الفهرس 
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Abstract
Diarrhea is a common health problem at the age of under five years and has series complication such as dehydration, malnutrition and death. There are many risk factors which lead to diarrhea such as failure of exclusively breast-feeding,starting weaning in summer, poor feeding practices, and personal hygiene, as well as, inadequate water supply, poor environmental sanitation, family size (overcrowding), seasonal pattern, and poverty.
The aim of the present study was to identify risk factors associated with recurrence of diarrheal episodes among children under two years.
The current study was conducted in Out Patient Clinic at Damnhour Medical National Institute (DMNI). A convenient sample of 200 mothers having children with recurrence of diarrheal episodes comprised the study subjects. The age of their children ranged from 3 months to less than 2 years and free from other chronic illness.
One tool was used to collect the necessary data.
Risk factors associated with recurrence of diarrheal episodes among children under two years structured interview schedule. This was developed by the researcher. It consisted of three parts; Part I included characteristics of mothers and their children. Part II Diarrhea and dehydration assessment. Part III Risk factors associated with recurrence of diarrheal episodes among children under two years.
Tool was tested for their content validity by five experts in the field of Pediatric Nursing. The reliability of the tool was done by measuring the internal consistency of its items using Cronbach Coefficient Alpha Test where r = 0.760. Pilot study was carried out by the researcher on 20 mothers. Every mother was interviewed individually in the waiting room during working hours of pediatric outpatient’s clinic. The data was collected over 3 months from July to the end of November 2021.
The main results of the current study revealed the following:
More than half of mothers (55.5.0%) were in the age group from 18 to less than 25 years.
The majority of mothers (93.5%) were married and only 42.0% of them were having a secondary school.
More than half of them have not enough income, and live in rural areas.
Only 13.6 % of mothers give their children exclusive breast feeding (from birth to 6 months). Also, more than half of mothers (59.8%) never washing their breast before breast feeding.
More than two third of them (69.0%) used the bottle after one month from opening. more than half of them (55.8%) always kept the residual of the bottle feeding.
The majority of the studied mothers’ (93.8%) introduced new food when their child was less than 6 months. It also obvious that 61.3% of them started to introduce new food at summer.
Portrays that, 56.8% and 47.3% of mothers were obtain satisfactory regarding their breast- and bottle-feeding practices.
Illustrates that, 55.2% and 45.5% of mothers were unsatisfactory regarding weaning and personal hygiene practices. Also, shows that, 49.5%, 67.0%, 43% of mothers` were obtained unsatisfactory regarding environmental sanitation, water sanitation and contact with animal respectively.
Show that slightly more than half of mothers (51%) obtained unsatisfactory in overall practices while only 13 % were good.
More than one third of children (36%) had medium frequency of diarrhea, while less than one third of children (30.5%) had low frequency of diarrhea and one third of them (33.5%) had high frequency of diarrhea.
There were statistically significant differences between recurrence of diarrheal episodes and socio-demographic characteristics of mothers which mother age, occupation, income, and residence and crowding index where P=0.002, P=0.026, P=0.034, P=0.011, P=0.006 respectively.
There is statistically significant relation between recurrence of diarrheal episodes of studied children and their age and feeding type where P<0.001, P<0.001 respectively.
There is statistically significant relation between recurrence of diarrheal episodes of studied children and their duration of breast feeding and exclusive breast feeding (P=0.016, P<0.001 respectively.
There is statistically significant relation between recurrence of diarrheal episodes of studied children and Prescription of milk by doctor, washing the bottle before each feeding and washing hand before preparing bottle feeding where P=0.001, P=0.007, P=0.014 respectively.
There is statistically significant relation between recurrence of diarrheal episodes of studied children and duration of keeping formula, age of the child when they introduce new food, the child sickness, type of food began, the child have animal milk before the first year of life and chewing the food before giving it to child where P<0.001.
There is statistically significant relation between recurrence of diarrheal episodes of studied children and having Measles vaccine, having Vitamin A capsule, having Rotavirus vaccine, where P<0.006, P<0.002, P=0.042, respectively.
The highest frequency of diarrhea in children occurred when mothers started weaning in summer which constitutes 76.1%. There was statistically significant relation between recurrence of diarrheal episodes of studied mothers ’children and seasonal pattern where P= 0.029.
that there is statistically significant relation between recurrence of diarrheal episodes of mothers` children and breast-feeding practices, weaning practices, personal hygiene, vaccination status and seasonal pattern where P=0.001, P<0.001, P=0.003, P=0.009 and P=0.029* respectively. Moreover, there were statistically significant differences between recurrence of diarrheal episodes and total score of overall practice of mothers were P<0.001.