DISCUSSION
The present study provides some evidence that in this Kenyan
district and at the aggregate level diarrhoea morbidity is correlated
with malnutrition among young children. Though this correlation
does not indicate causality, it may imply that addressing one issue
may lead to an improvement in the other. A quarter of children in
Ijara district are at risk of malnutrition. Kenya’s North Eastern
province has the highest proportion of moderate and severely
underweight children, estimated to affect about 25% (KDHS,
2008). The district is characterized by frequent drought and
unreliable rainfall, which do not favour the growth of food crops
and pasture for livestock. These conditions create food insecurity
and high poverty levels.
According to the present study every month almost 9 of every 100
children suffer a bout of diarrhoea in Ijara district. This may be an
under-estimate given the fact that the health facilities may not be
always accessed or accessible. This is a possibility given the
vastness of the district and especially during the rainy season,
when roads become impassable. A previous survey done in
Kenya’s North Eastern province found that 16% of children less
than 5 years of age had diarrhoea in the two weeks preceding the
survey (KDHS, 2008).
The seasonal calendar of Ijara is divided into a short dry spell
between January and March. During this time milk yield drops due
to decline in pasture and water scarcity. The rainy season usually
commences between April and June bringing with it high milk
yield as well as calving, kidding and lambing. July to October have
long dry spells seeing again low milk yield and water scarcity. The
short rains occur from November to December during which time
milk yield increases again. The months of July and November
showed the highest number of cases of diarrhoeal disease. These
were also the driest and wettest months, respectively, in 2009.
The occurrence of diarrhoea has been shown to display a
seasonal variation. In temperate climates, bacterial diarrhoea
occur more frequently during the summer (Siraj et al, 2008),
whereas viral diarrhoea, particularly diarrhoea caused by rotavirus
peak during the winter. In tropical areas, rotavirus diarrhoea
occurs throughout the year, increasing in frequency during the
drier, cool months, whereas bacterial diarrhoeas peak during the
warmer, rainy season. This study was unable to delineate
between viral and bacterial diarrhoea.