Factors Influencing Diarrhoea Among Children Below Five Years of Age in Ikere-Ekiti, Ekiti State, Nigeria

Background: Childhood diarrhoea remains among the foremost causes of preventable morbidity and mortality among children under five years of age globally, particularly in low-resource communities across sub-Saharan Africa. In Nigeria, the situation is compounded by inadequate water and sanitation infrastructure, low maternal education levels, and entrenched cultural practices. Objectives: This study investigates the environmental, socio-economic, and cultural factors influencing the occurrence and recurrence of diarrhoeal disease among children under five years in Ikere Local Government Area, Ekiti State, Nigeria. Methods: A descriptive cross-sectional survey design was employed, utilizing a structured questionnaire administered to 271 purposively and randomly selected caregivers of children under five across three wards of Ikere-Ekiti. Data were analysed using descriptive and inferential statistics with SPSS software. Results: Findings reveal that 72.0% of caregivers had access to clean water, yet 28.0% lacked it, exposing their children to waterborne diarrhoeal risk. Environmental hygiene deficits were also noted, with 31.4% reporting poorly maintained toilets and 25.1% practising improper waste disposal. Handwashing with soap was strongly endorsed (55.0% strongly agreed it prevents diarrhoea), while 36.5% of caregivers had no formal education, limiting health literacy. Religion exerted minimal negative influence, with 88.9% endorsing religious leaders as hygiene advocates. Recurrence was high: 79.7% of children had diarrhoea within two weeks, and 59.0% experienced multiple episodes annually. Prolonged episodes (>3 days) were reported by 88.9%. Conclusion: Childhood diarrhoea in Ikere-Ekiti is driven by multifactorial determinants spanning environmental, socio-economic, and cultural domains. Integrated, community-responsive public health interventions are urgently required. Recommendations: Government investment in water and sanitation infrastructure, community-based maternal health education, engagement of faith leaders, and subsidised healthcare access are recommended to reduce the burden of childhood diarrhoea.