Burden of Childhood Diarrhea and Knowledge of Management Strategies Among Caregivers in Rural and Urban Areas of Rivers State, Nigeria

Diarrhea remains a major cause of morbidity and mortality, especially among children in low-resource settings such as Nigeria. This study assessed the prevalence of childhood diarrhea and caregivers’ knowledge of its management in urban and rural communities of Rivers State, Nigeria. A cross-sectional study was conducted using structured questionnaires administered to caregivers. Diarrhea prevalence and knowledge levels were estimated in rural and urban settings. Statistical analyses, such as percentages for prevalence, Chi-square tests for association, and binary logistic regression to identify the predictors of poor knowledge management strategies. All statistical significance was set at P<0.05. Diarrhea prevalence was significantly higher in rural areas (60.7%; 95% CI: 53.1%-67.9%) compared to urban areas (38.8%; 95% CI: 33.0%-45.0%). Knowledge levels also differed markedly: rural caregivers (n = 163) had a mean knowledge score of 10.15 ± 4.402, with 64.4% classified as having poor knowledge, while urban caregivers (n = 250) achieved a higher mean score of 14.92 ± 4.669, with 76.0% demonstrating good knowledge. The difference was statistically significant (t = -7.43, p < 0.001). Urban caregivers had better access to healthcare services, improved water sources, and higher education levels, which contributed to more effective diarrhea management practices, including greater uptake of exclusive breastfeeding (54.8% vs. 28.2% in rural areas). Key predictors of poor knowledge included young age, low income, limited education, lack of exclusive breastfeeding, and use of unimproved water sources. Surprisingly, urban caregivers using improved water sources were more likely to have poor knowledge, possibly due to false perceptions of safety. Significant disparities in diarrhea prevalence and caregiver knowledge exist between urban and rural areas. Targeted health education and improved rural infrastructure are critical to reducing this burden.