Includes bibliographic references

Lack of safe water, poor hygiene and sanitation accounts for about 90% of the diarrheal
diseases in the world. Globally, half a million people lack adequate sanitation, leading to
fatalities for above five million people annually. This study examined the sanitation risk
factors associated with childhood diarrhea in Igembe South Sub County in Meru County. The
objectives of the study were; to establish the sanitation etiological causes of diarrhea, identify
the distribution of diarrhea cases, identify the household sanitation risk factors contributing to
diarrhea, assess household water and hygiene practices, and analyze the microbial
contamination of water sources in Igembe South Sub County, Meru County. A retrospective
and cross sectional study was carried out in Nyambene Sub County Hospital, Igembe south
Sub County for the period December 2022 to March 2023. The sample size was 196 children.
Data for the under five years children treated for diarrheal diseases was collected from both
inpatient and outpatient department. Thereafter, the guardians and care givers were followed
up in their homes where sanitation indicators were collected through a structured
questionnaire and observations. Water samples were collected from communal and individual
water sources from every ward, for microbial analysis. Data was analyzed by use of SPSS
version 24 and ANOVA, inferential statistics was done and presented in figures and tables.
There was a significant relationship between cases of diarrhea in children below five years
and shortage of household latrines. There was also a positive significant relationship
(p=0.0034) between the diagnosis made and the sanitation risk factors (hand washing and
source of household water). Besides, sanitation related factors were reported to significantly
influence the prevalence of diarrhea among children below 5 years; hand washing before
preparing the baby’s food (p = 0.048) and source of household water (p = 0.042). The study
established that the predominant sanitation etiological cause of diarrhea in children under five
yearsin Igembe South was E. histolytica (65% (n=13)). Besides, 75.5% (n=148) of the children
in the Sub County diagnosed with diarrhea were partially immunized, and 55.6% (n=109) of
children below five years with diarrhea in Igembe South SubCountywere residents of Amwathi
and Kiegoi Antubochiu wards. The study also revealed that more than 43% (n=84) of the
households did not have a hand washing facility. The water samples from three sources tested
positive for E coli contamination. Ura River, Mwamba River, and Muura River were unfit for
human consumption,as they were grossly polluted (category D). Kanuni ward whose larger
population (34.2%) depend on Ura river is the mostly affected. The study concluded that the
predominant sanitation etiological cause of diarrhea in children under five years in Igembe
South was E. histolytica which is prevalent in the contaminated rivers in South Igembe
SubCounty. Basic sanitation is paramount in ensuring hygienic excreta disposal and a clean
and healthful environment within the households. Availability of safe drinking water, can
significantly reduce diarrhea episodes in children underfive years. TheCountyGovernment of
Meru should closely monitor proper use of sanitation facilities and safety of water sources in
all wards, to ensure that each household has basic sanitation facilities.