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<p>Insufficient clean water, poor sanitation, and inadequate hygiene practices (WASH) are major causes of diarrheal diseases among children under five in resource-limited areas like North Kordofan, Sudan. This study investigates the prevalence of diarrhea and its association with WASH conditions and caregivers’ practices. A cross-sectional study was conducted in 29 villages of North Kordofan during a short-term medical mission. Water quality was assessed using H<sub>2</sub>S kits, microbiological, and physicochemical analyses. Questionnaires were administered to female caregivers of 560 children under five to assess WASH practices, diarrhea prevalence, and healthcare-seeking behaviors. Statistical analysis identified factors associated with diarrhea. Among 211 water samples tested, 84.4% (n = 178) showed microbiological contamination, with 16.3% (n = 15) and 4.3% (n = 4) exceeding safe limits for nitrates and fluoride, respectively. <i>E. coli</i> contamination was found in 27.3% (n = 9) of source, 30.8% (n = 8) of distribution line, and 32.5% (n = 12) of household samples. The prevalence of diarrhea was 43.6% (n = 244). Despite 85.4% (n = 478) satisfaction with water quality, only 33.2% (186) of households followed water safety measures, with rinsing and sedimentation being common methods. Factors such as detergent use, water purification knowledge, and proper waste disposal were strongly associated with reduced diarrhea risk (p-value &lt; 0.0001). The study highlights the need for interventions to improve water quality, sanitation, and hygiene. Community education and enhanced healthcare access are essential to reduce waterborne diseases and improve child health.</p>

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Water access, sanitation, and hygiene (WASH): exploring the interplay of practices and diarrhea in children under five in North Kordofan State, Sudan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月28日

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  • Lina Hemmeda,
  • Musab Mohammed Yassin Siddig,
  • Ola Yaser Mohammed,
  • Moayad Abdelhay Mohamed Ali,
  • Mohab Hassaballah Jobartallah Mursal,
  • Muhammed Mansoor Albadawi AbdAllah,
  • Mustafa Eltayeb Abdelgadir Elsiddig,
  • Shaima Omer Mohamed Elawad,
  • Yousra Ibrahim Abdallah Mohammed,
  • Ayah Omer Suliman,
  • Hanan Adam Abdalla Hassan,
  • Maab Elfadil Ahmed Abbas,
  • Mariam Osman Elnaeir Elbashir,
  • Omer Yousif Abdelrahman Mohamed,
  • Rayan Mohamed Mahgoub Mohamed Ahmed,
  • Mohammed Haydar Awad,
  • Salma S. Alrawa,
  • Eisraa Habib Ahmed Makhtoum,
  • Reem Emadeldin Mohamed Gassim

摘要

Insufficient clean water, poor sanitation, and inadequate hygiene practices (WASH) are major causes of diarrheal diseases among children under five in resource-limited areas like North Kordofan, Sudan. This study investigates the prevalence of diarrhea and its association with WASH conditions and caregivers’ practices. A cross-sectional study was conducted in 29 villages of North Kordofan during a short-term medical mission. Water quality was assessed using H2S kits, microbiological, and physicochemical analyses. Questionnaires were administered to female caregivers of 560 children under five to assess WASH practices, diarrhea prevalence, and healthcare-seeking behaviors. Statistical analysis identified factors associated with diarrhea. Among 211 water samples tested, 84.4% (n = 178) showed microbiological contamination, with 16.3% (n = 15) and 4.3% (n = 4) exceeding safe limits for nitrates and fluoride, respectively. E. coli contamination was found in 27.3% (n = 9) of source, 30.8% (n = 8) of distribution line, and 32.5% (n = 12) of household samples. The prevalence of diarrhea was 43.6% (n = 244). Despite 85.4% (n = 478) satisfaction with water quality, only 33.2% (186) of households followed water safety measures, with rinsing and sedimentation being common methods. Factors such as detergent use, water purification knowledge, and proper waste disposal were strongly associated with reduced diarrhea risk (p-value < 0.0001). The study highlights the need for interventions to improve water quality, sanitation, and hygiene. Community education and enhanced healthcare access are essential to reduce waterborne diseases and improve child health.