Environmental risk factors associated with community diarrheal disease in Ethiopia

Background: Diarrhea is a major contributor to mortality in sub-Saharan Africa, where access to improved sanitation and clean water is limited. Identifying factors associated with diarrhea across geographical regions and age groups can inform resource allocation toward water infrastructure, healthca...

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Main Authors: LaPolt, D., Smith, S., Gazu, Lina, Alonso, Silvia, Teshale, A.M., Azmeraye, B.M., Ayana, G.M., Angaw, D.A., Degefaw, D., Garsow, A.V., Beczkiewicz, A., Yimer, G., Krakowski, M.J., Scharff, R., Seyoum, E.T., Kowalcyk, B.
Format: Journal Article
Language:Inglés
Published: BioMed Central 2025
Subjects:
Online Access:https://hdl.handle.net/10568/174847
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author LaPolt, D.
Smith, S.
Gazu, Lina
Alonso, Silvia
Teshale, A.M.
Azmeraye, B.M.
Ayana, G.M.
Angaw, D.A.
Degefaw, D.
Garsow, A.V.
Beczkiewicz, A.
Yimer, G.
Krakowski, M.J.
Scharff, R.
Seyoum, E.T.
Kowalcyk, B.
author_browse Alonso, Silvia
Angaw, D.A.
Ayana, G.M.
Azmeraye, B.M.
Beczkiewicz, A.
Degefaw, D.
Garsow, A.V.
Gazu, Lina
Kowalcyk, B.
Krakowski, M.J.
LaPolt, D.
Scharff, R.
Seyoum, E.T.
Smith, S.
Teshale, A.M.
Yimer, G.
author_facet LaPolt, D.
Smith, S.
Gazu, Lina
Alonso, Silvia
Teshale, A.M.
Azmeraye, B.M.
Ayana, G.M.
Angaw, D.A.
Degefaw, D.
Garsow, A.V.
Beczkiewicz, A.
Yimer, G.
Krakowski, M.J.
Scharff, R.
Seyoum, E.T.
Kowalcyk, B.
author_sort LaPolt, D.
collection Repository of Agricultural Research Outputs (CGSpace)
description Background: Diarrhea is a major contributor to mortality in sub-Saharan Africa, where access to improved sanitation and clean water is limited. Identifying factors associated with diarrhea across geographical regions and age groups can inform resource allocation toward water infrastructure, healthcare, and disease mitigation. The objective of this study was to identify environmental risk factors associated with diarrhea in the general population across multiple communities in Ethiopia. Methods: A prospective cross-sectional study was conducted in three regions in Ethiopia from October 2021-October 2022. REDCAP mobile app was used to collect data during face-to-face interviews using a structured, pretested questionnaire. Descriptive statistics characterized household environmental exposures. Univariate and multivariable logistic regression were used to identify factors associated with diarrhea. Results: A total of 2,436 households participated in the study. Of these, 10.3% of households reported at least one case of diarrhea during the previous four weeks. Household animal ownership varied by site, with Addis Ababa reporting the lowest animal ownership and Harar reporting the highest ownership. Across all sites, pit latrines without covers were the most common sanitation facility. Water piped to yard was the most frequent source of drinking water and most households did not use treated water (boiled/filtered) when handling food. No environmental factors were associated with diarrhea in Addis Ababa. In Gondar, drinking water from unprotected wells was associated with increased odds of diarrhea [COR:4.81(95%CI:2.03,11.43)]. Dry season was associated with decreased odds of diarrhea compared to short [COR:0.42(95%CI:0.24,0.75)] and long rains seasons [COR:0.55(95%CI: 0.34,0.88)]. In Harar, drinking water from communal taps was associated with increased odds of diarrhea [COR:2.02(95%CI:1.32,3.09)]. Conclusion: Multiple environmental factors for diarrhea were identified. Given the variation in factors by site, strategies for intervention and management should be community-specific. These factors can be managed through improved water treatment, sanitation practices, and educational programs focused on proper hygiene. Efforts to manage these factors can potentially reduce the burden of diarrheal diseases.
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spelling CGSpace1748472025-10-26T12:52:59Z Environmental risk factors associated with community diarrheal disease in Ethiopia LaPolt, D. Smith, S. Gazu, Lina Alonso, Silvia Teshale, A.M. Azmeraye, B.M. Ayana, G.M. Angaw, D.A. Degefaw, D. Garsow, A.V. Beczkiewicz, A. Yimer, G. Krakowski, M.J. Scharff, R. Seyoum, E.T. Kowalcyk, B. diarrhoea environment health Background: Diarrhea is a major contributor to mortality in sub-Saharan Africa, where access to improved sanitation and clean water is limited. Identifying factors associated with diarrhea across geographical regions and age groups can inform resource allocation toward water infrastructure, healthcare, and disease mitigation. The objective of this study was to identify environmental risk factors associated with diarrhea in the general population across multiple communities in Ethiopia. Methods: A prospective cross-sectional study was conducted in three regions in Ethiopia from October 2021-October 2022. REDCAP mobile app was used to collect data during face-to-face interviews using a structured, pretested questionnaire. Descriptive statistics characterized household environmental exposures. Univariate and multivariable logistic regression were used to identify factors associated with diarrhea. Results: A total of 2,436 households participated in the study. Of these, 10.3% of households reported at least one case of diarrhea during the previous four weeks. Household animal ownership varied by site, with Addis Ababa reporting the lowest animal ownership and Harar reporting the highest ownership. Across all sites, pit latrines without covers were the most common sanitation facility. Water piped to yard was the most frequent source of drinking water and most households did not use treated water (boiled/filtered) when handling food. No environmental factors were associated with diarrhea in Addis Ababa. In Gondar, drinking water from unprotected wells was associated with increased odds of diarrhea [COR:4.81(95%CI:2.03,11.43)]. Dry season was associated with decreased odds of diarrhea compared to short [COR:0.42(95%CI:0.24,0.75)] and long rains seasons [COR:0.55(95%CI: 0.34,0.88)]. In Harar, drinking water from communal taps was associated with increased odds of diarrhea [COR:2.02(95%CI:1.32,3.09)]. Conclusion: Multiple environmental factors for diarrhea were identified. Given the variation in factors by site, strategies for intervention and management should be community-specific. These factors can be managed through improved water treatment, sanitation practices, and educational programs focused on proper hygiene. Efforts to manage these factors can potentially reduce the burden of diarrheal diseases. 2025-05-27 2025-05-27T18:30:52Z 2025-05-27T18:30:52Z Journal Article https://hdl.handle.net/10568/174847 en Open Access BioMed Central LaPolt, D., Smith, S., Gazu, L., Alonso, S., Teshale, A.M., Azmeraye, B.M., Ayana, G.M., Angaw, D.A., Degefaw, D., Garsow, A.V., Beczkiewicz, A., Yimer, G., Krakowski, M.J., Scharff, R., Seyoum, E.T. and Kowalcyk, B. 2025. Environmental risk factors associated with community diarrheal disease in Ethiopia. BMC Public Health 25: 1959.
spellingShingle diarrhoea
environment
health
LaPolt, D.
Smith, S.
Gazu, Lina
Alonso, Silvia
Teshale, A.M.
Azmeraye, B.M.
Ayana, G.M.
Angaw, D.A.
Degefaw, D.
Garsow, A.V.
Beczkiewicz, A.
Yimer, G.
Krakowski, M.J.
Scharff, R.
Seyoum, E.T.
Kowalcyk, B.
Environmental risk factors associated with community diarrheal disease in Ethiopia
title Environmental risk factors associated with community diarrheal disease in Ethiopia
title_full Environmental risk factors associated with community diarrheal disease in Ethiopia
title_fullStr Environmental risk factors associated with community diarrheal disease in Ethiopia
title_full_unstemmed Environmental risk factors associated with community diarrheal disease in Ethiopia
title_short Environmental risk factors associated with community diarrheal disease in Ethiopia
title_sort environmental risk factors associated with community diarrheal disease in ethiopia
topic diarrhoea
environment
health
url https://hdl.handle.net/10568/174847
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