A CROSS-SECTIONAL STUDY ON UNDER-FIVE DIARRHOEAL PREVALENCE AND ITS ASSOCIATED RISK FACTORS IN MATANIKO INFORMAL SETTLEMENTS, IN HONIARA, SOLOMON ISLANDS

Background:
Diarrhoea is one of the leading causes of mortality in the world for children under-five. It kills 2,195 children every day; more than AIDS, malaria and measles combined. In Solomon Islands about 1 in every 10 children die from this disease before the age of five years. Though factors associated with under-five diarrhoea are well documented elsewhere in other developing regions, this is not true in many Pacific Island Countries and Territories (PICTs), like Solomon Islands.
Objective:
To assess factors which are associated with under-five diarrhoeal prevalence in Mataniko informal settlements, in Honiara, Solomon Islands.
Methodology:
A cross-sectional survey was conducted with a total of 205 caregivers being interviewed using pre-tested survey forms. Spatial data, like under-five households, were georeferenced using GPS technology. The study settlements were randomly selected, whereas caregivers were purposely selected, based on having at least one child less than five years in their care. The raw data were then entered into IBM SPSS version 23. The data was then analyzed using descriptive statistics, followed by binary logistic regression to explore the relationship between the investigated variables. A p-value less than 0.05 was considered to be statistically significant.
Results:
Of the 205 caregivers, the response rate was 100%. Female caregivers (95.0%) were more prominent than male caregivers (5.0%), and were usually the mothers of the children. The mean ages of caregivers and children were 30.7 (±8.2SD) years and 2.6 (±1.5SD) years, respectively. This indicated a high concentration of younger caregivers and infants (≤2 years). Nearly half (41.0%) of the caregivers had more than one child (<5 years) and a majority (79.5%) were living
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in overcrowded or big household sizes. This further resulted in an average household size of 7.9 (± 2.5SD). The under-five diarrhoeal prevalence rate within 2 weeks prior to the survey was 45.9%. A number of socio-demographic risk factors including age group of children (<5 years) from 2 years and below, having at least 2 children (<5 years) per caregiver and fortnightly income less than $1,500 (SBD), were significantly associated with under-five diarrhoea (p<0.05). Furthermore, practice factors which were associated with under-five diarrhoea were found to be: irregular hand-washing, inappropriate methods of disposing faecal waste and using the river for bathing and laundry. In terms of environmental risk factors the presence of stagnant waste water, flies, solid waste and water-filled containers near households, and distance of under-five households less than 125 meters to the river, were independently associated with under-five diarrhoea (p<0.05).
Conclusion:
Under-five diarrhoea was a major public health problem in Mataniko informal settlements, in Honiara, Solomon Islands. Thus, appropriate intervention programmes targeting the associated risk factors should be designed. Further studies are needed to address other potential confounders.