The association of sanitation, birth history, and nutritional status on the incidence of diarrhea among children under five in Zambia, South Africa
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Negara sub-sahara dikenal memiliki pasokan sumber air bersih dan sanitasi yang belum mumpuni, sehihngga mempengaruhi peningkatan risiko kejadian diare. Diketahui bahwa masalah gizi juga menjadi penyebab diare. Lalu bagaimana pengaruh faktor risiko tersebut di negara sub-sahara? Oleh karena itu, tujuan penelitian ini adalah untuk mengetahui hubungan sanitasi, riwayat kelahiran, dan status gizi terhadap kejadian diare pada balita di Zambia dan besaran risikonya. Desain studi yang digunakan adalah cross sectional dengan memanfaatkan data sekunder Zambia Demographic and Health Survey tahun 2018 yang tersedia dari DHS program. Total sampel sebanyak 6504 balita dengan data lengkap meliputi diare, karakteristik sosio ekonomi, riwayat kelahiran, status anemia, serta antropometri (BB dan TB). Hasilnya, sebanyak 15,6% balita mengalami diare (2 minggu terakhir). Berdasarkan sosio ekonomi, tingkat pendidikan berhubungan signifikan (p=0,000) dengan diare dimana ibu yang tidak bersekolah berisiko hingga 1,542 kali. Sumber air minum berhubungan signifikan terhadap kejadian diare (p=0,001), dengan risiko 1,297 kali. Pada status gizi, hanya variabel BB/U (underweight) yang ditemukan berhubungan signifikan (p=0,000), dengan besar risiko 1,413 kali. Temuan menarik pada riwayat kelahiran balita, yaitu balita yang diberi ASI eksklusif meningkatkan kejadian diare hingga 2,5 kali (p=0,000). Penelitian ini mengkonfirmasi hipotesis bahwa kejadian diare pada balita di Zambia dipengaruhi secara signifikan oleh sumber air minum, tingkat pendidikan ibu, riwayat IMD, dan status gizi BB/U atau underweight. Namun pada riwayat pemberian ASI eksklusif, diare lebih banyak terjadi pada balita yang mendapat ASI eksklusif.
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