Parasitic etiology of diarrhea and associated factors among under-five-year children attending Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

Introduction: globally, an estimated two billion cases of diarrhea occur every year, and an estimated 1.7 million children under the age of five years, mostly in developing countries die due to diarrheal cases. It is caused by different enteropathogens such as bacteria, viruses, and parasites. Diarrhea caused by parasitic etiology is common in under-five-year children in sub-Saharan Africa. The objective was to investigate the parasitic etiology of diarrhea among under-five-year children in Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Methods: institution-based cross-sectional study was conducted from September to November 2021. A total of 300 under-five-year children presenting with diarrhea in Mizan-Tepi University Teaching Hospital were included in the study. Data used to assess associated factors for intestinal parasitic infections (IPIs) was collected using a structured questionnaire. Stool specimens were collected from the study participants for investigations of the parasitic etiology of diarrhea. The specimens were processed microscopically using direct wet mount and formol ether concentration techniques. Modified Ziehl-Neelsen staining of formol-ether concentrated specimens was also performed. Data was entered using Epi-Data version 4.6.0 and analyzed using Stata/SE version 14.0. Crude odds ratio and adjusted odds ratio were used to determine the association. Results: from a total of 300 children who participated in this study, 68 (22.67%) were positive for at least one intestinal parasite. E. histolytica23(7.67%) and G. lamblia17(5.67%) were the predominant parasitic etiologies and 28(9.33%) were positive for intestinal helminthic parasites; 11(3.67%) Ascaris lumbricoides, 10(3.33%) Trichuris trichiura, 4(1.33%) Hymenolepsis nana, and 3(1%) were double infection with Trichuris trichuria and Ascaris lumbricoides. Multivariable analysis revealed the age group category 2-3 years of age children was more attributable to intestinal parasitic infections (AOR= 0.466, 95% CI: 0.204-0.976). Conclusion: the overall prevalence of intestinal parasitic infections (IPIs) in this study was 22.67%. Diarrheal etiology of intestinal parasites among under five years of children identified in this study were significantly associated with maternal/ guardians´ educational status, (AOR=94.900, 95% CI: 24.664-365.155) use of unprotected water for drinking, (AOR =25.189, 95% CI: 4.671-135.847).