Background: Malaria remains a major public health problem in Ethiopia. The use of LLINs is an effective approach to reducing transmission. Persistent use of LLINs is determined by numerous factors. Quantitative studies have assessed LLIN ownership and utilization, but the behavioral, socio-cultural, socioeconomic and net distribution contexts that impact their use have not been examined in depth. This study aimed to explore barriers of persistent LLIN use among communities around Lake Tana. Methods: Twenty-three community residents who owned LLINs (15) or not (8) during the study period and 38 key informants were interviewed from April to June 2017. Phenomenological study was employed to explore the local contexts and factors that influence persistent use of LLINs. Individuals were purposefully selected to capture different views. Community residents were selected based on their permanent residence and LLIN use experience. Key informants were health extension workers, local leaders, students, and health professionals. The data were managed using QSR International NVivo Version 10 software and coded, and themes were identified. Results: Killing ability of nets against arthropods other than mosquitoes reportedly made use of LLINs a favored malaria prevention method despite their ineffectiveness after 3 months. Conical nets were preferred due to their compatibility with varied sleeping structures. Numerous factors influenced persistent use, notably erroneous perceptions about LLINs, malaria and mosquitoes; bedbug infestation; inconvenience; unintended uses; distribution problem of nets; and socio-cultural and economic factors. Unintended uses were often associated with local needs and seldom linked with social issues and deficiencies in information about malaria and LLINs. Collateral benefits were considered important, principally in terms of disinfestation of bedbugs. Conclusions: Non-persistent LLIN use was associated with inconvenient bed net design and early damage; non-potency of the insecticide against other arthropods; facilitation of bedbug infestation; unintended uses; wrong perceptions about malaria, mosquitoes, and LLINs; and inadequate follow-up regarding LLINs utilization. Distribution of conical nets and provision of adequate information on LLINs and malaria may promote persistent use. Using an insecticide that also kills arthropods other than mosquitoes may reduce unintended uses and increase persistent use.

Background: Diarrheal diseases remain a leading cause of preventable death among children under-five in low- and middle-income countries (LMICs). In Ethiopia, diarrhea is the major contributor to deaths for children under the age of 5 years. In order to develop prevention strategies for the alleviation of childhood diarrhea, it is necessary to identify the important predisposing factors. These predisposing factors have been observed to vary by location across Eastern Ethiopia. Moreover, the evidence on prevalence and determinants of diarrhea among children under 5 years of age in Dire Dawa and its suburbs is very limited and those available have been erratic. The objective of this study was to determine the prevalence and predisposing factors of diarrhea among children under the age of 5 years in rural Dire Dawa, East Ethiopia. Methods: A community-based cross-sectional study was conducted in rural Dire Dawa City Administration in May 2018. Multistage sampling technique was employed to recruit 1180 under-five children from the rural population of Dire Dawa City Administration. Data on socio-demographic, environmental, and child- and hygiene-related factors were collected by trained data collectors using a structured questionnaire. Logistic regression was used to identify independent risk factors for childhood diarrhea. Results: The 2-week prevalence of diarrhea among the under-five children was 23% (95% CI 20.8–25.7%). Maternal diarrhea (AOR = 2.22, 95% CI 1.10–4.47), handwashing after contact with child feces (AOR = 6.27, 95% CI 2.01–19.55), use of a dipper to draw water from containers (AOR = 2.88, 95% CI 1.41–5.89), and presence of a refuse disposal facility (AOR = 2.47, 95% CI 1.09–5.60) were the significant predisposing factors of diarrhea. Conclusion: Our study identified a high burden of childhood diarrheal disease in rural Dire Dawa City Administration in Eastern Ethiopia. The identified risk factors were maternal diarrhea, handwashing after contact with child feces, use of a dipper to draw water from containers, and presence of refuse disposal facility. To minimize the risk of diarrhea, health education programs focusing on good hygiene practice and sanitation as well as early treatment are recommended.

Background: Diarrhea is the second leading cause of under-five mortality in Ethiopia. Information on the prevalence and the impacting factors of diarrhea in the rural suburbs of Dire Dawa is inadequate.Objective: This study was aimed at determining risk factors of diarrhea among children less than five years of age in the rural suburbs of Dire Dawa, eastern Ethiopia.Methods: A cross-sectional study was conducted from 02 May 2018, to 31 May 2018. The required 1146 children for this study were selected from the rural suburbs of Dire Dawa using multi-stage sampling. Both bi-variable and multivariable Robust Poisson regressions were used for identifying the risk factors. Explanatory variables with a p-value < 0.05 were considered as independently associated with diarrhea.Results: The prevalence of diarrhea among the children was 23% (95% CI: 20.7 - 25.4). The type of house floor (aPR [adjusted prevalence ratio] = 0.89, 95% CI: 0.84 - 0.95) and sharing latrine with neighbours (aPR = 1.18, 95% CI: 1.09 - 1.26) were the significant factors associated with childhood diarrhea.Conclusion: Earthen house floor and shared use of latrine were the risk factors associated with childhood diarrhea. Hence, improving the house floor condition and construction of private latrine together with health education are recommended.Keywords: Prevalence; diarrhea; rural Dire Dawa; Robust Poisson Regression.