Statistical Analysis of diarrheal disease prevalence among children in households in Haiti

In children, diarrheal disease can lead to malnutrition, poor growth, and increased risk of developing other infectious disease. With multiple cholera outbreaks, natural disasters damaging vital infrastructure, and political unrest, the health and safety of Haitians, especially children, is at risk. The purpose of this cross-sectional study was to examine the relationships between the outcome variable, diarrheal disease reporting in the last two weeks and predictor variable, source of drinking water, while accounting for additional characteristics such as region, type of place of residence, education level of the child’s mother, and toilet facility in the home. Demographic and Health Survey data from 2016-2017, collected from the mothers of households in Haiti, (n=10654) was requested and analyzed. To be included in the current analysis, respondents had to have answered whether they had any household diarrheal illness in the last two weeks and the type of water source they used, leaving an analytic sample size of 3,599 individuals. Characteristics of the population were described using weighted percentages and unweighted frequencies. Bivariate and multivariate logistic regressions were used to examine factors associated with diarrheal disease in the last two weeks (yes/no). Unadjusted and adjusted odds ratios and corresponding 95% confidence intervals were reported. Nearly one quarter of households (24.40%) reported any diarrheal illness in the last two weeks. In the study’s final multivariate model, only region had a significant relationship with diarrheal illness. The regions of Nippes, Nord-Est, Nord-Ouest, Rest-Ouest, Sud, and Sud-Est all had lower odds of contracting diarrheal disease as compared to Aire-Metropolitaine. Children living in Sud-Est were 52.9% less likely to develop diarrheal disease in two weeks than those in Aire-Metropolitaine (OR=0.471, p=0.0061). In Rest-Ouest (OR=0.561, p=0.201), Nippes(OR=0.576, p=0.0420), and Nord-Est(OR=0.585, p=0.0327), children were 43.9%, 42.4%, and 41.5% less likely to develop diarrheal disease in the last two weeks, respectively, when compared to the Aire-Metropolitane region. Lastly, Nord-Ouest (OR=0.600 p=0.0371) and Sud (OR=0.605, p=0.0463). were both approximately 40% less likely than the reference group, Aire-Metropolitan. The statistical analyses conducted calls for multiple interventions, one of which being an assessment of infrastructure and health in the region of Aire-Metropolitaine. The capital city of Haiti, Port-au-Prince, is located in this region and has experienced many natural diseases as of late, especially earthquakes. As a result, the damaged infrastructure associated with septic lines and water sources could be impacting the quality of sanitation of water in the city. Despite the results of this study, there were limitations. The most pertinent limitation involves the cross-sectional nature of this study, which means that causality between variables cannot be established. Furthermore, only about one third of respondents answered questions related to household diarrheal illness and water source, limiting the sample size. Future research should involve inspecting prevalence of diarrheal disease over time, especially in Port-au-Prince, in order to better understand potential relationships between causative factors and diarrheal disease. In addition to this, geographic analyses examining specific areas of Port-au-Prince could be conducted in an attempt to identify areas needing additional support and infrastructure within the Aire-Metropolitaine region