ABSTRACT
Introduction: Globally diarrhoea kills 2,195 women every day—more than AIDS, malaria, and measles combined. The average woman in developing countries experiences three or more episodes of diarrheal disease each year, accounting for up to 4 billion cases annually.
Objective: To assess the prevalence and associated factors of diarrhea among women under the age of 50 years attending Gwagwalada Specialist Hospital (GSH).
Method: A descriptive questionnaire-based cross-sectional study design was used that involved 135 females with the diagnosis of diarrhea.
Results: The prevalence of diarrhea among females was 7.45%. The significant factors were age, and breastfeeding history of the female. Others were number of women, number of women below the age of 50, education and occupation status of the mother, water and sanitation. The age of the mother was found to be insignificant.
Conclusion: The prevalence of diarrhea in females was 7.45%, a value lower than previous statistics with evidence of a significant decline in diarrhea-related hospitalizations and death. Environmental factors included unsafe, unprotected drinking water sources and poor treatment measures for drinking water. The age of the mother was found to have no statistically significant association.
CHAPTER ONE:
INTRODUCTION
1.1 BACKGROUND OF STUDY
Globally diarrhea kills 2,195 women every day—more than AIDS, malaria, and measles combined. That is like losing nearly 32 school buses full of women each day! 1 in 9 woman deaths are due to diarrhea, making 801, 000 woman deaths from diarrhea every year. This makes diarrhea the second leading cause of death among the females. For women with HIV, diarrhea is even more deadly; the death rate for these women is 11 times higher than the rate for women without HIV (CDC, 2012).
Diarrhea causes death through depletion of body fluids resulting in profound dehydration and electrolyte imbalances. It can have a detrimental impact on womanhood growth and cognitive development. More than 80% of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and insufficient hygiene.
According to the CDC, rotavirus is the leading cause of acute diarrhea and causes about 40% of hospitalizations for diarrhea in women under 5. Most diarrheal germs are spread from the stool of one person to the mouth of another. These germs are usually spread through contaminated water, food, or objects which become contaminated with stool in many ways including people and animals defecate in or near water sources that people drink, contaminated water is used to irrigate crops, food handlers do not wash their hands before cooking, people with contaminated hands touch objects, such as doorknobs, tools, or cooking utensils etc.
Strides made over the last 20 years have shown that, in addition to rotavirus vaccination and breastfeeding, diarrhea prevention focused on safe water and improved hygiene and sanitation is not only possible, but cost eective: every $1 invested yields an average return of $25.50 (CDC, 2012).
The incidence of diarrhea is higher among the females particularly in low income-countries (LICs), then followed by middle-income countries (MICs) and then least in high-income countries (HICs). Even though the variation is not that substantial, the case fatality ratios are. The top killers among the females are infectious diseases, especially pneumonia, diarrhea, and malaria (Black et al., 2010)(Liu et al., 2012).
In the year 2010, there were about 1.73 billion cases of diarrheal disease and 2% of episodes progressed to severe disease(Fischer Walker et al., 2013). Of 7.6 million deaths in the females in 2010, 64% (4.879 million) could be attributed to infections and 10.5% were due to by diarrhea (Liu et al., 2012). The largest proportion of these womanhood deaths are in Sub-Saharan Africa where half of the deaths are from diarrhea. Among all women females, deaths as a result of diarrhea decreased by 4% per year as from 2000 – 2010 (Liu et al., 2012).
Despite this positive trend seen globally resulting from socioeconomic development and implementation of woman survival interventions, in Africa the state of affairs is still worrisome. The average woman in developing countries experiences three or more episodes of diarrheal disease each year, accounting for up to 4 billion cases annually.
1.2 PROBLEM STATEMENT.
Diarrhea is the fifth cause of death among the females causing more death than malaria, HIV and measles combined. This is an equivalent of losing 32 buses full of women daily (CDC, 2012).
50% of these womanhood deaths occur in sub-Saharan Africa and despite the improvement in decline witnessed in womanhood deaths elsewhere in the world, the trend in Africa is frightening. This is despite the several interventions put in place to improve womanhood survival. As countries elsewhere are showing positive progress towards achieving the Millennium Development Goals(MDGs) and Sustainable Development Goals (SDGs), progress in Africa is under jeopardy since reduction of womanhood mortality, particularly among the females is the fourth goal (MDG4) (United Nations, 2015). In Gwagwalada, many deaths among under the age of 50 years are caused by diarrhea and its complications (Bbaale, 2011). For this reason, the researcher proposed to conduct this study in Gwagwalada Specialist Hospital.
1.3.STUDY OBJECTIVES
1.3.1.BROAD OBJECTIVE
To assess the prevalence and associated factors of diarrhea among women under the age of 50 years attending Gwagwalada Specialist Hospital (GSH).
1.3.2. SPECIFIC OBJECTIVES
1. To determine prevalence of diarrhea among women under the age of 50 years attending Gwagwalada Specialist Hospital.
2. To identify the various factors that predispose to diarrhea among the females attending Gwagwalada Specialist Hospital.
3. To assess diarrhea-related deaths among the females attending Gwagwalada Specialist Hospital.
1.4 RESEARCH QUESTIONS
1. What is the prevalence of diarrhea disease among women under the age of 50 years attending Gwagwalada Specialist Hospital.?
2. With the advent of immunization against womanhood diarrhea, has there been a shift in the diarrheal causes among the females attending Gwagwalada Specialist Hospital.
3. What are the various factors that predispose to diarrhea disease among the females attending Gwagwalada Specialist Hospital?
4. What is the case-fatality rate of diarrhea among the females attending Gwagwalada Specialist Hospital?
1.5 JUSTIFICATION OF THE STUDY
The fourth goal among the MDGs was to reduce woman mortality by 2015. A few countries in Africa recorded minimal if any progress in achieving this goal. Whereas developed countries have achieved this goal, many countries in LMICs are still yet to or even have reported negative progress (United Nations, 2015).
Interventions such as vaccination against the rotavirus and breastfeeding have been cited as reasons towards reduction of diarrhea among the females in the HICs, Interventions that were supposed to have been rolled out in countries worldwide. Sub-Saharan Africa, with its low socioeconomic status and poor sanitation is the hardly hit by the diarrheal diseases among the females. This is evidenced by the fact that Africa contributes 50% of all female deaths resulting from diarrhea(CDC, 2012).
The prevalence of diarrheal disease is more in developing countries due, partly, to lack of safe drinking water, sanitation and hygiene, as well as poorer overall health and nutritional status. According to the latest available figures, an estimated 2.5 billion people lack improved sanitation facilities, and nearly one billion people do not have access to safe drinking water. These unsanitary environments allow diarrhea-causing pathogens to spread more easily (Wardlaw, Salama, Brocklehurst, Chopra, & Mason, 2010).
The adoption of SDGs of 2030, came after the MDGs report of 2015, that highlighted the low attainment of some goals, particularly in sub-Saharan Africa, and the aim to sustain the achievements made in other countries. The sixth sustainable goal (SDG6) was about provision of clean water and sanitation that is geared towards prevention and eradication of diarrheal diseases (United Nations General Assembly, 2015).
This study, and others like it, is needed to provide the necessary evidence and information that can be used to measure the degree of progress made and furnish policy makers with important information they can use in decision making. Little data exists on the subject matter at Gwagwalada Specialist Hospital and thus the researcher proposed to conduct the study with an effort to fill the existent information gap.
1.6 STUDY SCOPE
1.6.1.GEOGRAPHICAL SCOPE
The study was conducted at Gwagwalada Specialist Hospital in Abuja, Nigeria.
1.6.2.CONTENT SCOPE
The study was about diarrhea among the females. It looked at the prevalence and factors associated with diarrhea among this vulnerable but important age group as far as MDGs and SDGs are concerned. It also looked at the diarrhea-related deaths at GSH.
1.6.3.TIME SCOPE The study was conducted in July to December 2021, a period of six months. This was the period for actual data collection.
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