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Background <p>Globally, an estimated 11.2&#xa0;billion tons of municipal solid waste are generated annually. The increasing volume and complexity of waste, together with rapid urbanization, pose major risks to human health through diarrheal disease outbreaks. In many urban centers of low- and middle-income countries, solid waste management (SWM) practices remain inadequate. In Mbale City, Uganda, diarrheal disease ranks among the top five causes of morbidity and mortality, with over 28,000 cases reported in 2018. This study assessed the association between diarrheal disease and SWM practices and perceptions among residents of Industrial Division, Mbale City.</p> Methods <p>A descriptive cross-sectional study employing both quantitative and qualitative approaches was conducted among 424 adult respondents (≥ 18 years) during the entire month of February 2020 in the Industrial Division of Mbale City. Quantitative data were collected using a structured questionnaire, while qualitative data were obtained through Focus Group Discussions (FGDs) and Key Informant (KI) interviews with community leaders and municipal officials. Data were entered into Epidemiological Data Software (EpiData) and analyzed using STATA. Potential confounders were identified from literature and expert consultation, including age, sex, education, water source, sanitation, and family size. Bivariable and multivariable logistic regression analyses were performed to assess associations between diarrhea and predictor variables. Qualitative data were analyzed using thematic content analysis. Diarrheal disease was defined as the passage of three or more loose or watery stools in 24&#xa0;h (WHO).</p> Results <p>The prevalence of diarrheal disease among adults in Industrial Division was 36.8%. After adjusting for confounders (age, sex, education, water source, water treatment, and toilet type), only the type of solid waste generated was significantly associated with diarrhea: households generating textiles had lower odds compared to those generating paper waste (AOR = 0.46; 95% CI: 0.24–0.90). Other significant factors included household size, source of drinking water, and toilet ownership.</p> Conclusion <p>While overall SWM practices were moderate, key risk factors for diarrheal disease included unsafe water sources, lack of household toilets, and larger household sizes. The findings underscore the urgent need for improved sanitation, safe water supply, and community awareness on proper waste handling.</p> Recommendations <p>Local authorities should strengthen community sensitization on SWM, ensure continuous water quality surveillance, promote construction of household toilets, and integrate family planning initiatives into urban public health programs.</p>

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Association of diarrheal disease with solid waste management practices and perceptions among residents of industrial division in Mbale City: a cross sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月4日

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  • Charles Okolimong,
  • Emanuel Walekula,
  • Sam Orech,
  • David Okia,
  • David Mukunya,
  • Peter Olupot-Olupot

摘要

Background

Globally, an estimated 11.2 billion tons of municipal solid waste are generated annually. The increasing volume and complexity of waste, together with rapid urbanization, pose major risks to human health through diarrheal disease outbreaks. In many urban centers of low- and middle-income countries, solid waste management (SWM) practices remain inadequate. In Mbale City, Uganda, diarrheal disease ranks among the top five causes of morbidity and mortality, with over 28,000 cases reported in 2018. This study assessed the association between diarrheal disease and SWM practices and perceptions among residents of Industrial Division, Mbale City.

Methods

A descriptive cross-sectional study employing both quantitative and qualitative approaches was conducted among 424 adult respondents (≥ 18 years) during the entire month of February 2020 in the Industrial Division of Mbale City. Quantitative data were collected using a structured questionnaire, while qualitative data were obtained through Focus Group Discussions (FGDs) and Key Informant (KI) interviews with community leaders and municipal officials. Data were entered into Epidemiological Data Software (EpiData) and analyzed using STATA. Potential confounders were identified from literature and expert consultation, including age, sex, education, water source, sanitation, and family size. Bivariable and multivariable logistic regression analyses were performed to assess associations between diarrhea and predictor variables. Qualitative data were analyzed using thematic content analysis. Diarrheal disease was defined as the passage of three or more loose or watery stools in 24 h (WHO).

Results

The prevalence of diarrheal disease among adults in Industrial Division was 36.8%. After adjusting for confounders (age, sex, education, water source, water treatment, and toilet type), only the type of solid waste generated was significantly associated with diarrhea: households generating textiles had lower odds compared to those generating paper waste (AOR = 0.46; 95% CI: 0.24–0.90). Other significant factors included household size, source of drinking water, and toilet ownership.

Conclusion

While overall SWM practices were moderate, key risk factors for diarrheal disease included unsafe water sources, lack of household toilets, and larger household sizes. The findings underscore the urgent need for improved sanitation, safe water supply, and community awareness on proper waste handling.

Recommendations

Local authorities should strengthen community sensitization on SWM, ensure continuous water quality surveillance, promote construction of household toilets, and integrate family planning initiatives into urban public health programs.