affiliations

Effects of community-led total sanitation and hygiene implementation on diarrheal diseases prevention in children less than five years of age in South Western Ethiopia: A quasi- experimental study

Gedamu Bushen et al. PLoS One. .

Abstract

Background: Lack of improved sanitation is the most important contributing factor to diarrheal disease among under-five children in low and middle-income countries. There was no study to identify the effect of Community-Led Total Sanitation and Hygiene intervention on diarrheal diseases in the study area. Hence, this study was designed with the aim of finding the effects of Community-led Total Sanitation and Hygiene implementation for preventing diarrhea among under-five children.

Methods: A community-based Quasi-Experimental study was conducted among a sample of 846 households selected from intervention (kersa) and comparison (mana) districts using the four-stage random cluster-sampling method. A Semi-structured questionnaire was used to collect data. The collected data was cleaned, coded, and entered into EpiData version 3.1 and exported to SPSS version 20 for analysis. Difference-in Difference method with McNemar's tests was used to compare the prevalence of diarrhea between the intervention and comparison districts, and the significance of change between the pre-test and post-test was declared at p-value less than 0.05 with 95% confidence interval.

Results: The intervention led to decreased diarrhea prevalence [pp = -8.2, 95% CI: -15.9, -0.5], increased latrine ownership [pp = 5.6, 95% CI: 0.5, 10.8], and increased latrine utilization [pp = 10.7, 95% CI: 4.7, 16.6] in intervention district at post-test compared to the baseline; while the presence of handwashing facility near the latrine, home-based water treatment, and proper water storage and handling practice were decreased at post-test compared to the baseline.

Conclusion: Implementation of Community-Led Total Sanitation improved sanitation and hygiene status of community that resulted in the reduction of diarrhea diseases in under-five children. Further implementation, evaluation, and scale-up of the interventions are needed to reduce diarrheal disease in under-five children.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Map of the study area.
Fig 2
Fig 2. Schematic presentation of sampling procedure.
Fig 3
Fig 3. Difference-in-Difference on prevalence of diarrhea in children less than five years in intervention and comparison districts, Jimma zone, Oromia region, southwest Ethiopia, 2019.
See this image and copyright information in PMC

References

    1. Nwaoha AF, Ohaeri CC, Amaechi EC. Prevalence of diarrhoea, and associated risk factors, in children aged 0–5 years, at two hospitals in Umuahia, Abia, Nigeria. URJ [Internet]. 2017. Mar.14 [cited 2020 Feb.28];9(1):7–14. Available from: https://revistas.uned.ac.cr/index.php/cuadernos/article/view/1672
    1. Fischer Walker C.L., Perin J., Aryee M.J. et al. Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review. BMC Public Health 12, 220 (2012). doi: 10.1186/1471-2458-12-220 - DOI - PMC - PubMed
    1. World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO
    1. Hürlimann E, Silué KD, Zouzou F, et al.. Effect of an integrated intervention package of preventive chemotherapy, community-led total sanitation and health education on the prevalence of helminth and intestinal protozoa infections in Côte d’Ivoire. Parasit Vectors. 2018;11(1):115. Published 2018 Feb 27. doi: 10.1186/s13071-018-2642-x - DOI - PMC - PubMed
    1. Dreibelbis R, Freeman MC, Greene LE, Saboori S, Rheingans R. The impact of school water, sanitation, and hygiene interventions on the health of younger siblings of pupils: a cluster-randomized trial in Kenya. Am J Public Health. 2014;104(1):e91–e97. doi: 10.2105/AJPH.2013.301412 - DOI - PMC - PubMed