title: Hygiene and sanitation risk factors of diarrhoeal disease among under-five children in Ibadan, Nigeria.
abstract: BACKGROUND
  Diarrhoea diseases are among the leading causes of morbidity and mortality in under-five-children (U-5C) in Nigeria. Inadequate safe water, sanitation, and hygiene account for the disease burden. Cases of diarrhoea still occur in high proportion in the study area despite government-oriented interventions.
  
  
  OBJECTIVE
  To determine the hygiene and sanitation risk factors predisposing U-5C to diarrhoea in Ibadan, Nigeria.
  
  
  METHODS
  Two hundred and twenty pairs of children, matched on age, were recruited as cases and controls over a period of 5 months in Ibadan. Questionnaire and observation checklist were used to obtain information on hygiene practices from caregivers/mothers and sanitation conditions in the households of 30% of the consenting mothers/caregivers. Data were analysed using descriptive and inferential statistics.
  
  
  RESULTS
  Caregivers/mothers' mean ages were 31.3 ±7.5 (cases) and 30.6 ±6.0(controls) years. The risk of diarrhoea was significantly higher among children whose mothers did not wash hands with soap before food preparation (OR=3.0, p<0.05), before feeding their children (OR=3.0, p<0.05) and after leaving the toilet (OR=4.7, p<0.05). Factors significantly associated with diarrhoea were: poor water handling (OR=2.0,CI=1.2-3.5), presence of clogged drainage near the house (OR=2.1,CI=1.2-3.7) and breeding places for flies (OR=2.7,CI=1.6-4.7). The mean risk score among cases and controls from the sanitary inspection of drinking water sources were 5.4 ± 2.2 and 3.2 ± 1.9 (p<0.05) and household storage containers were 2.4 ± 1.8 and 1.2 ± 0.7 (p<0.05) respectively.
  
  
  CONCLUSIONS
  Hygiene and sanitation conditions within households were risk factors for diarrhoea. This study revealed the feasibility of developing and implementing an adequate model to establish intervention priorities in sanitation in Ibadan, Nigeria.
authors.affiliation: Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Elizabeth Omoladun
authors.initials: EO
authors.lastname: Oloruntoba
authors.affiliation: Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Taiwo Bukola
authors.initials: TB
authors.lastname: Folarin
authors.affiliation: Department of Paediatrics, University College Hospital, Ibadan, Nigeria.
authors.forename: Adejumoke Idowu
authors.initials: AI
authors.lastname: Ayede
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003153:Community Health Services; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D060766:Drinking Water; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006306:Health Surveys; D006801:Humans; D006920:Hygiene; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers; D009549:Nigeria / Q000453:epidemiology; D012307:Risk Factors; D012499:Sanitation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014881:Water Supply
chemical_list: D060766:Drinking Water
keywords: Diarrhoea; Drinking water; Hygiene Risk Factors; Sanitation; Under five children
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