Diarrheal Disease Burden and Risk Factors Among Under-Five Children in Moro Local Government Area, Kwara State, Nigeria

Background: Diarrheal disease is still a major public health concern, particularly among children under-five in low-resource areas. It is responsible for high rate of illness and deaths of children mainly in developing countries.  Objectives: To determine the prevalence and associated risk factors of Diarrheal disease among children under five years of age in selected communities in Moro Local Government Area, Kwara State, Nigeria.  Methods: This descriptive cross-sectional study was conducted in three communities in Moro LGA, Kwara State, Nigeria. It included 410 caregivers of children under five years. A multi-stage sampling technique was used to select participants. Data were collected using a pretested, semi-structured, interviewer-administered questionnaire. Analysis was performed with SPSS version 26.0. Descriptive statistics and chi-square tests (p<0.05) were employed.  Results: Two-week prevalence of diarrhea was 22.2% (n = 91). Among affected children, 80.2% had 2–3 episodes, with 66.3% exhibiting fever and 70.0% showing signs of dehydration. Environmental risk factors included the use of untreated well water (44.6%) and uncovered water storage (31.7%). Only 53.7% of households had hand-washing facilities. While 87.8% of caregivers sought medical care, only 34.2% did so immediately. Antibiotic use (56.1%) was more common than the use of oral rehydration solution (ORS) (34.4%) and Zinc tablet (9.4%). Households with more than three under-five children had poorer hygiene and higher diarrhea prevalence due to resource constraints and caregiver fatigue.  Conclusions: Significant associations were found with socio-demographic factors, environmental risks, and poor hygiene practices. Healthcare-seeking behavior was high (87.8%), but gaps existed in ORS use and preparation. Recommendations include improving water safety, sanitation, caregiver education, and adherence to WHO guidelines for diarrheal management.