Adequacy of improved sources of drinking water, sanitation, and hygiene practice for the reduction of diarrheal disease among people living with HIV/AIDS, Harar Region, Ethiopia

Abstract

Background: Home-based care services like improved water supply, sanitation, and hygiene (WaSH) practice are vital for people living with HIV/AIDS (PLWHA) to improve their quality of life. The negative impact of inadequate WaSH services is more pronounced among HIV-infected individuals leading them to low economic productivity, poor-nourished, immuno-compromised, and death. The aim of this study was to investigate the adequacy of improved sources of drinking water, sanitation, and hygiene practice for the reduction of diarrheal disease among people living with HIV/AIDS, Harar region, Ethiopia. Methods: A cross-sectional study was conducted on 422 PLWHA in the Harar region related to WaSH as home-based care services and the prevalence of diarrheal disease using a standardized survey questionnaire. Descriptive statistics and multivariate Poisson regres-sions models were performed by SPSS Version 25. Using generalized linear models, adjusted prevalence ratio (APR) with 95%Cl and p-value were computed to assess the strength of association between the outcome and explanatory variables. A significant association was assured when the p-value is less than 0.05. Results: In the present study, the two-week prevalence of diarrheal disease was 25%, of which 16% experienced two or more diarrheal episodes. Moreover, 87% of PLWHA used an improved source of drinking water, 66% used improved sanitation facilities, and 68% have good hygiene practices. Only 37% of the respondents acquired a basic water service level (≥20lcd) and 58% of PLWHA acquired the recommended quantity of safe water for drinking (≥1.5lcd). In multivariate analysis, the adjusted prevalence ratio of the 2-week prevalence of diarrhea was lower by 8% (APR =1.08; 95%Cl: 1.02, 1.14), 7% (APR =1.07; 95%Cl: 1.01, 1.14), and 5% (APR =1.05; 95%Cl: 1.00, 1.11) among PLWHA who have good hygiene practice, wash their hand with soap 24 hours before the survey, and used sanitation facility consistently, respectively. Conclusion: The current study results showed that PLWHA has inadequate access to improved drinking water sources, improved sanitation facilities, and hygienic practice; these triggers stakeholders for proper interventions, effective integration of adequate WaSH services to the HIV/AIDS program to enhance the quality of life of PLWHA.