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Determinants of Acute Bloody Diarrhea among Adult Outpatient Visits in Bibugn District, Northern Ethiopia

Among Belay, Lamessa Dube, Solomon Berhanu

Background: Acute bloody diarrhea (dysentery) is a medical emergency that warrants serious medical investigation for patients of all ages. It is also among weekly reportable disease in Ethiopia. However, studies related to its determinants have been limited.

Objective: To identify determinants of acute bloody diarrhea among adult outpatient visits in Bibugn district, northern Ethiopia.

Methods: We conducted a case-control study with 222 participants (56 cases and 166 controls) in Bibugn district governmental health facilities. A case was defined as a person of age ≥ 18 years, who attends adult outpatient department in selected governmental health facilities of Bibugn district with acute diarrhea containing visible blood in the stool between February and April, 2017. A control was defined as, non- diarrheal outpatient visitors of age ≥ 18 years who attends adult outpatient departments in the selected governmental health facilities of the district. Face to face interview with consecutive sampling method was used to collect data. Epi Data version 3.1 and SPSS version 22 were used for data entry and analysis respectively. Bivariate analysis was done and all covariates with p-value <0.25 were entered into multivariable logistic regression analysis. AOR with 95% CI were calculated to identify independent variables which were significantly associated with acute bloody diarrhea, p-value <0.05 were considered as determinants of acute bloody diarrhea.

Results: Storage of drinking water not separate from water for others uses (AOR=3.00 (1.39-6.48)), dipping use to draw drinking water from the storage container (AOR=2.49 (1.21- 5.14)), refuse disposal in open fields (AOR=2.71 (1.37-5.38)) and using less than 20 L daily water consumption per capita (AOR=2.89 (1.28-6.49)) were independently associated with acute bloody diarrhea.

Conclusion: Daily water consumption per capita use of <20 L, storage of drinking water not separate from water for others uses, dipping use to draw water from storage container and open field refuse disposal practice were found to be associated with an increased riskof adult acute bloody diarrheal diseases.