Trends and Risk Factors For Childhood Diarrhoea in Rwanda: A Secondary Data Analysis of Three Rwanda Demographic and Health Surveys (RDHS 2010, 2014/15, and 2019/20).

Background: Diarrhoea continues to be a leading cause of morbidity and mortality among children under five, particularly in developing countries, including Rwanda. This study examined trends and risk factors for childhood diarrhea in Rwanda. Methods: A secondary analysis of children's records was conducted among 8,706 households in 2010, 7,261 in 2014/15, and 4,409 in 2019/20. The univariate analysis summarized the variables and described the trends in diarrhea by districts during the 2010, 2014/15, and 2019/2020 RDHS. Simple logistic regression identified associations between diarrhea and potential factors, while a multivariable model retained significant variables after addressing multicollinearity. The results were presented as adjusted odds ratios with 95% confidence intervals and p-values <0.05. Results: The prevalence of childhood diarrhoea in Rwanda followed a U-shaped trend, falling from 12.81% in 2010 to 11.62% in 2015, and then rising to 13.65% in 2020. Factors independently associated with diarrhea included household heads less than 25 years old, households with ≥4 members, not breastfeeding, less frequent radio/TV exposure, bottle feeding and unimproved toilet facilities. Conclusion: Interventions should focus on supporting less educated caregivers through health education, improved water, hygiene, and sanitation practices, and promotion of breastfeeding. Ensuring equitable access to clean water is also essential for reducing diarrhoea.