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Determinants of diarrhoeal diseases and height-for-age z-scores in children under five years of age in rural central Tanzania

Kock, Richard


Richard Kock


Introduction. Childhood diarrhoeal diseases and stunting are
major health problems in low- and middle-income countries
(LMICs). Poor water supply, sanitation services and hygiene,
frequently encountered in resource-poor settings, contribute to
childhood diarrhoea and stunting.
Methods. Data on demographic characteristics, hygiene practices,
sanitation and human-animal interactions (predictors) and
child height-for-age z-scores (HAZ) (outcome) were collected
once, while diarrhoea incidences were collected fortnightly for
24 months (outcome).
Results. Drinking water from public taps (OR = 0.51, 95% CI.
0.44 - 0.61; p < 0.001) and open wells (OR = 0.46, 95% CI. 0.39
- 0.54; p < 0.001) and older age of children (OR = 0.43, 95%
CI. 0.27 - 0.67; p < 0.001) were protective against diarrhoea.
Inappropriate disposal of children’s faeces (OR = 1.15, 95% CI.
1.02 - 1.31; p = 0.025), sharing water sources with animals in the
dry season (OR = 1.48, 95% CI. 1.29 - 1.70; p < 0.001), overnight
sharing of houses with cats (OR = 1.35, 95% CI. 1.16 -
1.57; p < 0.001) and keeping chickens inside the house overnight
regardless of room (OR = 1.39, 95% CI. 1.20 - 1.60; p < 0.001)
increased the risk of diarrhoea. The Sukuma language group
(p = 0.005), washing hands in running water (p = 0.007), access
of chickens to unwashed kitchen utensils (p = 0.030) and overnight
sharing of the house with sheep (p = 0.020) were associated
with higher HAZ in children.
Conclusions. Until a more precise understanding of the key risk
factors is available, these findings suggest efforts towards control
of diarrhoea and improved linear growth in these areas should
be directed to increased access to clean and safe water, handwashing,
sanitation, and improved animal husbandry practices.


Kock, R. (2020). Determinants of diarrhoeal diseases and height-for-age z-scores in children under five years of age in rural central Tanzania. Open Journal of Preventive Medicine,

Journal Article Type Article
Acceptance Date Jun 10, 2020
Publication Date Jul 1, 2020
Deposit Date Apr 16, 2021
Publicly Available Date Apr 16, 2021
Journal Journal preventive medicine and hygiene
Print ISSN 2162-2477
Publisher Scientific Research Publishing
Peer Reviewed Peer Reviewed
Public URL


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