Community Knowledge and Practice on Sanitation, Hygiene, Household water utilization and Prevalence of Diarrhea in Afabet City, Northern Red Sea Zone; Eritrea: Cross Sectional study: 2020

Abstract Background: Water and sanitation entitles the human right to affordable access and sanitation. The objective of this study was to determine the knowledge and practice on sanitation, hygiene and water utilization and to estimate the prevalence of diarrhea in Afabet city.Methods: It was a community-based descriptive cross-sectional type of study with a multistage cluster sampling technique. First 12 clusters were selected from the city and 30 households were nominated from each cluster, then a total of 360 individuals were sampled and every family head was interviewed. A structured interviewer administered questionnaire and field observation was used for data collection from December 05-20, 2020. Ethical approval was obtained from the Ministry of Health Research and Ethics Clearance Committee and written informed consent was signed by each respondent. Cross tabulation and association of variables using chi-square test was determined. Results: A total of 360 respondents were enrolled in the study with females (75.3%) and Muslim (98.9%) predominance. Above half (65.3%) and (67.5%) were satisfied with the amount and quality of water they received respectively. The prevalence of diarrhea in the community in the last six months of 2020 was 12.5%. The investigators practically approved that 88.9% of the communities revealed functional toilets and feces were observed in only 4.7% of the living area in the community. The community’s comprehensive good knowledge and practice was 99.4% and 93.9% respectively. Study participants from administrative area of one and three and those from four and five had the best good practice and practicing hand washing of greater than five times a day respectively (p=0.001). Respondents from administrative area of two were traveling longer distance to municipality water source (p<0.001). Conclusion: The community had good level of knowledge and practice but the prevalence of diarrhea was relatively high. Latrines were highly utilized but the usage of soap, personal and food hygiene was slightly low. The level of comprehensive practice, prevalence of diarrhea, distance to municipality water source and hand washing practice was associated to the administrative areas. Enhancing environmental sanitation, personal hygiene and provision of adequate and clean water are highly recommended.