Association of Diarrheal Disease with Solid Waste Management Practices and Perceptions among Residents of Industrial Division in Mbale City: A Cross-Sectional Study
Authors: Okolimong Charles , Walekula Emmanuel , Orech Sam , Okia David , Mukunya David , Olupot Peter Olupot 
Published: May 2024

Background
Globally, an estimated 11.2 billion tons of municipal solid waste is generated annually. The increasing volume and complexity of waste associated with the modern economy and rapid urbanization pose a serious risk to human health due to diarrheal disease outbreaks. Studies conducted in various cities and municipalities show a high prevalence of diarrheal diseases as a result of poor solid waste management practices. Solid Waste Management Practices are unsatisfactory, leading to the high prevalence of diarrheal disease. The prevalence of the disease is estimated at 3.6% as expressed in disability-adjusted life years and it’s the leading killer accounting for approximately 8% of all deaths among children below 5 years. In the Industrial division, Mbale City, diarrheal disease ranks among the top five causes of morbidity and mortality among the general population. In 2018, about 28649 cases were reported. In addition, episodes of cholera Outbreaks are not uncommon for example, 59 adult cases were reported in 2016. These diseases are rampant among slum dwellers of Mbale Industrial Division where poor solid waste management has been reported.
Objective
The main objective of this study was to assess the association of diarrheal disease with Solid Waste Management Practices and perceptions among residents of Industrial Division, Mbale City
Methods
This study was a cross-sectional survey design. Both quantitative and qualitative data collection methods were employed. 424 respondents aged 18 years and above from the sampled households participated in the survey. A standardized structured questionnaire was used to collect quantitative data while FGD and KI interview guides were used to collect qualitative data. Quantitative data was collected, coded, cleaned, and entered into EPI data. Bivariate and Multivariate analysis was used to examine the relationship between the outcome variable (presence of diarrhea and its predictors for quantitative data. Thematic content analysis approach was used to explore the perceptions of the residents of Industrial Division, Mbale City on diarrhea and Solid Waste Management Practices.
Results
The prevalence of diarrhea disease among the residents of Industrial Division was 37%. After adjusting for confounders such as age, sex, education, source of drinking water, water treatment method, and type of toilet facility, the only SWM practice associated with diarrhea was the type of SW generated. Generating textiles had lower odds of diarrhea disease as compared to paper, 0.46 CI (0.239-0.900). Other factors associated with diarrhea were; household size, source of drinking water, and toilet ownership by the household.
Conclusion
In this study, the type of solid waste generated by a household was the only SWM-related factor that was associated with the presence of diarrhea. However, the type of toilet used; water source, and family size were other important factors that were associated with the presence of diarrhea in the Industrial division of Mbale City.