{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T18:36:46Z","timestamp":1785091006998,"version":"3.55.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, in 2017, there were nearly 1.7 billion cases of childhood diarrheal diseases, and it is the second most important cause of morbidity and mortality among under-five children in low-income countries, including Ethiopia. Sanitary conditions, poor housing, an unsanitary environment, insufficient safe water supply, cohabitation with domestic animals that may carry human pathogens, and a lack of food storage facilities, in combination with socioeconomic and behavioral factors, are common causes of diarrhea disease and have had a significant impact on diarrhea incidence in the majority of developing countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based unmatched case-control study was conducted on 407 systematically sampled under-five children of Jimma Geneti District (135 with diarrhea and 272 without diarrhea) from May 01 to 30, 2020. Data was collected using an interview administered questionnaire and observational checklist adapted from the WHO\/UNICEF core questionnaire and other related literature. Descriptive, bivariate, and multivariate binary logistic regression analyses were done by using SPSS version 20.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Sociodemographic determinants such as being a child of 12\u201323\u2009months of age (AOR 3.3, 95% CI 1.68\u20136.46;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) and mothers\u2019\/caregivers\u2019 history of diarrheal diseases (AOR 7.38, 95% CI 3.12\u201317.44;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) were significantly associated with diarrheal diseases among under-five children. Environmental and behavioral factors such as lack of a hand-washing facility near a latrine (AOR 5.22, 95% CI 3.94\u201326.49;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), a lack of hand-washing practice at critical times (AOR 10.6, 95% CI 3.74\u201329.81;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), improper domestic solid waste disposal (AOR 2.68, 95% CI 1.39\u20135.18; P\u2009&lt;\u20090.05), and not being vaccinated against rotavirus (AOR 2.45, 95% CI 1.25\u20134.81; P\u2009&lt;\u20090,05) were found important determinants of diarrheal diseases among under-five children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The unavailability of a hand-washing facility nearby latrine, mothers\u2019\/caregivers\u2019 history of the last 2 weeks\u2019 diarrheal diseases, improper latrine utilization, lack of hand-washing practice at critical times, improper solid waste disposal practices, and rotavirus vaccination status were the determinants of diarrheal diseases among under-five children identified in this study. Thus, promoting the provision of continuous and modified health information programs for households on the importance of sanitation, personal hygiene, and vaccination against rotavirus is fundamental to decreasing the burden of diarrheal disease among under-five children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12887-021-03022-2","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T12:43:19Z","timestamp":1638276199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study"],"prefix":"10.1186","volume":"21","author":[{"given":"Dejene","family":"Mosisa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mecha","family":"Aboma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teka","family":"Girma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abera","family":"Shibru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"3022_CR1","unstructured":"UNICEF, WHO. Diarrhoea: Why children are still dying and what can be done, Unicef-WHO. New York: UNICEF\/WHO 2009. doi, 10, pp.S0140\u20136736."},{"key":"3022_CR2","unstructured":"Peterson KM, Diedrich E, Lavigne J. Strategies for Combating Waterborne Diarrheal Diseases in the Developing World. 2008."},{"issue":"4","key":"3022_CR3","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1136\/archdischild-2011-301191","volume":"97","author":"M Chopra","year":"2012","unstructured":"Chopra M, Binkin NJ, Mason E, Wolfheim C. Integrated management of childhood illness: what have we learned and how can it be improved? Arch Dis Child. 2012;97(4):350\u20134.","journal-title":"Arch Dis Child"},{"key":"3022_CR4","volume-title":"Diarrhoeal disease","author":"WHO","year":"2017","unstructured":"WHO, Diarrhoeal disease. 2017."},{"key":"3022_CR5","volume-title":"Diarrhoeal disease","author":"UNICEF","year":"2018","unstructured":"UNICEF, Diarrhoeal disease. 2018."},{"key":"3022_CR6","unstructured":"World Health Organization. Progress on drinking water, sanitation and hygiene: 2017 update and SDG baselines. 2017."},{"key":"3022_CR7","doi-asserted-by":"publisher","first-page":"109","DOI":"10.11604\/pamj.2017.28.109.8152","volume":"28","author":"MD Dairo","year":"2017","unstructured":"Dairo MD, Ibrahim TF, Salawu AT. Prevalence and determinants of diarrhoea among infants in selected primary health centres in kaduna north local government area, nigeria. Pan Afr Med J. 2017;28:109 PubMed| Google Scholar.","journal-title":"Pan Afr Med J"},{"issue":"1","key":"3022_CR8","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s13690-015-0090-z","volume":"73","author":"M Azage","year":"2015","unstructured":"Azage M, Haile D. Factors associated with safe child feces disposal practices in Ethiopia: evidence from demographic and health survey. Arch Public Health. 2015;73(1):40.","journal-title":"Arch Public Health"},{"issue":"9875","key":"3022_CR9","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1016\/S0140-6736(13)60222-6","volume":"381","author":"CLF Walker","year":"2013","unstructured":"Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405\u201316.","journal-title":"Lancet"},{"key":"3022_CR10","unstructured":"Csa I. Central statistical agency (CSA)[Ethiopia] and ICF. Ethiopia demographic and health survey, Addis Ababa, Ethiopia and Calverton, Maryland, USA. 2016."},{"issue":"1","key":"3022_CR11","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s12887-020-02138-1","volume":"20","author":"AA Fenta","year":"2020","unstructured":"Fenta AA. Kassahun Angaw, Dessie Abebaw, prevalence and associated factors of acute diarrhea among under-five children in Kamashi district, western Ethiopia: community-based study. BMC Pediatr. 2020;20(1):236.","journal-title":"BMC Pediatr"},{"key":"3022_CR12","volume-title":"Ethiopia Demographic and Health Survey 2016","author":"Central Statistical Agency (CSA) [Ethiopia] and ICF","year":"2016","unstructured":"Central Statistical Agency (CSA) [Ethiopia] and ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, E., and Rockville, Maryland, USA: CSA and ICF; 2016."},{"key":"3022_CR13","doi-asserted-by":"publisher","unstructured":"Girma M, Gobena T, Medhin G, Gasana J, Roba KT. Determinants of childhood diarrhea in West Gojjam, Northwest Ethiopia: a case control study. Pan Afr Med J. 2018;30:234. https:\/\/doi.org\/10.11604\/pamj.2018.30.234.14109. PMID: 30574253; PMCID: PMC6295292.","DOI":"10.11604\/pamj.2018.30.234.14109"},{"issue":"2","key":"3022_CR14","first-page":"29","volume":"2","author":"H Brhanu","year":"2017","unstructured":"Brhanu H, Negese D, Gebrehiwot M. Determinants of acute diarrheal disease among under-five children in pawi hospital, Northwest Ethiopia. Am J Pediatr. 2017;2(2):29\u201336.","journal-title":"Am J Pediatr"},{"key":"3022_CR15","unstructured":"Jimma Geneti district health office first-quarter performance work report. 2019\/2020."},{"issue":"2","key":"3022_CR16","first-page":"78","volume":"26","author":"M Tarekegn","year":"2012","unstructured":"Tarekegn M, Enquselassie F. A case control study on determinants of diarrheal morbidity among under-five children in Wolaita Soddo town, southern Ethiopia. Ethiop J Health Dev. 2012;26(2):78\u201385.","journal-title":"Ethiop J Health Dev"},{"key":"3022_CR17","doi-asserted-by":"crossref","unstructured":"Ayalew AM, Mekonnen WT, Abaya SW, Mekonnen ZA. Assessment of diarrhea and its associated factors in under-five children among open defecation and open defecation-free rural settings of Dangla District, Northwest Ethiopia. J Environ Public Health. 2018;2018.","DOI":"10.1155\/2018\/4271915"},{"key":"3022_CR18","volume-title":"Core questions on drinking water and sanitation for household surveys","author":"WHO\/UNICEF","year":"2006","unstructured":"WHO\/UNICEF. Core questions on drinking water and sanitation for household surveys. 2006."},{"key":"3022_CR19","unstructured":"Jimma Geneti agricultural and natural resource office annual work report. report. 2019."},{"issue":"1","key":"3022_CR20","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1186\/s12887-018-1098-7","volume":"18","author":"KF Asfaha","year":"2018","unstructured":"Asfaha KF, Tesfamichael FA, Fisseha GK, Misgina KH, Weldu MG, Welehaweria NB, et al. Determinants of childhood diarrhea in Medebay Zana District, Northwest Tigray, and Ethiopia: a community based unmatched case\u2013control study. BMC Pediatr. 2018;18(1):120.","journal-title":"BMC Pediatr"},{"key":"3022_CR21","first-page":"324","volume":"16","author":"S Megersa","year":"2019","unstructured":"Megersa S, Benti T, Sahiledengle B. Prevalence of diarrhea and its associated factors among under-five children in open defecation free and non-open defecation free households in Goba District Southeast Ethiopia: a comparative cross-sectional study. Clin Mother Child Health. 2019;16:324.","journal-title":"Clin Mother Child Health"},{"issue":"1","key":"3022_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12887-020-02141-6","volume":"20","author":"MM Ferede","year":"2020","unstructured":"Ferede MM. Socio-demographic, environmental and behavioural risk factors of diarrhoea among under-five children in rural Ethiopia: further analysis of the 2016 Ethiopian demographic and health survey. BMC Pediatr. 2020;20(1):1\u20139.","journal-title":"BMC Pediatr"},{"issue":"1","key":"3022_CR23","first-page":"31","volume":"26","author":"N Rohmawati","year":"2012","unstructured":"Rohmawati N, Panza A, Lertmaharit S. Factors associated with diarrhea among children under five years of age in Banten Province, Indonesia. J Health Res. 2012;26(1):31\u20134.","journal-title":"J Health Res"},{"issue":"2","key":"3022_CR24","first-page":"E93","volume":"60","author":"A Edward","year":"2019","unstructured":"Edward A, Jung Y, Chhorvann C, Ghee AE, Chege J. Association of mother's handwashing practices and pediatric diarrhea: evidence from a multi-country study on community oriented interventions. BMC Public Health. 2019;60(2):E93\u2013e102.","journal-title":"BMC Public Health"},{"key":"3022_CR25","doi-asserted-by":"publisher","first-page":"109","DOI":"10.2147\/PHMT.S159366","volume":"9","author":"MZ Degebasa","year":"2018","unstructured":"Degebasa MZ, Weldemichael DZ, Marama MT. Diarrheal status and associated factors in under five years old children in relation to implemented and unimplemented community-led total sanitation and hygiene in Yaya Gulele in 2017. Pediatric Health Med Ther. 2018;9:109.","journal-title":"Pediatric Health Med Ther"},{"issue":"1","key":"3022_CR26","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1186\/s12879-019-4445-x","volume":"19","author":"GY Workie","year":"2019","unstructured":"Workie GY, Akalu TY, Baraki AG. Environmental factors affecting childhood diarrheal disease among under-five children in Jamma district, south Wello zone, Northeast Ethiopia. BMC Infect Dis. 2019;19(1):804.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"3022_CR27","first-page":"26","volume":"2","author":"B Getachew","year":"2018","unstructured":"Getachew B, Mengistie B, Mesfin F, Argaw R. Factors associated with acute diarrhea among children aged 0-59 months in Harar town, eastern Ethiopia. East Afr J Health Biomed Sci. 2018;2(1):26\u201335.","journal-title":"East Afr J Health Biomed Sci"},{"issue":"1","key":"3022_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5923\/j.food.20190901.01","volume":"9","author":"DM Reuben Mutama","year":"2019","unstructured":"Reuben Mutama DM, Wakibia J. Risk factors associated with diarrhea disease among children under-five years of age in Kawangware slum in Nairobi County, Kenya. Food and Public Health. 2019;9(1):1\u20136.","journal-title":"Food and Public Health"},{"issue":"2","key":"3022_CR29","doi-asserted-by":"publisher","first-page":"9","DOI":"10.14302\/issn.2641-4538.jphi-18-2470","volume":"1","author":"SG Beyene","year":"2018","unstructured":"Beyene SG, Melku AT. Prevalence of diarrhea and associated factors among under five years children in Harena Buluk Woreda Oromia region, south East Ethiopia, 2018. J Public Health Int. 2018;1(2):9.","journal-title":"J Public Health Int"},{"issue":"6","key":"3022_CR30","doi-asserted-by":"publisher","first-page":"581","DOI":"10.4314\/ejhs.v26i6.12","volume":"26","author":"W Regassa","year":"2016","unstructured":"Regassa W, Lemma S. Assessment of diarrheal disease prevalence and associated risk factors in children of 6-59 months old at Adama District rural Kebeles, eastern Ethiopia, and January\/2015. Ethiop J Health Sci. 2016;26(6):581\u20138.","journal-title":"Ethiop J Health Sci"},{"issue":"3","key":"3022_CR31","doi-asserted-by":"publisher","first-page":"228","DOI":"10.21276\/apjhs.2017.4.3.34","volume":"4","author":"C Musonda","year":"2017","unstructured":"Musonda C, Siziya S, Kwangu M, Mulenga D. Factors associated with diarrheal diseases in under-five children: a case control study at arthur davison children\u2019s hospital in Ndola. Zambia Asian Pac J Health Sci. 2017;4(3):228\u201334.","journal-title":"Zambia. Asian Pac J Health Sci."},{"issue":"1","key":"3022_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-020-4905-3","volume":"20","author":"S Shine","year":"2020","unstructured":"Shine S, Muhamud S, Adanew S, Demelash A, Abate M. Prevalence and associated factors of diarrhea among under-five children in Debre Berhan town, Ethiopia 2018: a cross sectional study. BMC Infect Dis. 2020;20(1):1\u20136.","journal-title":"BMC Infect Dis"},{"key":"3022_CR33","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s40985-018-0107-6","volume":"39","author":"G Shumetie","year":"2018","unstructured":"Shumetie G, Gedefaw M, Kebede A, Derso T. Exclusive breastfeeding and rotavirus vaccination are associated with decreased diarrheal morbidity among under-five children in Bahir Dar, Northwest Ethiopia. Public Health Rev. 2018;39:28.","journal-title":"Public Health Rev"},{"key":"3022_CR34","doi-asserted-by":"publisher","unstructured":"Ayuk TB, Carine NE, Ashu NJ, et al. Prevalence of diarrhoea and associated risk factors among children under-five years of age in Efoulan health district- Cameroon, sub-Saharan Africa. MOJ Public Health. 2018;7(6):259\u201364. https:\/\/doi.org\/10.15406\/mojph.2018.07.00248.","DOI":"10.15406\/mojph.2018.07.00248"},{"issue":"7","key":"3022_CR35","doi-asserted-by":"publisher","first-page":"e0158862","DOI":"10.1371\/journal.pone.0158862","volume":"11","author":"RV Randremanana","year":"2016","unstructured":"Randremanana RV, Razafindratsimandresy R, Andriatahina T, Randriamanantena A, Ravelomanana L, Randrianirina F, et al. Etiologies, risk factors and impact of severe diarrhea in the under-fives in Moramanga and Antananarivo, Madagascar. PLoS One. 2016;11(7):e0158862.","journal-title":"PLoS One"},{"issue":"8","key":"3022_CR36","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1586\/14760584.2015.1059282","volume":"14","author":"M O\u2019Ryan","year":"2015","unstructured":"O\u2019Ryan M, Giaquinto C, Benninghoff B. Human rotavirus vaccine (Rotarix): focus on effectiveness and impact 6 years after first introduction in Africa. Expert Rev Vaccines. 2015;14(8):1099\u2013112.","journal-title":"Expert Rev Vaccines"},{"issue":"1","key":"3022_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.21149\/9943","volume":"62","author":"UD Parashar","year":"2020","unstructured":"Parashar UD, Tate JE. The control of diarrhea, the case of a rotavirus vaccine. Salud P\u00fablica De M\u00e9xico. 2020;62(1):1\u20135.","journal-title":"Salud P\u00fablica De M\u00e9xico"}],"container-title":["BMC Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-03022-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12887-021-03022-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12887-021-03022-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T12:43:34Z","timestamp":1638276214000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-021-03022-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,30]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3022"],"URL":"https:\/\/doi.org\/10.1186\/s12887-021-03022-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-267187\/v1","asserted-by":"object"}]},"ISSN":["1471-2431"],"issn-type":[{"value":"1471-2431","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,30]]},"assertion":[{"value":"22 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical clearance was obtained from the Ethical Review Board of Ambo University College of Medicine and Health Sciences, with the Ref. No of PGC\/18\/2020. Hierarchically, all administrative bodies were communicated and permission was secured. Written informed consent was obtained from the parent\/legal guardian for study subjects after explaining the objectives and procedures of the study and their right to participate or to withdraw at any time of the interview. The Research and Ethical Review Committee also approved its ethical issues as there was no procedure that affects the study subject and the data is used only for research purposes. For this purpose, a one-page consent letter was attached to the cover page of each questionnaire stating the general purpose of the study and issues of confidentiality, which were discussed by data collectors before proceeding to the interview. Parent\/legal guardian who was found that their children are sick during the study time; they were consulted about the causes of the disease and refer her\/him to a health facility nearby. Lastly, we confirm that this study was conducted in accordance with the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"532"}}