Epidemiology of diarrheal disease in children under five years, Hohoe Municipality, Ghana, 2017 - 2021

Introduction: Diarrheal disease remains a major contributor to childhood morbidity and mortality in resource-constrained settings, particularly sub-Saharan Africa. Despite significant progress in prevention and management, diarrheal illness persists as a major public health problem in Ghana. We assessed a five-year pattern of diarrheal morbidity in children aged 0-59 months by examining epidemiological trends, including demographic distribution and seasonal variation in Hohoe Municipality, to guide localized interventions. Methods: A retrospective descriptive study was conducted using routinely collected outpatient surveillance data from Hohoe Municipality. The dataset recorded 13,292 diarrheal cases from January 1, 2017, to December 31, 2021 and was sourced from the District Health Information Management System II of the Ghana Health Service. The extracted data were analyzed by age, sex, and year. Descriptive statistics using percentages were computed, and temporal trends were visualized using Microsoft Excel 2018 to assess annual and seasonal fluctuations. Results: A total of 13,292 diarrheal cases from 2017 to 2021 were included in the analysis. The prevalence fluctuated between 2,015 (9.97%) and 3,586 (18.57%), peaking in 2018 and showing a resurgence in 2021. Children aged 12-59 months accounted for the largest proportion of cases, 9,556 (71.89%), followed by those aged 1-11 months (27.72%), while neonates contributed less than 2% of reported cases. Male children consistently recorded slightly higher prevalence than females. Clear seasonal peaks were observed between March and July, aligning with the early wet season. Conclusion: Diarrheal morbidity among children under five in Hohoe Municipality remained high with year-to-year fluctuations and a resurgence in 2021. Children aged 12-59 months and males recorded the highest case proportion. Clear peaks during the early wet season highlight the role of environmental factors. Strengthening surveillance systems to include pathogen-specific data will further enhance local public health response and policy planning.