Influence of latrine coverage and usage on diarrhoea incidence among children under 5 living in slum areas of Douala 5th sub-division, Cameroon

Introduction: lack of adequate sanitation facilities remain a major concern in developing countries. While around 41% of Cameroonians lack access to improved sanitation facilities, the 2011 National Survey revealed a diarrhoea incidence rate of 21% in children under five years, two weeks before interview. This study aimed at evaluating the influence of latrine coverage and usage on diarrhoeic disease outcome among children under 5. Methods: a cross-sectional study was carried out in March 2016 in pre-selected slums areas of Douala 5th district. A structured questionnaire was used to collect data from one consenting adult per household. Data analysis was carried out using Epi Info version 7.1.4.0. Pearson's Chi square and Fisher exact test were used to estimate the influence of latrine coverage on the incidence of diarrhoea. Statistical significance was set at p < 0.05. Results: of the 384 households enrolled, 69.01% had latrine facilities, while 30.99% shared latrines with neighbouring households. Sixty point sixteen percent (60.16%) (231/384) of all households used pit latrines. Although consistent use of latrines by all adults was reported, 20.05% of children under 5 practiced open-air defecation. The incidence of diarrhoea among children under 5 years 2 weeks before interview was 29.25%, of which 26.35% were bloody stools. Diarrhoea outcome was significantly associated with use of pit latrines (p < 0.01); lack of cover on latrines hole (p < 0.0001) and proximity of latrines to household (p=0.01). Conclusion: poor faecal waste management and lack of improved sanitation facilities contribute significantly to diarrhoeal episodes among children under 5. A structured strategy to improve community-based sanitation considering urban planning and sanitation campaigns would promote safer environment and reduce outcome of water-borne and diarrhoeic diseases.