Project – Prevalence of Diarrheal Diseases and Its Association with Household Water Sources in Ojo Local Government Area, Lagos State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Diarrheal diseases remain a major public health problem globally, particularly in low‑ and middle‑income countries, where inadequate access to safe water, sanitation, and hygiene (WASH) persists. Diarrhea is commonly defined as the passage of three or more loose or watery stools within a 24‑hour period and is caused by a wide range of bacterial, viral, and parasitic pathogens, most of which are transmitted through contaminated water and food or via the fecal–oral route. Despite being largely preventable, diarrheal diseases continue to account for significant morbidity and mortality, especially among children under five years of age (World Health Organization [WHO], 2023).

Globally, diarrheal diseases are among the leading causes of death in children under five, contributing to approximately half a million deaths annually. Beyond mortality, repeated episodes of diarrhea contribute to malnutrition, impaired physical growth, cognitive deficits, and reduced educational and economic productivity later in life. The burden of diarrheal diseases is closely linked to environmental and social determinants of health, particularly the availability and quality of household water sources, sanitation facilities, and hygiene practices (UNICEF & WHO, 2021).

In sub‑Saharan Africa, rapid urbanization, population growth, and inadequate infrastructure have exacerbated challenges related to water supply and sanitation. Many urban and peri‑urban communities rely on unimproved water sources such as shallow wells, surface water, water vendors, and poorly regulated boreholes. Even where improved water sources exist, contamination during collection, transportation, and storage at the household level remains common. These conditions create an enabling environment for the transmission of diarrheal pathogens (Prüss‑Ustün et al., 2019).

Nigeria bears a substantial share of the global burden of diarrheal diseases. Diarrhea remains one of the leading causes of under‑five morbidity and mortality in the country, despite national efforts to improve access to potable water and sanitation. National surveys have consistently shown disparities in access to improved water sources across states, local government areas, and socio‑economic groups. Urban poor communities are often disproportionately affected due to overcrowding, poor housing conditions, and unreliable public water supply (National Population Commission [NPC] & ICF, 2019).

Household water source is a critical determinant of diarrheal disease risk. Improved water sources—such as piped water, protected boreholes, and protected wells—are generally associated with lower risk of diarrhea compared to unimproved sources like surface water, unprotected wells, and water from informal vendors. However, the protective effect of improved sources may be undermined by intermittent supply, poor water quality monitoring, and unsafe storage practices. Understanding the relationship between household water sources and diarrheal disease prevalence is therefore essential for guiding effective public health interventions.

Ojo Local Government Area (LGA) of Lagos State is a densely populated urban and peri‑urban area characterized by rapid population growth, informal settlements, and diverse sources of household water supply. Many households rely on boreholes, wells, water vendors, and packaged water due to limited or inconsistent access to pipe‑borne water. These varying water sources differ in quality, regulation, and susceptibility to contamination. Given the environmental conditions and population density in Ojo LGA, residents—particularly children—may be at increased risk of water‑related diseases such as diarrhea. However, there is limited localized evidence examining the prevalence of diarrheal diseases and their association with household water sources in this setting, underscoring the need for this study.

1.2 Statement of the Problem

Despite ongoing public health interventions aimed at improving water supply and reducing waterborne diseases, diarrheal diseases remain prevalent in many parts of Lagos State. Ojo Local Government Area, like many urban LGAs, faces persistent challenges related to water quality, sanitation, and environmental hygiene. Frequent reliance on alternative water sources such as private boreholes, wells, water vendors, and sachet water raises concerns about safety, regulation, and potential contamination.

Many households in Ojo LGA lack consistent access to safe, treated pipe‑borne water and are compelled to use multiple water sources depending on availability and affordability. These sources may be exposed to contamination from poor waste disposal practices, flooding, leaking sewage systems, and inadequate environmental sanitation. In addition, household‑level factors such as improper water storage, lack of water treatment, and poor hygiene practices may further increase the risk of diarrheal disease transmission.

Although diarrheal diseases are preventable, cases continue to occur among both children and adults in Ojo LGA, contributing to avoidable illness, healthcare costs, loss of productivity, and, in severe cases, death. The absence of up‑to‑date, community‑specific data on the prevalence of diarrheal diseases and how it relates to different household water sources limits the ability of health authorities and policy makers to design targeted and effective interventions. Without clear evidence on which water sources are most strongly associated with diarrheal disease in this context, resources may not be optimally allocated. This study therefore seeks to determine the prevalence of diarrheal diseases and examine its association with household water sources in Ojo Local Government Area, Lagos State.

1.3 Objectives of the Study

General Objective
To determine the prevalence of diarrheal diseases and its association with household water sources in Ojo Local Government Area, Lagos State.

Specific Objectives

1. To determine the prevalence of diarrheal diseases among households in Ojo LGA.
2. To identify the common household water sources used by residents of Ojo LGA.
3. To assess the association between type of household water source and occurrence of diarrheal diseases.
4. To examine selected socio‑demographic factors associated with diarrheal disease occurrence.

1.4 Research Questions

1. What is the prevalence of diarrheal diseases in Ojo LGA?
2. What types of household water sources are commonly used in the study area?
3. Is there an association between household water sources and occurrence of diarrheal diseases?
4. What socio‑demographic factors are associated with diarrheal diseases in Ojo LGA?

1.5 Research Hypothesis

H₁: There is a significant association between household water source and prevalence of diarrheal diseases among residents of Ojo Local Government Area, Lagos State.

1.6 Significance of the Study

The findings of this study will provide valuable data on the burden of diarrheal diseases and the role of household water sources in Ojo LGA. The results will be useful to local government authorities, Lagos State Ministry of Health, and environmental health officers in planning and implementing targeted water, sanitation, and hygiene interventions. The study will also contribute to the existing body of knowledge and serve as a reference for researchers and students interested in water‑related public health issues.

1.7 Scope of the Study

This study focuses on households residing in Ojo Local Government Area, Lagos State. It examines the prevalence of diarrheal diseases and their association with household water sources. Other factors such as detailed microbiological water quality analysis are beyond the scope of this study.

1.8 Operational Definition of Terms

• Diarrheal Diseases: Conditions characterized by the passage of three or more loose or watery stools within 24 hours.
• Prevalence: The proportion of households reporting at least one episode of diarrhea within a specified period.
• Household Water Source: The primary source from which a household obtains water for drinking and domestic use.
• Improved Water Source: Water sources protected from outside contamination, such as piped water and protected boreholes.

Project – Prevalence of Diarrheal Diseases and Its Association with Household Water Sources in Ojo Local Government Area, Lagos State