Determinants of co-occurrences of diarrhea and fever among children under five years of age in South Sudan

ABSTRACT Children in developing countries continue to suffer a disproportionate burden of morbidities, including diarrhea and fever, which are major causes of mortality. These morbidities tend to co-occur due to shared or overlapping risk factors. This study examines the determinants of co-occurrences of diarrhea and fever among children under five years of age (n = 8,338) in South Sudan using the national representative sample drawn from the 2010 South Sudan Multiple Indicator Cluster Survey (MICS4). The results show more than 50% of children under five are affected either by diarrhea (19%) or fever (16%), or both ailments (16%). Multinomial logistic regression analysis shows that variables related to the individual (child’s age, breastfeeding status, uptake of vitamin A supplements), family (mother’s pregnancy status, family wealth index), hygiene (water treatment status, waste disposal practices), and environment (national state of residency) significantly influence comorbidities among children under five years relative to children with neither diarrhea nor fever in South Sudan.The study suggests the need for parents and caregivers to be well advised and equipped with customized sanitation and hygiene skills to combat infectious diseases, so that they can play a key role in reducing comorbidities and mortalities among children under five years of age in their communities.