Journal of Public Health International

Journal of Public Health International

Current Issue Volume No: 4 Issue No: 2

Research-article Article Open Access
  • Available online freely Peer Reviewed

  • Proportion Of WaterBorne Diseases In Children Aged 0 To 5 Years In The Health Area Of The Urban Dispensary In Ebolowa - Cameroon

    Pamela Nana 1
        M Tebeu P 1 2     Ngouakam H 1 3     I Takougang 1     H Fouedjio 1 2     J C Boukou 4     H Woromogo 1     D Nebardoum 1     A Jesse 1 2     C Mbicka 1 2     Ja Kitembo 1 2     Ja Mbongo 1 2    

    1 Interstate center in public health in Central Africa (CIESPAC) 

    2 Faculty of Medicine and biomedical sciences Yaounde, Cameroon. 

    3 University of Buea, Buea, Cameroon. 

    4 Marien Ngouabi University Brazzaville Congo. 

    Abstract

    Background

    Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject.

    Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020.

     Methodology

    This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05.

    Bold

    The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1.

     Conclusion

    We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.
    Author Contributions
    Received Jul 10, 2021     Accepted Jul 24, 2021     Published Jul 31, 2021

    Copyright© 2021 Pamela Nana, et al.
    License
    Creative Commons License   This work is licensed under a Creative Commons Attribution 4.0 International License. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Competing interests

    The authors have declared that no competing interests exist.

    Funding Interests:

    Citation:

    Pamela Nana, M Tebeu P, Ngouakam H, I Takougang, H Fouedjio et al. (2021) Proportion Of WaterBorne Diseases In Children Aged 0 To 5 Years In The Health Area Of The Urban Dispensary In Ebolowa - Cameroon Journal of Public Health International. - 4(2):16-23
    DOI 10.14302/issn.2641-4538.jphi-21-3897

    Introduction

    Introduction

    Waterborne diseases are contracted through ingestion, direct contact with contaminated water, or when water is a living environment for hosts such as larvae or parasites. Water-related diseases are very diverse and sometimes directly related to water through a host or a vector. According to the WHO, epidemics due to water contamination are usually characterized by an explosive onset. Waterborne diseases are water-related disorders of the body.

    Worldwide, "Waterborne diseases kill more than 5 million people per year. Almost 2.3 billion people suffer from water-related diseases and they account for about 60% of child mortality" (WHO, UNICEF). These diseases are observed in developing countries 1. They cause 3.4 million deaths per year, of which 2.2 million are due to diarrheal diseases, particularly cholera 2. They are the second most common cause of death among children under five years of age. In Cameroon, the lack of public drinking water distribution forces the inhabitants to resort to spring and well water. 3. Blastocysts Hominis had been identified in the municipal lake of Yaoundé in the Center by Ajaegah in 2017 4. Cameroon has 10 regions and very few recent studies in the South region which has a fairly dense hydrographic network 5. But the explanatory factors are important to detect because although more than 76% of the population (WHO 2015) uses safely managed drinking water in Cameroon these pathologies persist. In Ebolowa, the disease burden remains high; 23% of cases until 2019. Children are not the only ones affected and the incidence is alarming.

    The purpose of this study was to found out the proportion of waterborne diseases in children aged 0-5 years in the health area of the Ebolowa urban dispensary in Cameroon in 2020.

    Materials And Methods

    Materials/Methods Study Design, Setting and Population

    This was a cross-sectional analytical study with an assigned/unassigned design. The study was conducted in the Ebolowa health district in the urban dispensary health area. Ebolowa is an urban community in Cameroon. It is the regional capital of Southern Cameroon and the chief town of the Mvila department. Ebolowa has an area of 56km2,

    The Ebolowa Health District has a total population of 216,455. The study population is the urban clinic area, which represents 42,013 inhabitants went from December 28, 2020 to January 22, 2021.Target population: after calculations, the number of children aged 0 to 5 years in our study site was 2285. We included: Children aged 0 to 5 years old, in the vicinity of the study site. Children aged 0-5 years in households with parental/guardian consent; Children aged 0 to 5 years living in the health area of the urban clinic without any previous history. In Ebolowa for 6 months or more. Children with and without waterborne diseases. Exclusion criteria: If no answer, absent and unavailable

     Sample Size and Data Collection Tools

    The type of sampling was probability and cluster sampling. Households were randomly selected by neighborhood. To determine the sample size in our study, we used Kelsey's formula.

    N=2P (1-P) ((Zα/2 + Z1-β) / (Pο-P1)) ², P = (P1+P0) /2

    This sample size was calculated using the STATCALC application of Epi- Info software version 7.2.2.6. We considered safe sanitation as a determinant of waterborne diseases in children; with the hypothesis that children from the health area who are sick under 5 years of age are related to poor water quality is 50% (P0 exposed) and 33% sick children with good water quality (P1 unexposed). Power at 80% and 5% for α and 20% for β errors. N= 420. 7 Dependent variables: occurrence of a waterborne disease: (present, absent), qualitative binary. Independent variables: either qualitative or quantitative.

    Collection Tools: Data were collected from households using a four-section questionnaire after informed consent/assent.

    Collection Procedure: we conducted semi-structured interviews using a questionnaire that underwent several modifications.

    Data Analysis

    The software epiinfo7.2.2.6 was used for data analysis. Concerning statistical tests, in order to assess the relationships between the dependent and independent variables, we calculated the OR (IC95%) and P value at the 0.05 significance level. The Wald test was used, taking into account the significance level below 0.2.

     Ethical Considerations

    we have received: a research authorization issued by the deanery of CIESPAC; An ethical clearance issued by the ethics committee of CIESPAC; A research authorization issued by the regional delegate of public health of the south Authorization from the Ebolowa District Chief. The participant was asked to answer our questions after giving his consent.

    Results

    Results

    The proportion of waterborne diseases was 97% for 566 children aged 0-5 years surveyed in 420 households selected in the health area of the Ebolowa urban dispensary (Algorithm).

    According to table 1, the 50–60-months age group had a higher proportion of 32.98%. The 0–5-months age group had a lower proportion of 5.28%. The 6–16-months age group had a proportion of 15.66%. The 17-27 months age group has a proportion of 8.20%, 28-38 months 97.43%, 39-49 months 12.20%.

    Proportion of waterborne diseases by age group
    Age group (months) Waterborne diseasesN=566    
    Present Pn=549 Absent An=17 Total 
    n % n % n %
    0-5 29 5,28 4 23,53 33 5,83
    6-16 86 15,66 3 17,65 89 15,72
    17-27 141 25,68 5 29,41 146 25,80
    28-38 45 8,20 1 5,88 46 8,13
    39-49 67 12 ,20 3 17,65 70 12,37
    50-60 181 32,98 1 5,88 182 32,16

    According to table 2, the first cause of consultation for children aged 0-5 years was diarrhea (78.62%); the second was malaria (78.09%); the third was bilharzia (9.54%); the fourth was scabiosis or scabies (1.94%); The fifth cause of consultation was dysentery (0.71%); the sixth cause was typhoid fever (0.71%); the last and seventh cause was pityriasis versicolor or skin mycosis (0.35%). These are probable cases, i.e., consistent with the clinical picture.

    Proportion of each waterborne disease in the health area of the urban dispensary of the Ebolowa health district (June to December 2020) (source epi info)
      Waterborne diseases (N=566)  
    P n=549 % A n=17 %  Total  
    Diarrhea        
    Present 445 78,62 0 0,00 445 78,62
    Absent 104 18,94 17 100,0 121 21,38
    Malaria            
    Present 442 80,51 0,00 0,00 442 78,09
    Absent 107 19,49 17 100,00 124 21,91
    Shistosomiasis        
    Present 53 9,65 1 5,88 54 9,54
    Absent 496 90,35 16 94,12 512 90,46
    Scabies            
    Present 11 2,00 0 0,00 11 1,94
    Absent 538 98,00 17 100,00 555 98,06
    Dysenteria            
    Present 4 0,73 0 0,00 4 0,71
    Absent 545 99,27 17 100,00 562 99,29
    Typhoïd fever            
    Present   0,73 0 0,00 4 0,71
    Absent 545 99,27 17 100,00 562 99,29
    Pytiriasis versicolor            
    Present 2 0,36 0 0,00 2 0,35
    Absent 547 99,64 17 100,00 564 99,65

    It emerges that in Table 3, the median age of the children with these conditions was 36 months with Q1 of 24 months and Q3 of 60 months. The proportion of boys who suffered from waterborne diseases was 67.21%. On the other hand, the proportion of girls was 32.79%.

    Sociodemographic characteristics of children aged 0-5 years in the health area of the urban clinic in 2020
    Characteristics Water borne diseases (N=566) Total P value
    P(n=549) A(n=17) n %  
    Age(months)              
    Extreme age (Min, Max)   1-60 1-60  1-60
    Median age 36 (24,60) 24 (9 ;36) 36 (24 ;60) 0,007
    Gender             0,770
    Male 369 67,21 12 70,59 381 67,31  
    Female 180 32,79 5 29,41 185 32,69  

    Discussion

    Discussions Limitations of the Study

    All scientific and human work is fraught with pitfalls, and we have noted several limitations.

    Conclusion

    Conclusion

    The proportion of waterborne diseases was 97% (549/566) among the children aged 0-5 years examined. Children with water-related illnesses had a median age of 36 months (24; 60). The proportion of boys who suffered from water-related diseases was 67.21% (369/549) and that of girls was 37.79% (180/549). This calls for new strategies to combat these waterborne diseases taking these factors into account in 2021.

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