An Analysis of Geospatial Patterns and Diarrhoeal Prevalence in Children Under Five: A Case Study of Matungulu and Mavoko Sub-Counties, Kenya
Abstract
Despite ongoing advancements in prevention efforts, diarrhoea remains a critical public health challenge, particularly threatening the health of infants and young children. The rising prevalence of childhood diarrhoea, especially in developing nations, has emerged as a pressing concern within public health discourse. This study examined both the prevalence and spatial distribution of diarrhoea-related illness among children under the age of five, with the goal of enhancing the monitoring and implementation of effective intervention programs. Data were collected from 398 mothers or caregivers of children under five years through a structured survey. The prevalence rate was determined by dividing the number of reported diarrhoea cases by the total number of children in the sampled households. To analyse spatial distribution patterns, the study employed spatial statistical techniques, including Moran’s I and Getis-Ord Gi*. Findings indicated a high two-week prevalence rate of childhood diarrhoea, affecting 34% of children under five in Mavoko and Matungulu Sub-Counties. Mavoko reported a higher rate at 37%, compared to 27% in Matungulu. Hotspot analysis using Moran’s I and Getis-Ord Gi* identified the western parts of Mavoko, specifically Athi River, Mlolongo, and sections of Katani and Kinanie, as areas with significantly high diarrhoea prevalence. These spatial insights highlight the need for geographically targeted interventions. The study recommends prioritising high-prevalence hotspots through improved access to safe water, expansion of sewerage systems, enhanced waste management, and strengthened hygiene promotion programs. Such targeted measures, combined with sustained surveillance and community engagement, could significantly reduce disease burden and improve child health outcomes within and beyond the study area
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Alebel, A., Tesema, C., Temesgen, B., Gebrie, A., Petrucka, P., & Kibret, G. D. (2018). Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis. In PLoS ONE (Vol. 13, Issue 6). Public Library of Science. https://doi.org/10.1371/journal.pone.0199684
Almasi, A., Zangeneh, A., Ziapour, A., Saeidi, S., Teimouri, R., Ahmadi, T., Khezeli, M., Moradi, G., Soofi, M., Salimi, Y., Rajabi-Gilan, N., Ramin Ghasemi, S., Heydarpour, F., Moghadam, S., & Yigitcanlar, T. (2022a). Investigating Global Spatial Patterns of Diarrhea-Related Mortality in Children Under Five. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.861629
Almasi, A., Zangeneh, A., Ziapour, A., Saeidi, S., Teimouri, R., Ahmadi, T., Khezeli, M., Moradi, G., Soofi, M., Salimi, Y., Rajabi-Gilan, N., Ramin Ghasemi, S., Heydarpour, F., Moghadam, S., & Yigitcanlar, T. (2022b). Investigating Global Spatial Patterns of Diarrhea-Related Mortality in Children Under Five. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.861629
Apanga, P. A., & Kumbeni, M. T. (2021). Factors associated with diarrhoea and acute respiratory infection in children under-5 years old in Ghana: an analysis of a national cross-sectional survey. BMC Pediatrics, 21(1). https://doi.org/10.1186/s12887-021-02546-x
Asfaha, K. F., Tesfamichael, F. A., Fisseha, G. K., Misgina, K. H., Weldu, M. G., Welehaweria, N. B., & Gebregiorgis, Y. S. (2018). Determinants of childhood diarrhea in Medebay Zana District, Northwest Tigray, Ethiopia: A community based unmatched case-control study. BMC Pediatrics, 18(1), 1–9. https://doi.org/10.1186/s12887-018-1098-7
Ayele, A., Awoke, W., & Tarekegn, M. (2014). Crossectional Survey; Assessment of Diarrheal Disease. Global Journal of Medical Research: F Diseases, 14(3).
Bogale, G. G., Gelaye, K. A., Degefie, D. T., & Gelaw, Y. A. (2017). Spatial patterns of childhood diarrhea in Ethiopia: Data from Ethiopian demographic and health surveys (2000, 2005, and 2011). BMC Infectious Diseases, 17(1). https://doi.org/10.1186/s12879-017-2504-8
Dmello, M. K., Badiger, S., Kumar, S., Kumar, N., D’souza, N., & Purushotam, J. (2022). Geospatial analysis and hotspots of diarrheal cases among under-five children within a rural district of Karnataka, India. Biomedicine (India), 42(3), 594–599. https://doi.org/10.51248/.v42i3.1705
Freudenberg, N., Galea, S., & Vlahov, D. (2005). Beyond urban penalty and urban sprawl: Back to living conditions as the focus of urban health. Journal of Community Health, 30(1), 1–11. https://doi.org/10.1007/s10900-004-6091-4
Ghosh, K., Chakraborty, A. S., & Mog, M. (2021). Prevalence of diarrhoea among under five children in India and its contextual determinants: A geo-spatial analysis. Clinical Epidemiology and Global Health, 12. https://doi.org/10.1016/j.cegh.2021.100813
Ghosh, K., Chakraborty, A. S., & SenGupta, S. (2023). Identifying spatial clustering of diarrhoea among children under 5 years across 707 districts in India: a cross sectional study. BMC Pediatrics, 23(1). https://doi.org/10.1186/s12887-023-04073-3
Hernández-Vásquez, A., Vargas-Fernández, R., & Turpo Cayo, E. Y. (2023). Determinants, inequalities, and spatial patterns of diarrhea in the Peruvian under-five population: findings from nationally representative survey data. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1170670
Ho, J., Retno Mahanani, W., Louise Strong Bank Group Emi Suzuki, K., Andreev, K., Bassarsky, L., Gaigbe-Togbe, V., Gerland, P., Gu, D., Hertog, S., Li, N., Spoorenberg, T., Ueffing, P., Wheldon, M., Bay, G., Cruz Castanheira, H., Alkema, L., Black, R., Hopkins, J., Guillot, M., … Young, U. (2019). Levels & Trends in Mortality Child.
Kabew, G., Mengistie, B., Mulat, W., & Sahilu, G. (2019). Risk factors for acute childhood diarrhea: A cross-sectional study comparing refugee camps and host communities in Gambella Region, Ethiopia. Travel Medicine and Infectious Disease, 31(December 2018), 101385. https://doi.org/10.1016/j.tmaid.2019.02.003 KDHS 2022. (n.d.).
Khan, M. M. H., Zanuzdana, A., Burkart, K., & Krämer, A. (2014). Determinants of Diarrhoea in “Urban” Slums of Dhaka and Adjacent Rural Areas: A Household-level Analysis. Population, Space and Place, 20(6), 498–511. https://doi.org/10.1002/psp.1777
Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2015). Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: An updated systematic analysis. The Lancet, 385(9966), 430–440. https://doi.org/10.1016/S0140-6736(14)61698-6
Manetu, W. M., M’masi, S., & Recha, C. W. (2021). Diarrhea Disease among Children under 5 Years of Age: A Global Systematic Review. Open Journal of Epidemiology, 11(03), 207–221. https://doi.org/10.4236/ojepi.2021.113018
Mueller, T. G., Pusuluri, N. B., Mathias, K. K., Cornelius, P. L., Barnhisel, R. I., & Shearer, S. A. (1996). Map Quality for Ordinary Kriging and Inverse Distance Weighted Interpolation.
Naghavi, M., Abajobir, A. A., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abera, S. F., Aboyans, V., Adetokunboh, O., Ärnlöv, J., Afshin, A., Agrawal, A., Kiadaliri, A. A., Ahmadi, A., Ahmed, M. B., Aichour, A. N., Aichour, I., Aichour, M. T. E., Aiyar, S., Al-Eyadhy, A., … Murray, C. J. L. (2017). Global, regional, and national age-sex specifc mortality for 264 causes of death, 1980-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390(10100), 1151– 1210. https://doi.org/10.1016/S0140-6736(17)32152-9
Natnael, T., Lingerew, M., & Adane, M. (2021). Prevalence of acute diarrhea and associated factors among children under five in semi-urban areas of northeastern Ethiopia. BMC Pediatrics, 21(1). https://doi.org/10.1186/s12887-021-02762-5
Nyambe, S., Agestika, L., & Yamauchi, T. (2020). The improved and the unimproved: Factors influencing sanitation and diarrhoea in a peri-urban settlement of Lusaka, Zambia. PLoS ONE, 15(5). https://doi.org/10.1371/journal.pone.0232763
Sarkar, C., & Webster, C. (2017). Urban environments and human health: current trends and future directions. In Current Opinion in Environmental Sustainability (Vol. 25, pp. 33–44). Elsevier B.V. https://doi.org/10.1016/j.cosust.2017.06.001
Tareke, A. A., Enyew, E. B., & Takele, B. A. (2022). Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis. PLoS ONE, 17(4 April). https://doi.org/10.1371/journal.pone.0264559
Troeger, C., Blacker, B., Khalil, I. A., Rao, P. C., Cao, J., Zimsen, S. R. M., Albertson, S. B., Deshpande, A., Farag, T., Abebe, Z., Adetifa, I. M. O., Adhikari, T. B., Akibu, M., Al Lami, F. H., Al-Eyadhy, A., Alvis-Guzman, N., Amare, A. T., Amoako, Y. A., Antonio, C. A. T., … Reiner, R. C. (2018). Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Infectious Diseases, 18(11), 1191– 1210. https://doi.org/10.1016/S1473-3099(18)30310-4
Troeger, C., Forouzanfar, M., Rao, P. C., Khalil, I., Brown, A., Reiner, R. C., Fullman, N., Thompson, R. L., Abajobir, A., Ahmed, M., Alemayohu, M. A., Alvis-Guzman, N., Amare, A. T., Antonio, C. A., Asayesh, H., Avokpaho, E., Awasthi, A., Bacha, U., Barac, A., Mokdad, A. H. (2017). Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet Infectious Diseases, 17(9), 909–948. https://doi.org/10.1016/S1473-3099(17)30276-1 WHO 2017. (n.d.).
World Health Organization & UNICEF. (2009). Diarrhoea: Why children are still dying and what can be done. Retrieved from https://data.unicef.org/wp-content/uploads/2021/07/Diarrhoea_why-are-children-dying_UNICEF_WHO.pdf
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