Determinants of Acute Watery Diarrhea in Children Under Five Years: A Comprehensive Analysis

Background: Acute watery diarrhea (AWD), which has a sudden onset and is associated with a risk of severe dehydration, is primarily spread through unsafe water, poor sanitation, and inadequate hygiene. Socioeconomic factors, like low parental education and poverty, further increase risks. WHO-recommended interventions, including oral rehydration therapy, zinc supplementation, and rotavirus vaccinations, have reduced diarrhea-related deaths globally. Aim of the study: This study aims to explore the socio-demographic, environmental, and behavioral factors associated with childhood watery diarrhea, particularly in high-risk regions. Methods: This prospective observational study was conducted at the Department of Pediatric, 250 Bedded General Hospital, Khulna, Bangladesh, with 210 children aged 0–60 months presenting acute watery diarrhea, enrolled over one year July 2023 to June 2024. Eligible children met specific inclusion criteria, while exclusion was applied to cases of chronic diarrhea or unrelated pre-existing conditions. Data confidentiality was maintained, with ethical approval granted. The analysis involved descriptive statistics in SPSS (version 26) for comprehensive result interpretation. Result: The study included 210 children under five, with a mean age of 14.51±5.34 months; most were aged 7-12 months (38.10%), and 54.29% were male. Caregivers were predominantly aged 28.39±4.11 years, with 73.81% having completed primary education. Key findings included high MMR vaccination rates (62.38%), significant exclusive breastfeeding for six months (58.57%), and recent diarrhea reports among 20.95% of caregivers. In terms of WASH practices, 60.48% used piped water, 57.62% stored drinking water separately, and 95.71% had toilet facilities. Notably, 67.14% used water only for handwashing, and 45.24% washed hands with soap post-toilet use. Conclusion: Safe water, sanitation, and handwashing practices are essential to reducing acute watery diarrhea in children under five. Children in households with untreated water and inconsistent caregiver handwashing face higher risks. Targeted public health initiatives to improve water treatment and hygiene could greatly reduce diarrhea incidence and improve child health outcomes.