TITLE:
Prevalence and Factors Associated with Diarrhea in Households in Three Rural Health Zones of Haut-Uélé, Democratic Republic of Congo
AUTHORS:
Albert Wembakoy Okolongo, Zoé-Arthur Kazadi Malumba, Eugène Basandja Longembe, Joris Losimba Likwela
KEYWORDS:
Diarrhea, Domestic Water Management, Drinking Water, Rural Area, Households, SODIS, Democratic Republic of Congo
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.16 No.4,
November
3,
2026
ABSTRACT: Context: Waterborne diarrheal diseases remain a major cause of morbidity in rural households in low-income countries, with a particularly high incidence among children under 5 years of age. In the Democratic Republic of Congo, limited access to safe drinking water and inadequate household water management practices expose households to a high risk of diarrhea. Objective: To determine the prevalence of diarrhea in households and associated factors in three rural health zones of Haut-Uélé. Methods: A cross-sectional analytical study was conducted in January-February 2026 in the health zones of Isiro, Pawa, and Wamba. A sample of 331 households with at least one child under five years of age was selected by systematic sampling after random selection of zones and villages. Data were collected from mothers/caregivers using a structured questionnaire. The association between variables was tested using Fisher’s exact test, and factors independently associated with diarrhea were investigated using multivariate logistic regression. The significance level was set at p Results: Of the 331 households surveyed, 43.2% reported at least one case of diarrhea, across all age groups, in the two weeks preceding the survey (10.5% of the total household population); the prevalence among children under five years of age was 15.4% (86/560 children). Almost all households (95.8%) did not treat drinking water before consumption, and 63.7% stored it for more than 24 hours. In bivariate analysis, a large household size (OR = 2.43; 95% CI: 1.41 - 4.27; p = 0.001) and water storage for more than 24 hours (OR = 3.25; 95% CI: 1.99 - 5.30; p Conclusion: Diarrhea in households remains highly prevalent in the rural health zones of Haut-Uélé, where domestic water management practices, particularly the duration and security of storage, are major and modifiable determinants. These findings support the promotion of local, low-cost water treatment approaches, such as solar disinfection (SODIS), as a complementary measure for diarrhea prevention in rural areas.