The Determinants of the Incidence of Diarrhea in Underfive Children in Urban Coastal Areas: A Cross-sectional Study


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Manado-Access to clean water and proper sanitation remains a critical determinant of child health in Indonesia’s urban coastal communities. A recent study conducted by Oksfriani Jufri Sumampouw, Jeini Ester Nelwan, Frelly Valentino Kuhon, Odi Roni Pinontoan, Ester Candrawati Musa, and Jane Tahulending from Sam Ratulangi University, Manado, reveals that poor water sources and inadequate household latrines significantly increase diarrhea incidence among under-five children. The study was published in 2026 in the International Journal of Natural and Health Sciences (IJNHS).

The research was carried out in Girian Bawah Village, Bitung City, an urban coastal area characterized by dense settlements and limited sanitation infrastructure. The findings highlight why diarrhea remains a persistent public health challenge for young children in coastal environments.

Public Health Context

Urban coastal regions face heightened vulnerability due to environmental pollution, groundwater contamination, and limited access to sanitation facilities. In Indonesia, diarrhea continues to rank among the leading causes of illness and death in children under five, with coastal provinces showing particularly high case numbers.

In Bitung City, recurring diarrhea outbreaks among toddlers reflect broader sanitation and water safety challenges faced by coastal urban populations.

Study Design and Approach

The researchers employed a cross-sectional survey design, collecting data between July and August 2024. A total of 140 mothers of under-five children were interviewed using structured questionnaires, supported by direct environmental observations.

Statistical analysis included univariate and Chi-Square tests to examine associations between sanitation conditions and diarrhea incidence.

Key Findings

The study identified several critical patterns:

  • 54.3% of under-five children experienced diarrhea within the last three months

  • 45.7% of households relied on unsafe clean water sources

  • 40% used latrines that did not meet health standards

  • A significant association between water source condition and diarrhea incidence
    (p = 0.030)

  • A significant association between latrine condition and diarrhea incidence
    (p = 0.005)

Children living in households with unsafe water and poor sanitation faced substantially higher diarrhea risks.

Real-World Implications

These findings reinforce the role of basic sanitation as a cornerstone of child survival. Improving access to safe water and hygienic latrines can dramatically reduce diarrhea cases, prevent malnutrition, and lower child mortality rates in coastal urban areas.

The authors call for stronger sanitation policies, community education programs, and government-led infrastructure development to protect vulnerable children.

Academic Insight

According to Dr. Oksfriani Jufri Sumampouw of Sam Ratulangi University, “Household sanitation conditions, particularly clean water sources and latrine quality, are decisive factors in diarrhea incidence among under-five children in urban coastal settings.”

Author Profile

Oksfriani Jufri Sumampouw
Expertise: environmental health, sanitation, and environment-based diseases in coastal areas.

Jeini Ester Nelwan
Expertise: environmental health and family health.

Frelly Valentino Kuhon
Expertise: environmental sanitation and child health.

Odi Roni Pinontoan
Expertise: environmental health and health behavior.

Ester Candrawati Musa
Expertise: maternal and child health and basic sanitation.

Jane Tahulending
Expertise: coastal community health and health promotion.

Source

  • Article title: The Determinants of the Incidence of Diarrhea in Underfive Children in Urban Coastal Areas: A Cross-sectional Study

  • Journal: International Journal of Natural and Health Sciences (IJNHS)

  • Year: 2026

  • DOI: https://doi.org/10.59890/ijnhs.v4i1.147

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