Risk factors associated with acute diarrhea in children treated at Lodana Health Center in Ecuador

Christian Vinces; Tanya Brigitte; Doménica Violeta García Delgado; Milena Alcívar Palma; María Vera García; Fernanda Gómez

doi:10.59890/ijnhs.v4i3.226

Authors

Christian Vinces Universidad Particular San Gregorio de Portoviejo
Tanya Brigitte Universidad Particular San Gregorio de Portoviejo
Doménica Violeta García Delgado Universidad Particular San Gregorio de Portoviejo
Milena Alcívar Palma Universidad Particular San Gregorio de Portoviejo
María Vera García Universidad Particular San Gregorio de Portoviejo
Fernanda Gómez Universidad Particular San Gregorio de Portoviejo

DOI:

https://doi.org/10.59890/ijnhs.v4i3.226

Keywords:

Acute Diarrheal Diseases, Risk Factors, Children, Lodana Basic Sanitation

Abstract

Acute diarrheal diseases (ADDs) are among the leading causes of childhood morbidity and mortality worldwide. This study, conducted at the Lodana Health Center in Ecuador in 2024, analyzed risk factors associated with ADDs in children aged 0 to 9 years. Surveys were administered to 84 parents or guardians, revealing that although 81% were aware of the disease, only 61% identified preventive measures. Nearly half of the children experienced at least one diarrheal episode in the past six months, and 90% received medical care. Despite 100% being vaccinated against rotavirus and 99% of caregivers reporting handwashing before preparing food, risk conditions persisted: 41% consumed bottled water without additional treatment and nearly half of households lacked sewage procedures. The study concludes that ADDs are closely linked to deficiencies in sanitation and access to safe water

References

Ali, A. A., Naqvi, S. K., Hasnain, Z., Zubairi, M. B. A., Sharif, A., Salam, R. A., Soofi, S., Ariff, S., Nisar, Y. B., & Das, J. K. (2024). Zinc supplementation for acute and persistent watery diarrhoea in children: A systematic review and meta-analysis. Journal of Global Health, 14, 04212. https://doi.org/10.7189/jogh.14.04212

Alpaugh, V., Ortigoza, A., Braverman Bronstein, A., Pérez-Ferrer, C., Wagner-Gutierrez, N., Pacifico, N., Ezeh, A., Caiaffa, W. T., Lovasi, G., & Bilal, U. (2024). Association Between Household Deprivation and Living in Informal Settlements and Incidence of Diarrhea in Children Under 5 in Eleven Latin American Cities. Journal of Urban Health, 101(3), 629-637. https://doi.org/10.1007/s11524-024-00854-y

Astudillo, L. Á., Alcívar, L. M., Briones, J. N., Chica, K. A., Reyes, A. C., & Sánchez, G. N. (2024). Enfermedades diarreicas agudas en la población pediátrica en Ecuador 2013-2023: Revisión sistemática. Revista Gregoriana de Ciencias de la Salud, 1(1), 120-136. https://doi.org/10.36097/rgcs.v1i1.3108

Bhavnani, D., Goldstick, J. E., Cevallos, W., Trueba, G., & Eisenberg, J. N. S. (2014). Impact of Rainfall on Diarrheal Disease Risk Associated with Unimproved Water and Sanitation. The American Society of Tropical Medicine and Hygiene, 90(4), 705-711. https://doi.org/10.4269/ajtmh.13-0371

Burnett, E., Yen, C., Tate, J. E., & Parashar, U. D. (2016). Rotavirus Vaccines: Current Global Impact and Future Perspectives. Future Virology, 11(10), 699-708. https://doi.org/10.2217/fvl-2016-0082

Camacho, L. A. (2020). La paradoja de la disponibilidad de agua de mala calidad en el sector rural colombiano. Revista de Ingeniería, 49, 38-51. https://doi.org/10.16924/revinge.49.6

Chakraborty, R., Armijos, R. X., Beidelman, E. T., Rosenberg, M., & Margaret Weigel, M. (2024). Household food and water insecurity and its association with diarrhoea, respiratory illness, and stunting in Ecuadorian children under 5 years. Maternal & Child Nutrition, 20(4), e13683. https://doi.org/10.1111/mcn.13683

-Lindell, T. L., Moncayo, A. L., Vinueza Veloz, M. F., & Odoi, A. (2022). An exploratory assessment of human and animal health concerns of smallholder farmers in rural communities of Chimborazo, Ecuador. PeerJ, 9, e12208. https://doi.org/10.7717/peerj.12208

Condori Apaza, P. J. (2023). Conocimientos, actitudes y prácticas preventivas sobre enfermedad diarreica aguda en cuidadores primarios de menores de 5 años que acuden a un centro de salud rural. Salud Pública en Acción, 4(1), 1-7. https://doi.org/10.53287/ajai9270fs12l

Galezzo, M.-A., Günther, W. M. R., Diaz-Quijano, F. A., & Susa, M. R. (2020). Factors associated with diarrheal disease in the rural Caribbean region of Colombia. Revista de Saúde Pública, 54, 90. https://doi.org/10.11606/s1518-8787.2020054002054

Garzon-Villalba, X. (2024). We all deserve to live in a clean environment: Undernutrition and pollution in Ecuador. Journal of Public Health and Emergency, 8, 35-35. https://doi.org/10.21037/jphe-24-46

Gonzalez, Y. Z., Nunéz, D. C., & Fulgueira, L. M. (2020). Caracterización y factores de riesgo de la enfermedad diarreica aguda en niños menores de cinco años, en el Hospital de Cambiotede Huambo. Revista angolana de ciências, 2(3), 346-356. Disponible en: https://www.redalyc.org/journal/7041/704174699007/704174699007.pdf

Guzman Vera, L. (2016). Prevalencia de enfermedad diarreica aguda en pacientes pediátricos según el plan de atención en la unidad de rehidratación oral del Hospital Nacional Hipólito Unanue. Enero – marzo del 2015. https://hdl.handle.net/20.500.14138/455

Huicho, L., Tavera, M., Huayanay-Espinoza, C. A., Béjar-Díaz, M., Rivera-Ch, M., Tam, Y., Walker, N., & Black, R. E. (2019). Drivers of the progress achieved by Peru in reducing childhood diarrhoea mortality: A country case study. Journal of Global Health, 9(2), 020805. https://doi.org/10.7189/jogh.09.020805

Lalangui, K., Cotera-Mantilla, M., Sánchez-Murillo, M., Carrera-Alvarez, A., Duque-Cuasapaz, M., & Quentin, E. (2024). Space–time distribution of intestinal infectious diseases and their association with socioeconomic variables in Ecuador. Frontiers in Public Health, 12, 1412362. https://doi.org/10.3389/fpubh.2024.1412362

Larson, A. J., Haver, S., Hattendorf, J., Salmon-Mulanovich, G., Riveros, M., Verastegui, H., Mäusezahl, D., & Hartinger, S. M. (2023). Household-level risk factors for water contamination and antimicrobial resistance in drinking water among households with children under 5 in rural San Marcos, Cajamarca, Peru. One Health, 16, 100482. https://doi.org/10.1016/j.onehlt.2023.100482

Loyola, S., Sanchez, J. F., Maguiña, E., Canal, E., Castillo, R., Bernal, M., Meza, Y., Tilley, D. H., Oswald, W. E., Heitzinger, K., Lescano, A. G., & Rocha, C. A. (2020). Fecal Contamination of Drinking Water Was Associated with Diarrheal Pathogen Carriage among Children Younger than 5 Years in Three Peruvian Rural Communities. The American Journal of Tropical Medicine and Hygiene, 102(6), 1279-1285. https://doi.org/10.4269/ajtmh.19-0337

Macias, V. D., Macías, M. M., Sánchez, O. D., Veloz, R. A., Véliz, E. M., & Moreno, A. (2025). La pobreza como determinante asociada a las principales enfermedades detectadas en habitantes de Lodana, Ecuador. Revista Gregoriana de Ciencias de la Salud, 2(1), 19-31. https://doi.org/10.36097/rgcs.v2i1.3163

Nuño, N., Mäusezahl, D., Hattendorf, J., Verastegui, H., Ortiz, M., & Hartinger, S. M. (2022). Effectiveness of a home-environmental intervention package and an early child development intervention on child health and development in high-altitude rural communities in the Peruvian Andes: A cluster-randomised controlled trial. Infectious Diseases of Poverty, 11(1), 66. https://doi.org/10.1186/s40249-022-00985-x

Ogutu, E. A., Ellis, A., Rodriguez, K. C., Caruso, B. A., McClintic, E. E., Ventura, S. G., Arriola, K. R. J., Kowalski, A. J., Linabarger, M., Wodnik, B. K., Webb-Girard, A., Muga, R., & Freeman, M. C. (2022). Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: A formative research study. BMC Public Health, 22(1), 1865. https://doi.org/10.1186/s12889-022-14259-6

Organización Mundial de la Salud. (2024). Enfermedades diarreicas (Who.int.). https://www.who.int/es/news-room/fact-sheets/detail/diarrhoeal-disease

Overgaard, H. J., Alexander, N., Matiz, M. I., Jaramillo, J. F., Olano, V. A., Vargas, S., Sarmiento, D., Lenhart, A., & Stenström, T. A. (2016). A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia. PLOS Neglected Tropical Diseases, 10(11), e0005106. https://doi.org/10.1371/journal.pntd.0005106

Peñaherrera Lozada, C. E. (2023). Enfermedad Diarreica aguda en Ecuador en el periodo 2017-2022. Revisión sistemática. En Investigación en Ciencias de la Salud desde la academia. Tomo 2. Red Editorial Latinoamericana de Investigación Contemporánea. Disponible en: https://redliclibros.com/index.php/publicaciones

Povea Alfonso, E., Hevia Bernal, D., Povea Alfonso, E., & Hevia Bernal, D. (2019). La enfermedad diarreica aguda. Revista Cubana de Pediatría, 91(4). http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S0034-75312019000400001&lng=es&nrm=iso&tlng=es

Reyes-Gómez, U., Reyes-Hernández, K. L., Santos-Calderón, L. A., Luévanos-Velázquez, A., Guerrero-Becerra, M., Martínez-Arce, P. A., Quero-Hernández, A., & López-Cruz, G. (2018). Enfermedad diarreica aguda en niños. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=92483

Sarmiento-Senior, D., Matiz, M. I., Vargas-Cruz, S., Jaramillo, J. F., Olano, V. A., Lenhart, A., Stenström, T. A., Alexander, N., & Overgaard, H. J. (2022). Improving knowledge, attitudes, and practices on dengue and diarrhea in rural primary school students, their parents, and teachers in Colombia: A cluster-randomized controlled trial. PLOS Neglected Tropical Diseases, 16(12), e0010985. https://doi.org/10.1371/journal.pntd.0010985

Sokic-Milutinovic, A., Pavlovic-Markovic, A., Tomasevic, R. S., & Lukic, S. (2021). Diarrhea as a clinical challenge: General practitioner approach. Digestive Diseases (Basel, Switzerland), 40(3), 282–289. https://doi.org/10.1159/000517111

Sosa-Moreno, A., Lee, G. O., Van Engen, A., Sun, K., Uruchima, J., Kwong, L. H., Ludwig-Borycz, E., Caruso, B. A., Cevallos, W., Levy, K., & Eisenberg, J. N. S. (2022). Characterizing Behaviors Associated with Enteric Pathogen Exposure among Infants in Rural Ecuador through Structured Observations. The American Journal of Tropical Medicine and Hygiene, 106(6), 1747-1756. https://doi.org/10.4269/ajtmh.21-1099

Toledo Curbelo, G. (2004). Fundamentos de salud pública. Editorial Ciencias Médicas.

U.S. Department of Health and Human Services & Centers for Disease Control and Prevention. (2021). Vacuna contra el rotavirus: lo que necesita saber (C-110A) [PDF]. Texas Department of State Health Services. https://www.dshs.texas.gov/sites/default

Vargas-Gaibor, K., Rendón-Viteri, K., Alvarado-Villa, G., & Faytong-Haro, M. (2025). Influences of Maternal, Child, and Household Factors on Diarrhea Management in Ecuador. Children, 12(4), 473. https://doi.org/10.3390/children12040473

Velasquez-Portocarrero, D. E., Wang, X., Cortese, M. M., Snider, C. J., Anand, A., Costantini, V. P., Yunus, Aziz, A. B., Haque, W., Parashar, U., Sisay, Z., Soeters, H. M., Hyde, T. B., Jiang, B., & Zaman, K. (2022). Head-to-head comparison of the immunogenicity of RotaTeq and Rotarix rotavirus vaccines and factors associated with seroresponse in infants in Bangladesh: a randomised, controlled, open-label, parallel, phase 4 trial. The Lancet Infectious Diseases, 22(11), 1606–1616. https://doi.org/10.1016/S1473-3099(22)00368-1

Yard Foster, Y., Correoso Guevara, J. D., & Nuñez Ortega, J. M. (2021). Factores de riesgo de enfermedad diarreica aguda en menores de 5 años. Revista Médico Científica, 34(1), 1-8. https://doi.org/10.37416/rmc.v34i1.573