Nadila Lupita Puteri, Oktia Woro Kasmini Handayani, Yuni Wijayanti

Analysis of Characteristics of Toddlers, Mothers, and Living Environment on the Incidence of Diarrhea in Toddlers in Samarinda City in 2024

Introduction

Analysis of characteristics of toddlers, mothers, and living environment on the incidence of diarrhea in toddlers in samarinda city in 2024. Analyzes toddler, mother & environment characteristics linked to diarrhea incidence in Samarinda, 2024. Factors like nutrition, breastfeeding, immunization, clean water, and mother's occupation are key for prevention.

Abstract

Diarrhea is still a challenging health problem for children under five years of age in Indonesia. Diarrhea due to waterborne diseases is still prevalent in Samarinda, and this environmental health problem could trigger outbreaks in multiple regions. The objective of this study was to analyze the effect of child characteristics, mother characteristics, and environmental characteristics in Samarinda. The research method used a case-control design with a sample of 124 (62 cases and 62 controls), and the data was obtained by interview using a questionnaire. The sampling technique was consecutive sampling. Data analysis was carried out, including univariate and bivariate, by chi-square statistical tests. And multivariate analysis by multiple logistic regression. The results showed that the incidence of diarrhea with nutritional status P = 0.027 (OR = 2.292; 95% CI: 1.092-4.807); history of exclusive breast-feeding P = 0.040 (OR = 2.180; 95% CI: 1.030-4.612); history of immunization status P = 0.014 (OR = 2.860; 95% CI: 1.218-6.716); worker mother P = 0.08 (OR = 0.354; 95% CI: 0.163-0.771); and clean water source P = 0.09 (OR = 2.754; 95% CI: 1.280-5.923); and drinking water management P = 0.017 (OR = 2.444, 95% CI: 1.166-5.127). The factors that did not relate significantly in this research were the child’s age (P = 0.402), mother’s age (P = 0.467), mother’s education (P = 0.534), and family income (P = 0.579). The result from the multivariate shows the variable that had the most significant association with diarrhea was the mother’s occupation. The accessibility to clean water sources was an intervening variable that played an important role in diarrhea cases in Samarinda. Health institutions also need to conduct periodic water quality checks and increase community knowledge about water quality and diarrhea prevention. This study could provide valuable input for diarrhea prevention and control programs.

Review

This study addresses a crucial and persistent public health challenge in Indonesia: the incidence of diarrhea among young children, specifically focusing on toddlers in Samarinda City. Utilizing a case-control design with a respectable sample size, the researchers aimed to analyze the interplay between child characteristics, mother characteristics, and environmental factors. The abstract clearly outlines a comprehensive approach, employing univariate, bivariate (chi-square), and multivariate (logistic regression) analyses to identify significant associations. Key findings include statistically significant relationships between diarrhea incidence and nutritional status, history of exclusive breastfeeding, immunization status, and aspects of water safety (clean water source, drinking water management), providing valuable insights into potential risk factors. The identification of mother’s occupation as the most significant variable in the multivariate analysis and clean water accessibility as an important intervening variable are particularly noteworthy. While the study offers valuable insights, several aspects require clarification and critical consideration. The abstract presents some inconsistencies regarding statistical significance; for instance, "worker mother" (P=0.08) and "clean water source" (P=0.09) are listed among significant findings, yet their p-values fall outside the conventional threshold of P<0.05, and the abstract later explicitly lists factors *not* significantly related. This contradiction needs to be reconciled, perhaps by stating the chosen alpha level or re-evaluating their inclusion in the significant findings section. Furthermore, the claim that "mother’s occupation" was the "most significant association" in multivariate analysis warrants further explanation, especially given its bivariate P-value of 0.08. The methodology for identifying "accessibility to clean water sources" as an intervening variable also needs greater detail to substantiate this important claim, as does the distinction between "toddlers" and "children under five" for consistent scope. Reliance on interview-based questionnaires for historical data, such as exclusive breastfeeding, may also introduce recall bias. Despite these points for refinement, this study makes a relevant contribution to understanding the multifactorial nature of diarrhea in a specific urban Indonesian context. The identified risk factors, spanning individual child health, maternal practices, and environmental conditions, underscore the necessity of integrated public health interventions. The emphasis on water safety, including periodic quality checks and community education, is a practical and actionable recommendation stemming directly from the findings. This research provides a solid foundation for local health authorities in Samarinda to develop targeted and effective diarrhea prevention and control programs, and it highlights areas for future research to delve deeper into the causal pathways, particularly concerning the role of maternal occupation and the precise mechanism of water accessibility as an intervening variable.

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