Environmental factors associated with diarrhoea prevalence among under-five children in the Mataniko settlements in Honiara, Solomon Islands

INTRODUCTION: Children aged less than 5 years are often at high risk of diarrhoeal infection. In the Solomon Islands, diarrhoea is the second leading cause of under-five mortality with about one in every 10 children dying from it before reaching 5 years. This study aims to assess environmental factors that are associated with under-five diarrhoea prevalence in the Mataniko informal settlements, in Honiara, Solomon Islands. METHODS: Three out of the six settlements along the Mataniko River corridor were randomly selected. Caregivers who were taking care of at least one child under 5 years, and had signed a voluntary informed consent form, were included in the study. Instruments employed to collect the study variables were global positioning system technology and a questionnaire. Each child's medical record was used to verify the date of his or her diarrhoeal status. The data were entered and analysed using SPSS (v23). Binary logistic regression was used to measure the strength of association between under-five diarrhoea and the independent variables. A p-value of <0.05 was considered as statistically significant (p<0.05). RESULTS: A total of 205 caregivers with at least one child under 5 years participated in the study. Approximately half (45.9%) of the participants reported that their children (<5 years) had suffered with at least one episode of diarrhoea within the 2 weeks prior to the survey. Of the participants, 73.2% did not own a toilet facility and 61.0% of households were built on low-altitude areas (≤19 m above sea level), and above half (70.6%) were built near (≤125 m) the river. The presence of stagnant wastewater, flies, solid waste and water-filled containers near households, plus the distance of under-five households from the river, were found to be directly associated with under-five diarrhoea in the Mataniko informal settlements (p<0.05). CONCLUSION: Awareness and advocacy programs on environmental hygiene, food hygiene and potential health risks about the river should be ongoing at the community level.