Prevalence and Determinants of Diarrhea among Under Five Years Children in Musanze District

Background Diarrheal disease remains a significant public health issue worldwide, especially among children under five in low- and middle-income countries like Rwanda. Despite improvements in water and sanitation infrastructure, diarrhea prevalence among young children in Rwanda remains high, with Musanze District in the Northern Province being one of the most affected areas. Objective This study investigated the prevalence and determinants of diarrhea among children under five in Musanze with emphasis on household-level factors such as water treatment, sanitation, and maternal practices. Methods A cross-sectional quantitative study was conducted involving 206 mothers and caregivers from Ruhengeri Referral Hospital and 17 health centers, selected through cluster sampling. Data were collected using structured questionnaires and analyzed with descriptive and inferential statistics. Results The study found an overall diarrhea prevalence of 20.39%, with urban areas experiencing a higher prevalence (33.93%) than rural areas (15.33%), a statistically significant difference (χ² = 8.69, p < 0.01). Key risk factors included the presence of feces around households (OR = 27.507, p < 0.01), feces near pit latrines (OR = 4.691, p < 0.05), and larger family sizes (OR = 9.026, p < 0.05). Protective factors included higher socioeconomic status, maternal education, private latrine ownership, water treatment practices and living in urban areas. Conclusion the study underscores the persistent burden of diarrhea in Musanze and identifies critical household and environmental determinants. Targeted interventions addressing these factors could significantly reduce diarrhea prevalence in this region.