Akunga, DanielAnyango, S. O.Kimani, Humprey Mbuti2014-03-052014-03-052014-03-05http://ir-library.ku.ac.ke/handle/123456789/9200Department of Community Health, 2013Cause of diarrhea is known to have many risk factors. They include unsafe water, lack of water leading to low personal and domestic hygiene, poor water infrastructural and management systems. Contamination of drinking water is known to be a problem in many developing countries. This is even of more concern in high residential low income areas. Nairobi City is not an exception hence this study was conducted in Kasarani to assess diarrhea disease attributed to water, sanitation and hygiene (WASH) among under-fives. The study aimed at determining the quality of water the households were consuming. The main objective of this study was to establish the association between diarrhea among the under-five and water, sanitation and hygiene. To achieve this goal, the study area was categorized in four study environs namely low density high income (LDHI), medium density middle income (MDMI), high density low income (HDLI and informal settlement low income (ISLI). The study adopted a crosssectional study design. The study used both structured questionnaire and hygiene observational checklist as data collection instruments. To ascertain disease trends among the under fives, the study reviewed disease records from licensed health facilities. Derived values of tables, percentages, graphs and ratios were adopted for data presentation. To determine association and significant differences between variables, data were subjected to inferential statistics and Chi-square tests respectively. For comparisons of quantitative variables, ANOVA test was used. The findings of this study indicated that Nairobi water and sewerage company ( NWSCO) was the main source of water supply in the study environs (100%). Under five children from household consuming less than 60.75litres a day and who were predominantly from (ISLI) were at a higher risk of diarrhoea compared to those who consumed more than 60.75 litres a day (p<0.001). Households experiencing water shortages in frequencies of less than three days were found to carry a higher risk for childhood diarrhoea (p< 0.001). This study determined that water consumed in Kasarani was a risk for childhood diarrhoea (p=0.019) with tap water showing a significantly higher contamination 13.7% than household water container 7.2% for T. Coli bacteria. The microbial results observed attributed contamination to the distribution network or household and personal hygiene among the MDMI, HDLI and ISLI residential environs. Overall, the results indicated that the amount of water a household consumed per day was an important risk factor for childhood diarrhea in the study environs (p= 0.00 1). The study observed that Age of a child (p=0.046), Water treatment method (p=0.002), method of storage of solid waste p<O.OOl,quantities and frequencies of water supply (p<0.001) were found to be the most important risk factors for childhood Diarrhoea. The study determined that there was a significant difference in the mean Diarrhea incidences and prevalence across the residential environs (F= 422.995, df=3, p<0.001, F=96.69l, df=3, p<O.OOl.There was a strong linear association between ddiarrhea prevalence and the different residential environs. R2 = 0.88, 0.899 and 0.886 in the year 2008, 2009 and 2010 respectivey. The findings established that children ill ISLI were the most affected by ddiarrhea. The study concluded that there was a relationship between childhood diarrhoea, water, sanitation and hygiene in Kasarani Division. These study recommended that NWSCO institute programmes that will facilitate adequate and wholesome water supply and distribution to HDLI and ISLI residential environs respectively.enThesis