Contents

Cover page……………………………………………………………………………………………………..I
Acknowledgment……………………………………………………………………………………….…….II
Summary …………………………………..………………………………………………………………...III
Abbreviation…………………………………………………………………………………………………I

V
CHAPTER ONE.................................................................................................................................................4
INTRODUCTION..............................................................................................................................................4
1.1 BACKGROUND INFORMATION.................................................................................................................4
1.2 STATEMENT OF THE PROBLEM................................................................................................................5
1.3 Significance of the Study.................................................................................................................................5
CHAPTER TWO................................................................................................................................................7
LITERATURE REVIEW...................................................................................................................................7
CHAPTER THREE..........................................................................................................................................10
OBJECTIVE.....................................................................................................................................................10
3.1. General objective................................................................................................................................................10
3.2. Specific objectives..............................................................................................................................................10
CHAPTER FOUR.............................................................................................................................................11
RESEARCH METHDOLOGY........................................................................................................................11
4.1. Study Area and Period.........................................................................................................................................11
4.2 Study Design........................................................................................................................................................11
4.3. Source Population...............................................................................................................................................11
4.4. Sample Population..............................................................................................................................................11
4.5 Study Population..................................................................................................................................................12
4.6. Eligibility Criteria...............................................................................................................................................12
4.6.1 Inclusion Criteria...........................................................................................................................................12
4.6.2 Exclusion Criteria..........................................................................................................................................12
4.7. Sampling Technique............................................................................................................................................12
4.8. Sampling Size Determination..............................................................................................................................12
4.9. Study Variables...................................................................................................................................................13
4.9.1 Dependent Variables.....................................................................................................................................13
4.9.2 Independent Variables...................................................................................................................................13
 Socio-demographic factors like age, sex........................................................................................................13

1
 4.10. Data Collection Tool and Procedure..................................................................................................................13
4.11 Data Quality Control..........................................................................................................................................13
4.12 Data Analysis Plan.............................................................................................................................................13
4.13 Operational Definition........................................................................................................................................13
4.14 Ethical Consideration.........................................................................................................................................14
4.15 Dissemination and Utilization of Results...........................................................................................................15
CHAPTER FIVE..............................................................................................................................................16
WORK PLAN...................................................................................................................................................16
CHAPTER SIX.................................................................................................................................................17
BUDGET BREAK DOWN..............................................................................................................................17
CHAPTER SEVEN: - REFERANCE...............................................................................................................18
7.1. References..................................................................................................................................................18
Annex................................................................................................................................................................21

2
 CHAPTER ONE
INTRODUCTION

1.1 BACKGROUND INFORMATION

Diarrheal is passage of three or more loose or watery stool per 24 hours. It is one of the most important
causes of morbidity and mortality in developing countries especially in Africa countries including in
Ethiopia. (1)
There are three clinical types of diarrhea. These are acute watery diarrhea, dysentery and persistent diarrhea.
Acute watery diarrhea is a diarrheal episode that begins acutely and lasts for less than fourteen days with
passage of watery stool without blood. Whereas dysentery is diarrhea with blood stool and persistent diarrhea
is diarrheal episode that starts acutely and lasts fourteen days or longer. (2)
Globally, 530,000 children under 5 years old are dying in a year due to diarrheal disease. Diarrheal deaths
among children of under 5 years old show some change decreased by more Most of the deaths from diarrhea
occur among children of less than 2 years old living in South Asia and sub-Saharan Africa(1,2). Children who
are malnourished, children who have impaired immunity and children with HIV are more at risk of life
threatening diarrhea (3).
It is widely recognized that exposure to diarrheal pathogens in developing countries is affected by a factors
like age of the child, quality and quantity of water, availability of toilet facilities, housing conditions,
maternal level of education, house hold economic status, place of residence, feeding practices and general
sanitary condition around the house. (3) Although the diarrheal disease mortality reduced by half from 2000-
2015 worldwide, the diarrheal morbidity it remains the leading cause of common child illness in developing
countries like Ethiopia. This study attempted to determine the diarrheal disease prevalence and associated
factors in children of 6-59 months at Adama 01 kebeles. The result of the study can help in diarrheal disease
prevention plan.
1.2 STATEMENT OF THE PROBLEM
Diarrheal illness can have a significant impact on psychomotor and cognitive development in young children.
Early and repeated episode of childhood diarrhea during a period of critical development, especially
associated with malnutrition, co-infection, and anemia can have long term effects on linear growth as well as
on physical and cognitive function (1).
Diarrheal disease is the leading causes of death in children in under five years. Globally, it accounts for
1.8million death per year and 80% of childhood death. The overall diarrheal episode incidence is 3.2 per
children per year. (4). globally, mortality is declining but the overall diarrheal incidence remains unchanged
3
and it is estimated to account for 13% of childhood disability adjusted life years (1, 5). A number of deaths of
children due to any cause is 46%. The dangers of diarrhea related to dehydration and malnutrition, while
dysentery is another important cause of death due to fatal complication associated with it. (5).
In developing countries, morbidity and mortality associated with childhood diarrhea remains challenging
problem (4). Most of diarrheal episodes occur in children in the first year of life. In some areas young
children spend 15-20% of their time with diarrheal illness (5, 6).
Diarrhea can last several days, and can leave the body without water and salt that are necessary for survival.
Most people who die from diarrhea actually died from severe dehydration and fluid loss (7). According to
research done in India, west Bengal, the overall incidence of diarrhea in under five children was 1.7 episodes
per year per child(8).
1.2 Significance of the Study
Diarrhea is a common health problem in developing countries like Ethiopia. In our study area there is no
previous study on diarrhea. So we are interested to do this research and find prevalence and associated factors
of diarrhea in under five years of children.
Our research will show the magnitude and factors associated with the problem. The study also helps health
policy makers to take measures and for stakeholders to create awareness to the community on how big the
Observed by data collectors to determine its relationship with the occurrence of diarrheal.

4
 CHAPTER TWO
LITERATURE REVIEW
2.1 Literature Review

In developing countries mortality and morbidity associated with childhood diarrhea is still a big problem. A
ten-year review of the global problem of diarrheal disease has shown that there are more than 1 billion
episodes and 3 million deaths occurring each year among under-five children. It is also estimated that each
child in developing countries Experiences 3.2 episodes of diarrhea per day (4).Children who are
malnourished or have an impaired immunity are most at risk of life threatening diarrhea. (7).
Comprehensive analysis of 73 studies from 23 Sub-Saharan African countries showed that children under
five years of age experience about five episodes of diarrhea each year. The analysis also showed that
prevalence of childhood diarrhea ranged from 10.5 to 19 percent (9).
Another study child health research project report on childhood diarrhea in sub Saharan Africa, diarrhea is
one of the top three cause of childhood mortality and morbidities in sub Saharan African countries. Over
all death rates ranges from 3.4-31 per 1000 children per year. Acute diarrhea accounted for 1.9-37% of all
death with greatest proportion occurring in the first year of life. Persistent diarrhea (duration of more than
14 days) is also responsible for significant childhood mortality in Sub-Saharan Africa, where rates of 6.6 to
43 death per 1000 children per year have been observed. The median annual incidence of diarrhea peaks
among 6-12 months old children and decreases progressively there after according to the same study. A
review of longitudinal community based studies with frequent surveillance found that 6-11 month old
children in Africa had a median of 4.5 diarrheal episodes per year(9). In their study on the determinants of
childhood diarrhea in The Republic of Congo, Mock et al found a two week period prevalence of 18.6
percent in children under-three years of age (10). In rural Zaire, a longitudinal study done on children aged
3-35 months showed annual incidence of 6.3 episodes per child (11).
According to Morris, Black and Tomas Cobik review of literature on the causes of diseases among children
under five for sub Saharan Africa and Asia 21.9% of all deaths of children up to five years of age in sub-
5
Saharan Africa in the year 2000 were due to diarrhea, corresponding to a total of 935,000 deaths (12).
Another study conducted in the republic of Congo showed that highly educated mothers reported few
diarrheas (13).Another study on family size revealed that mothers having five or more living children
reported more frequently that their child had had diarrhea (13).In the same area the other study showed that
children coming from households that obtain water from protected source were less likely to have diarrhea
as compared to those who get water supply from unprotected source. This study also revealed that children
of families with latrine had a lower prevalence of diarrheal disease than those children whose families
didn't have latrine (14).
Study that was conducted in Eritrea shows that availability of toilet facility in the household was associated
with a 27% reduction of diarrhea in under five children (15). Diarrhea prevalence is highest among
children residing in households that drink from unprotected wells (15).The prevalence of diarrhea in under
five children in Botswana is 10% and 40% each in Senegal and Liberia. (16). each child in sub-Saharan
Africa has five episodes of diarrhea per year and 8,000,000 die each year due to diarrhea and dehydration.
(17).
In Ethiopia the two weeks prevalence of diarrhea in under five children is about 24%. (18).The analysis on
breast feeding and risk of diarrhea indicated that the risk of developing diarrheal disease in partially breast
feed infants was five times higher than that of infants exclusively on breast milk(18).The Ethiopian
Demographic and Health Survey (EDHS) 2011 report shows that diarrhea is a considerable child health
problem; 16% of children under five were reported to have had diarrhea and 6% had had diarrhea with
blood in the two weeks before the survey and watery diarrhea was the commonest form. This study also
shows that diarrhea was most common among children of age 6-23 months (23-25%) with the prevalence
varies seasonally. The prevalence of diarrhea in under five children residing in the Jima and Gambela (both
23%)Studies in different parts of Ethiopia have shown that diarrheal incidence and prevalence is very high
among under five children(20) One study done in Tigray region on the patterns of childhood morbidity
found that 3.05 diarrheal episodes per child per year(21). Another study that attempted to determine
household illness prevalence in Gondar showed that diarrhea was one of the most frequently occurring
symptom that accounts 11.4% of the overall illness prevalence (22).The analysis that was done on under
five children mortality in Giligel Gibe field was found that mortality rate due to acute watery diarrhea is
30%(23).
According to the research conducted in Nekemte town, western Ethiopia diarrhea morbidity prevalence
was 28.9% in under- five children (24). Another survey in Mana district and Jimma town, south west
Ethiopia revealed that the two week period with prevalence of childhood diarrhea morbidity was 33.7%
and 36.5% respectively (25).
6
The analysis of 1961 admission to Swedish pediatric clinic in Adds Ababa indicates that diarrheal disease
accounts for 21% prevalence and 2.3% of deaths (26). In the same place research in 20 health centers
shows that among 576 children taken, 229 of them are affected with diarrhea(27).
According to a follow-up study in Butajira, the incidence of diarrhea was about two-episodes per person
per year (28).A community based study conducted in East showa Zone, Eastern Ethiopia found a two-week
childhood diarrhea prevalence of 15 %(29).Diarrhea and malnutrition are known to have a bi-directional
relationship that is they are potentially causing each other. Diarrhea may lead to malnutrition due to
reduced dietary intake, mal absorption, and mal-digestion. On the other hand, mal-nutrition may cause and
worsen diarrhea and other infections due to weekend immunity system. (30)
Contaminated foods are responsible for 70% of diarrheal episodes. In developing countries, weaning foods
are often prepared in hygienic manner. Thus, weaning age is especially dangerous time for infants since
they are exposed to infective dose of food borne pathogens. Food contamination source includes unclean
hands, feces, polluted water. Flies, pest, domestic animals, unclean utensil and pot and unsanitary
environment. (31).Those residing in rural and urban area 14% and 11% respectively. One study showed
that house hold income was directly related to having in house water connection or private excreta disposal
facility in which both reduce the risk of having child hood diarrhea (32).
A study conducted on the determinants of diarrhea in under five children showed that the probability of
having diarrhea was 33-38% lower for children from the medium and high socio economic status than the
children from low socio economic status (15). One study on hygienic behavior sever child hood diarrhea
also showed that unhygienic practices were important risk factors for severe diarrhea in under five
children(33). The autoregressive effect of diarrheal episodes with a child's age was revealed in the
longitudinal study from more than 14 episodes to 2 episodes per year –child (34).

7
 CHAPTER THREE
OBJECTIVE
3. Objective
3.1. General objective
 Assessment of the prevalence and associated factors of diarrheal disease among under five
children in 01 kebele Adama town.
3.2. Specific objectives
 To assess the prevalence of diarrhea among under five children in 01 kebele Adama town
 To determine the associated factors with the diarrheal diseases.

8
 CHAPTER FOUR
RESEARCH METHDOLOGY
4. Research Methodology

4.1. Study Area and Period

This study wil conduct in Oromiya Regional State, East Showa Zone, Adama town, Kebele 01, Adama was
establishment in 1917 and It has got the municipal status in 1936; and named ‘Nazareth’ by Emperor
H/Sillassie in 1937 and was known by this name for more than half a century until officially regains its
original name”Adama” by the Oromia Regional State Council in the year 2000.GC. Adama city is located at
some 100 km from Addis Abeba on southeast along the main road to Harer. and the word Adama was
pointed to have originated from an Oromo word “adaamii “ it is the name for tree types called “cactus” in
English according to local people ,there were plenty of adaamii trees in and around old Adama areas.
Adama has been the original name of the town.
Adama is the city of business, National & International Conference Centre. Adama is situated within the
wonji fault belt, the main structural system of Ethiopian rift valley .geological studies indicates that the
present physiographic of the area is the result of volcano –tectonic activities occurred in the past and thus
deposition of segment largely of luvial and lacustraine origin.Adama town has been reorganized
/restructured in to 14 kebeles each of which has got its own council. In population is estimated to be Based
on the 2009 housing and census, population projection, it has an estimated total population of Adama town
500, 0094 (36). In 01 Keble totals population of 61669 of which about 14500 mother and children this
information has gated to Administer of adama town Bole sub-city of Goro 01 kebele. There are fourteen
kebeles in the town. The weather condition of Adama town is 35% low land 50% kola, 15% high land .
( 35 ) Data wil collected from Oct. to May, 2018.
Regarding to Ethnicity composition, majority of the population are Oromo and the rests are Gurage,
Amhara, Silte which are fewer in number. There is 24 hours electric service to the Town.
4.2 Study Design
A community based cross sectional study wil be conducted among children under-five years of age.
4.3. Source Population
All children under-five years of age in Adama town 01 kbele will be the source population.
4.4. Sample Population
The study population wil be all under five children in selected 01 kebeles of Adama town.

9
4.5 Study Population
The study population for this study will be children under-five years of age in 01 kebele Adama town and
permanent resident of selected kebele.
4.6. Eligibility Criteria
4.6.1 Inclusion Criteria
Children under-five years of age whose mothers/caretakers are permanent residents of Adama town kebele
01 will be included.
4.6.2 Exclusion Criteria
Those under five children who are severely ill for study area.
4.7. Sampling Technique
There are 14 kebeles in Adama town. Among these we selected Goro kebele by lottery method. Then we
used systematic sampling method after preparing sample frame to select study population. If more than one
under five children were present in a given household, we included both/all in our sample frame. If mothers
were not present data collection time, we went again the next day, if no response or not voluntary to give
response we went to the next house. There were703 under five children in the selected kebele
4.8. Sampling Size Determination
There was no study that shows the prevalence of diarrhea in Adama town kebele 01. Hence, the Sample size
proportion was taken 16.4% from past study done at kerssa district, eastern Ethiopia 2015 to calculate the
sample size. So, according to the past study done at kerssa district, eastern Ethiopia 2015 report, the
prevalence of diarrhea in kerssa district is about 16.4%. Accordingly sample size would be calculated as:
n = (Zα1/2)² P (1-P)
w2
Where n= sample size
p= prevalence of diarrhea in kerssa district =16.4%
z= confidence interval at 95%
w=margin of error (5%)
So, n= 211
Since there were 703 under five children in the selected kebele, the fraction (k) is 703/223 approximately 3.
From the first 3 study units we have selected the first by lottery method which was number 2.
No = 223

10
4.9. Study Variables
4.9.1 Dependent Variables
 The dependent variable was two weeks’ prevalence of diarrheal disease
4.9.2 Independent Variables
 Socio-demographic factors like age, sex
 feeding practice
 economic status of family
 educational status
 source of water and storage
 personal hygiene and environmental sanitation

4.10. Data Collection Tool and Procedure

Structured and pretested questionnaire and observational checklist will be used to collect quantitative data.
The questionnaire will be developed after reviewing relevant literatures to the subject to include all the
possible variables that address the objective of the study. The questionnaire will be first prepared in English
and then will be translated to local language oromifa and back to English to maintain the consistency of the
contents of the instrument.
4.11 Data Quality Control
Pretest on five percent of the sample size will be conducted in the near Keble where the actual study will
not be conducted. Vague terms, phrases and questions identified during the pretest will be modified and
changed. Missing responses like "No response" and "Others" were
Added and skipping patterns will also correct. We all group members discuss in detail about how we ask
respondents and take the common understandings on the questions.
4.12 Data Analysis Plan
Data will be analyzed manually.
4.13 Operational Definition
Diarrhea –passage of three or more loose stool per 24 hours resulting excessive loss of fluid and electrolyte
Acute diarrhea –diarrhea that begins acutely and terminate in less than two weeks.
Chronic diarrhea –diarrhea that stays beyond 2 weeks not necessarily occur acutely.
Persistent diarrhea –diarrhea occurs acutely and lasts more than 2 weeks.
Feeding practice
Exclusive breast feeding- the child is fed only breast milk.
Complementary feeding–when the child starts additional food besides breast milk.
11
On family diet- the child starts to eat food prepared for the family.
Care taker- any person other than the mother who take care of the child.
Cleanliness of the compound
Good: -ground of the compound is neat, use appropriate damping method, no feces and/or animal dung and
other wastes seen in the compound, burn collected and decomposable wastes.
Fair: - if feces and other wastes are found in the compound, have pit to dispose waste, but do not burn it.
Poor: -if the compound is dirty, dispose waste on the open field, feces were there and full of wastes which
is good provides best opportunity for breeding of insects and rodents breeding and does not meet either of
criteria in good.
Cleanliness of the Water Container
Good: - if the water container is placed in clean area, inside of the container is clean, no fluid is leaking is
seen and no other opening rather than normal opening, and has cover.
Fair: -inside of the container is clean, no fluid is leaking, and no opening is seen other than normal opening,
but placed in unclean area.
Poor: -does not fulfill either of the above criteria.
Cleanliness of the latrine
Good: -well constructed, no feces seen around the hole, area is dry, does not allow housefly breeding and
ventilated well.
Fair: -fairly constructed, ventilated, but there are feces around hole and allows housefly breeding.
Poor: -does not fulfill the either of above criteria.
4.14 Ethical Consideration
Data collection starts after formal letter will be written from Rift Valley University in order to get
permission and help on process of data collection from concerned authorities and community of the study
area.
The procedure and purpose of the study will be clearly explained permission will be asked from Adama
town and selected kebele administrators with formally written letter. Oral consent will be taken from
respondents before interview. Participation is in responding the question is free. We will tell the respondents
that the responses will be kept as secrete and will not be used for other purpose except for this study. We
will give advice and refer the sick children to the near health institution. We will not take the name of either
the respondent or the child.

12
4.15 Dissemination and Utilization of Results
Study finding will be submitted to Biftu health center and, to the woreda health office of Adama town in the
form of written document. The result of the study will be put in Rift Valley University library in hard copy
and soft copy.

13
 CHAPTER FIVE
WORK PLAN

5.1 Table 1 the work plan for the entire study 2017/2018

No Activity Nov. Dec. Jan. Feb. Mar. Apri May June

l

1 Topic Selection X X

2 Preparation of proposal X X

3 Collection of useful X
material

4 Data Collection X

5 Data Analysis and writing X X X

of final research

6 Submission of research X

7 Presentation of final X
research

14
 CHAPTER SIX

BUDGET BREAK DOWN

6.1 Table 2 the budget required to complete this study

Budget for stationary

NO Items Unit Unit price Total unit No of Total price Remark
days
Birr Cents Birr Cents

1 Paper Pack 150 00 5 750 00

2 Pen No 5 50 18 99 00
3 Pencil No 2 50 6 15 00
4 Pencil eraser Pecs 3 00 6 18 00
5 Shaper Pecs 4 00 6 24 00
6 Ruler No 16 00 6 96 00
7 Stapler No 145 00 1 145 00
8 Staples Pack 5 00 2 10 00
9 Clip board No 35 00 6 210 00
10 CD-WR No 7 00 6 42 00
11 Graph paper No 12 00 1 12 00
12 Marker No 13 00 6 78 00
Sub total 1499 00
Contingency(15% of the total) =224.85
TOTAL=1723.85
13 Photo copy Page 1 00 180 180 00
14 Internet Minute 75 240 180 00
15 Telephone Card 25 00 6 150
charge
Sub total 510 00
Contingency(15%) = 76.5 Total 586.5
GRAND TOTAL= 2310.35

CHAPTER SEVEN
REFERANCE
References
1. Robert M, Bonita F, Joseph W, Nina F and Richard E. Nelson text book of pediatrics, 19 thed.New York:
Elsevier; 2014.
2. Tsinuel G, Hbtamu F, Goitom G, Asfawosen B, Mekete L, Wegen T, Solomon A, Dule B and Yezna T.
Pediatrics and child health lecture not for health science students, 2004; 219-221.

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3. Timaeus IM & Lush L. Intra urban differential in child death. 1995; 5:163-190.Prevalence of diarrheal&
Associated risk factors among under 5 years of age children in eastern Ethiopia: Open journal of preventive
medicine: 2013:3(7):446-453
4. Bern C, Martines J, Zoysa Ide &Glass RI. The magnitude of the global problem of diarrheal disease: a ten
year update. Bull. WHO. 1992;70(6):705-714
5. Tefera B, Challi J, Kebede F, Girma M, Tsegaye A and Hbtamu A. Diarrheal disease. EPHTI; Jimma
university,2011.
6. Pervez Akeber Khan.Infectious disease.Basis of pediatrics 6 thedition.Nishtor medical college, India 346-
451.
7. [email protected] media center.
8. DN. Gubta. Studies on the nature and significance of diarrhea in the rural community among children
below 5 years. National institute of cholera and enteric diseases, calculate, India.
9. child health research project, childhood disease in Sub-Saharan Africa special report ,April 1998;2(1)
10. Mock NB, Sellers TA, Abdoh AA & Franklin RR. Socioeconomic, environmental, demographic and
behavioral factors associated with the occurrence of diarrhea in young
children.Soc.Sci.Med.2013;36(6):807-8.
11. Manun'ebo MN, Haggerty PA, Kalengaie M, Ashworth A & Kirkwood BR. Influence of demographic,
socioeconomic, environmental variables on childhood diarrhea in a rural areas of
Zaire.J.Trop.Med.Hyg.1994;97(1):31-38.
12. Morris S.S, Black R.E, Tomarkovic L. Predicting the distribution of under five death by cause in countries
without adequate vital registration system . International journal of epidemiology,2010;32:1041-1051.
13. Mock NB, Sellers TA, Abdoh AA & Franklin RR. Socioeconomic, environmental, demographic and
behavioral factors associated with the occurance of diarrhea in young children. Sci.Med.1993; 36(6):807-
816.
14. Teklemariam S, Getaneh T &Bekele F. Environmental determinants of diarrhea morbidity in under five
children, keffa- sheka zone, south west Ethiopia. Ethiop, med, J, 2012;38(1):27-34.
15. Woldemichael G. Diarrheal morbidity among young children in Eritrea; Environmental and socioeconomic
determinants, J Health populNutr, 2001 Jun;19(2):83-90.
16. African demographic and health survey 1992. The prevalence of diarrheal in under five children in
Boteswana.
17. WHO. Childhood disease in Africa.fact sheet, pages 1-6 Http://www.Who.inf/inf.fs/fact log.html
18. Ketsela T. Knowledge and practice of mothers or care takers towards diarrhea and its treatment in rural
communities in Ethiopia. Ethiopian medical journal, 1991;29(4).
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19. EDHS, 2011.
20. Central Statistical Authority, Ethiopian demographic and health survey, 2011. Addis abeba and Calverton,
Maryland, USA.
21. Ali M., Asfaw T, Beyene H., Bypass P.,Hisabu MS & Pederson FK. A community based study of
childhood morbidity in Tigray, Northern Ethiopia, J Health Dev, 2001; 15(3):165-172.21.
22. Mitike G. Prevalence of acute and persistent diarrhea in north Gondar zone, Ethiopia. East Africa, med .J.
aug, 2011; 78(8):44-48.
23. Amare D, Fasil T, Belayneh G. Determinants of under five mortality in Gilgel Gibe field research center,
south west Ethiopia. Ethiopian journal of health dev't; 2007; 21(2):117.
24. Wondwossen B. A stepwise regression analysis on under five morbidity prevalence in Nekemte town,
western Ethiopia. Maternal care giving and hygiene behavioral determinants. East African journal of public
health; 2008; 5(3):193-98.
25. Getaneh T, Assefa A, Taddese z. Diarrhea morbidity in urban areas of south west Ethiopia. East African
Med.Journal; 1997:74(8):491-494.
26. Arhammare G and Habte D. Retrospective analysis AV.Innelggandepateinter vid svensk. Ethiopian born
sjukhset, A.A; 1961.
27. James F, Renato C, Salelesh A. Management of children with ARI and diarrhea in A.A, Ethiopia.
Ethiopian medical journal oct.1996;34(4):225.
28. Shamebo D, Muhe L, Sandstrom A &Wall S. The Butajira rural health project in Ethiopia: Mortality
pattern of the under fives. J. Tropical pediatrics, Oct.2011; 37:254-261.
29. Teklemariam S, Getaneh T &Bekele F. Environmental determinants of diarrhea morbidity in under five
children, keffa- sheka zone, south west Ethiopia. Ethiop, med, J, 2000; 38(1):27-34.
30. Njuguna J, Muruka C. Journal of rural and tropical public health, diarrhea and malnutrition among
children in a Kenyan district. Kenya, 2011, 10:35-38.
31. Motaregem Y, Kaferstein F, Moy G, Quevedo F. Contaminated weaning food; A major risk factor for
diarrhea and associated malnutrition. Food safety unit, WHO, Geneva, Switzerland, 1993; 71(1):79-92.
32. Bern C, Martines J, Zoysa Ide &Glass RI. The magnitude of the global problem of diarrheal disease: a ten
year update. Bull. WHO. 1992; 70(6):705-714.
33. Baltazar JC, Tiglao TV &Tempongko SB. Hygiene behavior and hospitalized severechildhood diarrhea: A
case-control study. Bulletin of WHO, 1993; 71(3/4): 323-328.
34. Genser B, Strina A, Teles CA, Prado MS, Bareto ML. Risk factors for childhood diarrheal incidence.
Dynamic analysis of longitudinal study.Institutodesudecoletiva federal university of Bahia Salvador, Brazil
bernd, [email protected]; Nov2006; 17(6):658-67.
17
35. 2009 CIA map marks Nazrēt (Adama) as an administrative (regional) capital...
36. Central Statistical Agency. 2010. Population and Housing Census 2007 Report, National. [ONLINE]
Available at: http://catalog.ihsn.org/index.php/catalog/3583/download/50086. [Accessed 10 January 2017].

Annex
RIFT VALLEY UNIVERSITY
Research Interview Questions
On
“Assess the Prevalence and Associated Factors of Diarrheal Disease in under Five Children in Adama
Town Kebele 01”
RIFT VALLEY UNIVERSITY
DEPARTMENT OF NURSING

18
 ASSESS THE PREVALENCE AND ASSOCIATED FACTORS OF DIARRHEAL DISEASE IN
UNDER FIVE CHILDREN IN ADAMA TOWN KEBELE 01.
ETHIOPIA, 2018 G.C.
Dear Respondent: Good morning/afternoon! How are you? My name is ___________________. I am a
student of Rift Valley University, Now Me and my colleagues are conducting a study on prevalence and
associated factors of under five childhood diarrhea in Adama town.
I assure you that the information that you are going to give
Will be kept in secrete. We will not take your or your child's name. Therefore, you are free to respond or not
to respond the questions. Your support and willingness in responding the questions wil be very important
for the success of this study.
Do you agree to participate in this study? Yes________ No________
If no, go to the next houses
01. House number we gave during sampling frame: _______________
02. Address_____________________
Kebele: ______ House number: ____________
03. Number of persons in the household___________
04. Number of under-five children in the household_________

I. Socio-Demographic Characteristics.
No Questions Responses Remark
Socio-demographic Characteristics
1.1 Relation of the respondent to the
child 1. Mother
2. care taker

1.2 Age of the mother/care taker

------years

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1.3 Marital status of the mother / care
taker 1. Married
2. Divorced
3. Single
4. Widowed
1.4 Religion of the mother/care taker
1. Christian
2. Muslim
3. other
1.5 Ethnic group of the mother/ care
taker 1. Oromo
2. Amahara
3. Wolayta
4. siltie
5. other(specify)
1.6 1. illiterate
Educational level of the mother/care
taker 2. primary
3. secondary
4. Greater than Grade 12
1. Housewife
1.7 Occupation of the mother/care taker 2. Government employee
3. Self employer
4. Merchant
5. Other (specify)
1.8 Age of the child's father ------ years

1.9 Educational level of the father 1 illiterate

2. primary
3. secondary
4. Greater than Grade 12
1.10 Occupation of the father 1. Government employee
2. Merchant
3. Farmer
4. No job
5. Other (specify)

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1.11 Estimated average house hold 1. > 2000
income 2. 800-1500
3. < 800
1.12 Does the family have get the source 1. Yes
of information to diahharial disease 2. No
1.13 Does the family have live stock 1. Yes
2. No
3. No response

1.14 If yes to Q113, number and type …………………………………

Part Two Environmental Hygienic Condition

2.1 Do animals live in the same house where the 1.yes
members of the family live?(observation) 2.no
2.2 Is latrine house available? 1.yes
2.no
2.3 Ownership of the latrine 1. Privately owned
2. Shared with neighbors
2.4 Cleanness of latrine(OBSERVATION) 1 good
2 fair
3 poor
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 2.5 Cleaning compound(OBSERVATION) 1 good
2 fair
3 poor
2.6 If the family has no latrine, where do you dispose 1. Open field
human wastes? 2. Other (specify

2.7 How do you dispose refuse 1. Pit

2. Open field
3. Burning
4. Garbage can
5. Other
2.8 From where do you get water for drinking? 1. Pipe
2. Protectedwell/spring
Unprotected well/spring
3. River
4. Other (specify)
2.9 Distance from the house to the water source -----meter

2.10 Type of water storage container 1. Pot

2. Plastic Jug
3. Iron bucket
4. Jerican
5. other
2.11 How did you transport the collected drinking 1. In a covered container
water to the house yesterday 2. In uncovered container
3. Other (specify
2.12 How many litters of water you use per day? _______ Litters
No use

Part Three Behavioral Aspects

3.1 Does the child take other food than breast 1. Yes
milk? 2. No
3.2 If yes to Q3.1, Do you separately prepare 1. Yes
food for the child, using a separate 2. No
material?
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 3.3 What food/fluid is the child mostly 1. Cow's milk
receiving (if the child 2. Adults' food
is not on exclusive breastfeeding 3. Powder milk
4. Gruel
5. 0ther
3.4 What do you use to feed the child 1. Hand
2. Bottle
3. Cup and spoon
4. Child feeds by himself/herself
using hand
5. Other

3.5 Does the drinking-water storage container 1. yes

have a cover? 2. no
3.6 Is there a separate can for taking drinking 1. yes
water from the storage container 2. no
3.7 How do you take water from the drinking 1. Pouring
water storage container? 2. Dipping
3.8 Do you know that flies can transmit 1. yes
diseases? 2. no
3.9 If “Yes”, can you tell me the name of the 1. Diarrhea
diseases? 2. Typhoid fever
3. Cholera
4. Trachoma
5. Do not know the names
6. Other (specify)
3.10 Do you know that excreta of children can 1. yes
transmit diseases? 2. no

3.11 If “Yes “to Q3.10, what do you do to avoid ………………………………

this problem?

Part Four Information On The Study Child

4.1 Age of the study child ……….months

4.2 Sex of the study child 1. male
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 2. female

4.3 Where was your child born? 1. Health institution

2. Home
4.4 Did the child have diarrhea in the past 1. Yes
2 weeks? 2. No
4.5 If yes for Q4.4, how many times a day 1. Three times
he/she passes stool? 2. More than three times
3. Don't know
4.6 If yes for Q4.4,for how long the 1. Less than 14 days
diarrhea lasts? 2. Greater than 14 days
4.7 Type of diarrhea that the child had 1. Watery
2. mixed with blood and mucus
4.8 What actions do you take to treat/stop 1. Take him/her to health institution
the diarrhea? 2. Take him/her to traditionalhealer
3. Increase feeding
4. Give him/her ORS
5. Give him/her cereal based fluids
6. Stop/decrease feeding
7. Homemade treatment
8. Other (specify)

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Declaration of Advisor
I, the undersigned Advisor, declare that this proposal is my original work in partial fulfillment of the
requirement for the degree of Nursing for the stated student above to our best knowledge. I confirmed that
this proposal is ready for defense with my approval as the university advisor.

Date of Submission: ___________

Advisor name________________

Signature____________________

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Declaration of Investigator
We, the under signed students of BSc Nursing, declare that this proposal is our original work in partial
fulfillment of the requirement for the degree of Nursing to our best knowledge.
 

Name of Investigator Signature Date

1. KIDIST NIGUSE _________________ __________________
2. SANI YIMER __________________ _____________
3. TIGIST BORU __________________ __________________
4. TEMAM GEMECHU __________________ _______________
5. TIGIST GEREMEW __________________ ________________
6. WUBAYEHU DILNESAW __________________ __________________

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