Comorbidity of diarrhea and respiratory infection symptoms, and associated factors among under-five children in Gondar City, Northwest Ethiopia: a community-based cross-sectional study.

Background: Childhood morbidity is frequently characterized by more than one health condition. Children under the age of five in low- and middle-income countries including Ethiopia experience multiple episodes of diarrhea and respiratory infection symptoms. However, there have been limited studies on comorbidities of diarrhea and respiratory infection symptoms. In addition, most studies conducted in Ethiopia seek separate outcomes for diarrhea and respiratory infection symptoms. Therefore, this study aimed to determine the prevalence of diarrhea and respiratory infection symptoms comorbidity, and associated factors among under-five children in Gondar City.

Methods: Community-based cross-sectional study was conducted in Gondar City among under-five children from April 05 - May 04, 2023. Multi-stage sampling technique was used to collect a sample of 836. A structured questionnaire was employed through an interview-administered method for data collection at participants' homes. Bivariable and multivariable binary logistic regression analyses were undertaken to identify predictors of childhood comorbidity of diarrhea and respiratory infection symptoms.

Results: The comorbidity prevalence of diarrhea and respiratory infection symptoms in under-five children was 17.22% [CI: 14.8%-19.9%]. Mothers/caretaker age < 25 years (AOR = 3.52 at 95% CI:1.64,7.5), mothers/caretakers who had no formal education (AOR = 4.42 at 95% CI: 2.08,9.9.40), family size > 5 (AOR = 4.52 at 95% CI: 2.13,9.61), second birth order (AOR = 2.67 at 95% CI: 1.31,5.41), children playground not clean(AOR = 2.19 at 95% CI:1.01,4.71), started supplementary feeding at age > 6 months (AOR = 4.51 at 95% CI:1.50,13.58), mothers/caretakers who didn't wash their hands after visiting latrine (AOR = 2.03 at 95% CI: 1.03,4.03), mothers/caretakers who didn't wash their hands with soap and water (AOR = 1.92 at 95% CI: 1.00,3.69) were significantly associated factors with under five children comorbidity of diarrhea and respiratory infection symptoms.

Conclusions: According to the findings, the prevalence of diarrhea and respiratory infection symptoms comorbidity was higher and variation in the amount of comorbidity is explained by maternal and child predictors. Educating mothers/caregivers about hand washing, sanitation, hygiene, and supplementary feeding is a key approach for the prevention and control of comorbidities in children.