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Background <p>Diarrheal diseases remain a leading cause of morbidity and mortality among children under five years in low- and middle-income countries. In Rwanda, despite improvements in water, sanitation, and child health services, diarrhea continues to pose a significant public health challenge, particularly at the district level where context-specific determinants are not well understood. This study aimed to assess the prevalence and determinants of diarrhea among children under five years in Musanze District, Rwanda.</p> Methods <p>A facility-based cross-sectional study was conducted among 206 mothers or caregivers of children under five years attending Ruhengeri Referral Hospital and 17 health centers in Musanze District. Participants were selected using a two-stage cluster sampling technique with proportional allocation and systematic sampling. Data were collected using a structured, interviewer-administered questionnaire. Descriptive statistics were used to summarize participant characteristics. Associations were assessed using chi-square tests, and multivariate logistic regression was performed to identify independent predictors of diarrhea. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at <i>p</i> &lt; 0.05.</p> Results <p>The prevalence of diarrhea among children under five was found to be 20.4%. In multivariate analysis, children aged 13–24 months were less likely to experience diarrhea compared to those aged 1–12 months (AOR = 0.38; 95% CI: 0.16–0.92). Urban residence (AOR = 0.44; 95% CI: 0.20–0.97) and maternal education (AOR = 0.35; 95% CI: 0.15–0.78) were protective factors. Larger household size (≥ 5 members) increased the odds of diarrhea (AOR = 2.76; 95% CI: 1.25–6.09). Environmental factors significantly associated with higher odds included presence of feces around the household (AOR = 3.12; 95% CI: 1.37–7.09) and near pit latrines (AOR = 2.88; 95% CI: 1.25–6.63). Protective factors included water treatment practices (AOR = 0.34; 95% CI: 0.14–0.80), private latrine ownership (AOR = 0.31; 95% CI: 0.12–0.79), and higher socioeconomic status (AOR = 0.29; 95% CI: 0.09–0.88).</p> Conclusions <p>The prevalence of diarrhea among children under five in Musanze District remains high. Both socioeconomic and environmental factors significantly influence diarrhea occurrence. Interventions focusing on improving household sanitation, promoting water treatment, and enhancing maternal education are essential to reduce the burden of diarrheal diseases in this setting.</p>

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Prevalence and determinants of diarrhea among children under five in Musanze District, Rwanda

  • 期刊论文

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  • 发表日期：

    2026年7月29日

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  • Jean Baptiste Niyombabazi,
  • Viateur Hategekimana,
  • Simeon Sibomana,
  • Aimable Nkurunziza,
  • Francois Xavier Ndayambaje,
  • Sylvestre Gasurira,
  • Francine Nyirangorore

摘要

Background

Diarrheal diseases remain a leading cause of morbidity and mortality among children under five years in low- and middle-income countries. In Rwanda, despite improvements in water, sanitation, and child health services, diarrhea continues to pose a significant public health challenge, particularly at the district level where context-specific determinants are not well understood. This study aimed to assess the prevalence and determinants of diarrhea among children under five years in Musanze District, Rwanda.

Methods

A facility-based cross-sectional study was conducted among 206 mothers or caregivers of children under five years attending Ruhengeri Referral Hospital and 17 health centers in Musanze District. Participants were selected using a two-stage cluster sampling technique with proportional allocation and systematic sampling. Data were collected using a structured, interviewer-administered questionnaire. Descriptive statistics were used to summarize participant characteristics. Associations were assessed using chi-square tests, and multivariate logistic regression was performed to identify independent predictors of diarrhea. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, with statistical significance set at p < 0.05.

Results

The prevalence of diarrhea among children under five was found to be 20.4%. In multivariate analysis, children aged 13–24 months were less likely to experience diarrhea compared to those aged 1–12 months (AOR = 0.38; 95% CI: 0.16–0.92). Urban residence (AOR = 0.44; 95% CI: 0.20–0.97) and maternal education (AOR = 0.35; 95% CI: 0.15–0.78) were protective factors. Larger household size (≥ 5 members) increased the odds of diarrhea (AOR = 2.76; 95% CI: 1.25–6.09). Environmental factors significantly associated with higher odds included presence of feces around the household (AOR = 3.12; 95% CI: 1.37–7.09) and near pit latrines (AOR = 2.88; 95% CI: 1.25–6.63). Protective factors included water treatment practices (AOR = 0.34; 95% CI: 0.14–0.80), private latrine ownership (AOR = 0.31; 95% CI: 0.12–0.79), and higher socioeconomic status (AOR = 0.29; 95% CI: 0.09–0.88).

Conclusions

The prevalence of diarrhea among children under five in Musanze District remains high. Both socioeconomic and environmental factors significantly influence diarrhea occurrence. Interventions focusing on improving household sanitation, promoting water treatment, and enhancing maternal education are essential to reduce the burden of diarrheal diseases in this setting.