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Children under the age of five in low- and middle-income countries including Ethiopia experience multiple episodes of diarrhea and respiratory infection symptoms. However, there have been limited studies on comorbidities of diarrhea and respiratory infection symptoms. In addition, most studies conducted in Ethiopia seek separate outcomes for diarrhea and respiratory infection symptoms. Therefore, this study aimed to determine the prevalence of diarrhea and respiratory infection symptoms comorbidity, and associated factors among under-five children in Gondar City.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Community-based cross-sectional study was conducted in Gondar City among under-five children from April 05 \u2013 May 04, 2023. Multi-stage sampling technique was used to collect a sample of 836. A structured questionnaire was employed through an interview-administered method for data collection at participants\u2019 homes. Bivariable and multivariable binary logistic regression analyses were undertaken to identify predictors of childhood comorbidity of diarrhea and respiratory infection symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The comorbidity prevalence of diarrhea and respiratory infection symptoms in under-five children was 17.22% [CI: 14.8%-19.9%]. Mothers\/caretaker age\u2009&lt;\u200925\u00a0years (AOR\u2009=\u20093.52 at 95% CI:1.64,7.5), mothers\/caretakers who had no formal education (AOR\u2009=\u20094.42 at 95% CI: 2.08,9.9.40), family size\u2009&gt;\u20095 (AOR\u2009=\u20094.52 at 95% CI: 2.13,9.61), second birth order (AOR\u2009=\u20092.67 at 95% CI: 1.31,5.41), children playground not clean(AOR\u2009=\u20092.19 at 95% CI:1.01,4.71), started supplementary feeding at age\u2009&gt;\u20096\u00a0months (AOR\u2009=\u20094.51 at 95% CI:1.50,13.58), mothers\/caretakers who didn\u2019t wash their hands after visiting latrine (AOR\u2009=\u20092.03 at 95% CI: 1.03,4.03), mothers\/caretakers who didn\u2019t wash their hands with soap and water (AOR\u2009=\u20091.92 at 95% CI: 1.00,3.69) were significantly associated factors with under five children comorbidity of diarrhea and respiratory infection symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>According to the findings, the prevalence of diarrhea and respiratory infection symptoms comorbidity was higher and variation in the amount of comorbidity is explained by maternal and child predictors. Educating mothers\/caregivers about hand washing, sanitation, hygiene, and supplementary feeding is a key approach for the prevention and control of comorbidities in children.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13052-025-01866-3","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:49:59Z","timestamp":1740379799000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comorbidity of diarrhea and respiratory infection symptoms, and associated factors among under-five children in Gondar City, Northwest Ethiopia: a community-based cross-sectional study"],"prefix":"10.1186","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8906-0689","authenticated-orcid":false,"given":"Lidetu","family":"Demoze","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awrajaw","family":"Dessie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jember","family":"Azanaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gelila","family":"Yitageasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kidist","family":"Asrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zemichael","family":"Gizaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"issue":"2","key":"1866_CR1","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1093\/ije\/dyh335","volume":"34","author":"B Fenn","year":"2005","unstructured":"Fenn B, Morris SS, Black RE. 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BMC Pediatr. 2021;21(1):1\u20138.","journal-title":"BMC Pediatr"}],"container-title":["Italian Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13052-025-01866-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13052-025-01866-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13052-025-01866-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:50:12Z","timestamp":1740379812000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijponline.biomedcentral.com\/articles\/10.1186\/s13052-025-01866-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1866"],"URL":"https:\/\/doi.org\/10.1186\/s13052-025-01866-3","relation":{},"ISSN":["1824-7288"],"issn-type":[{"value":"1824-7288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]},"assertion":[{"value":"11 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical clearance was obtained from the Research and Institutional Review Board of the Institute of Public Health, College of Medicine and Health Science University of Gondar (reference number: IPH\/2501\/2023), the importance of the study was explained to study participants and we have informed the right to withdraw at any time during the study period. Informed consent was obtained from all the study participants of the study. All collected records were kept confidential. No personal identification such as name was collected to maintain the privacy and confidentiality of participants. Children who were found to be sick during the visits were informed to visit the nearby health Institution immediately. At all levels, officials were contacted and permission from administrators was secured.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript does not contain any individual person\u2019s data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None of the authors have any competing interests in the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"58"}}