Factors associated with diarrhea among under-five years old children in Banten province Indonesia : a secondary analysis of Indonesian national socio-economic survey 2007 and basic health research 2007

Abstract

This study was a secondary analysis of two surveys in Indonesia, Indonesian National Socio-economic Survey 2007 and Basic Health Research 2007. Related variables from these surveys were used to examine factors associated with diarrhea among under-five years old children in Banten Province, Indonesia. Primary data sources were consist of household economic, individual economic and health information. A two stage sampling was done using probability proportional to the number of households in district/city. There were 303 census blocks selected by random sampling which each block consist of 150 households. Then, from each census block 16 households randomly selected as the sample of household. Each household member became respondent of primary data collection. This study used the data of 1655 children under-five years old along with data of their mothers and households. Bivariate analysis was done with Pearson’s chi-square test, crude odds ratio for risk estimation, and multivariate analysis being done using binary logistic regression. The prevalence of diarrhea among under-five years children was 18.9%. The highest risk was in children age 6-11 months, lower education mother (p-value 0.001) and without gender influences. Mother’s defecation place and hand washing behavior has strong association with diarrhea in children (p-value < 0.001 and <0.001). Teenage mothers were found have high risk of having children with diarrhea (p-value 0.042) and also high proportion of never practiced hand washing with soap (15.8%). Using unsafe drinking water source and not good physical quality of drinking water were associated with diarrhea in children (p-value < 0.001 and 0.005). As well as the household that shared in the use of drinking water source and latrine, use open water container, open liquid drainage channel and did not use septic tank for feces landfills. Percentage of children’s diarrhea was higher in rural area, but after controlling other variables, urban area has 0.6 more likely develop diarrhea in children. Child health care, such as exclusive breast feeding, food and vitamin A supplementation, measles immunization were not enough to prevent the under-five years old children suffer from diarrhea. Health educations, especially for teenage mother, and promote the use of safe drinking water source, latrine and household sanitations are recommended. Specific intervention should be implemented for rural area with difficulties to get drinking water source. Longitudinal study is needed to identify confounding factors, causal relationships and seasonal differences in the epidemiology of diarrhea.