Abstract:
Introduction: In Mkuranga district diarrhoea was among the top ten causes of morbidity and mortality among children under the age of five. Household water treatment and safe storage also known as point of use water treatment (POU) has been shown to be an effective means of reducing diarrhoea and other diseases associated with unsafe drinking water. The purpose of this study was to determine factors associated with diarrhoea with focus on Household water treatment and safe storage and microbial contamination of drinking water. Methods: A Cross sectional analytical study was conducted in Mkuranga semi-urban area in Mkuranga district Coast region of Tanzania whereby a probability sample of 400 households was obtained using a multistage sampling technique. Semi-structured questionnaires were used to collect information. Moreover drinking water samples were collected from each household for micro-bacterial analysis mainly E.Coli and Total coli forms. WHO drinking water standards were used to categorize drinking water as acceptable or not. The data were entered; cleaned and analysed using Epi Info version 3.6.11 bivariate analysis was done to determine association between variables, while logistic regression was conducted to control for confounding effects, p values are reported at 95% level. The study was approved by Muhimbili University of Health and Allied Sciences Research and Publications Committee. Results: A total of 301 children between the age of 6 months to 59 months were studied with the response rate of 95%. The mean age of study population was 2years±1.3 Standard deviation with a male to female ratio of 0.9:1. The prevalence of under five diarrhoea was 32.7%, the proportion of households that reported treating water with any method was 49.5%. Out of 301 drinking water samples tested about 37.2% were fecally contaminated with the mean E.Coli count of 2.6cfu/100ml of water (SD=±4.8cfu). Also 78% of all drinking water samples tested had total coli forms with the mean total coli form count of 69.9cfu/100ml (SD=±43.2cfu). Drinking water within unacceptable standards (Adjusted OR=20.64, 95%CI 5.84-128, p=0.00), Storing water in container without lid (Adjusted vii OR=5.4 95%CI 2.6-11.3) and lack of formal education to guardians/parents (Adjusted OR=1.9, 95%CI 1.08-3.50) increased the risk of diarrhoea. Also treating water with any method (AOR=0.49, 95% CI 0.28-0.84), treating water by boiling (Adjusted OR=0.39, 95% CI 0.2-0.7), Store water in container with lid (Adjusted OR=0.31, 95%CI 0.17-0.53) and parents washing hands with soap following house activities (AOR=0.41, 95% CI 0.24-0.84) were associated with reduced risk of diarrhoea. Conclusion: Households should be sensitized to treat their drinking water, wash hands with soap, store drinking water in containers with cover in addition adult formal education should be provided in order to reduce the under five diarrhoea in Mkuranga semi urban area.
