Waterborne diseases are contracted through ingestion, direct contact with contaminated water, or when water is a living environment for hosts such as larvae or parasites. Water-related diseases are very diverse and sometimes directly related to water through a host or a vector. According to the WHO, epidemics due to water contamination are usually characterized by an explosive onset. Waterborne diseases are water-related disorders of the body.

Worldwide, "Waterborne diseases kill more than 5 million people per year. Almost 2.3 billion people suffer from water-related diseases and they account for about 60% of child mortality" (WHO, UNICEF). These diseases are observed in developing countries 1. They cause 3.4 million deaths per year, of which 2.2 million are due to diarrheal diseases, particularly cholera 2. They are the second most common cause of death among children under five years of age. In Cameroon, the lack of public drinking water distribution forces the inhabitants to resort to spring and well water. 3. Blastocysts Hominis had been identified in the municipal lake of Yaoundé in the Center by Ajaegah in 2017 4. Cameroon has 10 regions and very few recent studies in the South region which has a fairly dense hydrographic network 5. But the explanatory factors are important to detect because although more than 76% of the population (WHO 2015) uses safely managed drinking water in Cameroon these pathologies persist. In Ebolowa, the disease burden remains high; 23% of cases until 2019. Children are not the only ones affected and the incidence is alarming.

The purpose of this study was to found out the proportion of waterborne diseases in children aged 0-5 years in the health area of the Ebolowa urban dispensary in Cameroon in 2020.

The proportion of waterborne diseases was 97% for 566 children aged 0-5 years surveyed in 420 households selected in the health area of the Ebolowa urban dispensary (Algorithm).

According to table 1, the 50–60-months age group had a higher proportion of 32.98%. The 0–5-months age group had a lower proportion of 5.28%. The 6–16-months age group had a proportion of 15.66%. The 17-27 months age group has a proportion of 8.20%, 28-38 months 97.43%, 39-49 months 12.20%.

According to table 2, the first cause of consultation for children aged 0-5 years was diarrhea (78.62%); the second was malaria (78.09%); the third was bilharzia (9.54%); the fourth was scabiosis or scabies (1.94%); The fifth cause of consultation was dysentery (0.71%); the sixth cause was typhoid fever (0.71%); the last and seventh cause was pityriasis versicolor or skin mycosis (0.35%). These are probable cases, i.e., consistent with the clinical picture.

It emerges that in Table 3, the median age of the children with these conditions was 36 months with Q1 of 24 months and Q3 of 60 months. The proportion of boys who suffered from waterborne diseases was 67.21%. On the other hand, the proportion of girls was 32.79%.

The 97% proportion of cases of waterborne diseases can be explained by the fact that the 0–5-year-old age group seems to be more vulnerable. According to Luc Perino and Michèle Adam in 2019, the immune system matures during infancy and their digestive tract is immature. Southern Cameroon is a malaria endemic region with high rainfall. Some authors have addressed the same subject as us among them some results are similar. Notably the study conducted in 2014 by Some 1 in Tanghin in Burkina Faso showed that malaria was more prevalent than typhoid fever and dysentery. For Mendo and Nguidjol in 2018 in Cameroon, malaria is a major challenge in sub-Saharan Africa and waterborne diseases constituted 40% of the first ten consultations. On the other hand, for Some in 2014 ,50% of health register consultations in the Nomgr -Massson district in Burkina Faso were water related diseases 1. But also, this study reported a prevalence of intestinal diseases of 71% in 1-11 months versus 96% in 24 months to 48 months. 7. In addition, according to Sanou in 1999, there were 6.8 episodes of diarrhea per child per year in Burkina Faso compared to 3 episodes/year in Africa in 2017 (WHO) and 0.5 to 2/year in Europe.

Some results are lower than ours. The prevalence of diarrhea is 13% in South Cameroon according to DHS 2018. This is far lower than the proportion of diarrhea found in our study which is 78.62% (445/566). The DHS (2004) had shown a prevalence of 43% among 6-23 months old against 15.66% (6-16 months) and 25.68% (17-27 months) in our study. According to the author Sy et al in 2017, in Mauritania 8, diarrhea was 51.7% in children under 5 years. For Aubry (2012), dysentery represented 10% of diarrheal diseases. 6 versus 0.89% (4/449) in our study. According to Abdoulaye and Togo in 2019, 31% of diarrhea cases were noted in 12 months and older in Nara, Mali.

According to Djoudébbe, the prevalence of diarrhea was higher from 1996 to 2006 in Benin (24.2%) and Senegal (23.1%) than in Nigeria (7.9%) and Mali (9.2%).

These figures differ from those found in our study. The proportion of waterborne diseases in children under 14 years of age was 22% according to Aubry et al in 20117. The prevalence of malaria was 78.09% which is a little higher than that reported in the study of Ashaondu 9 in 2016 showed that 56.8% of children suffered from malaria, 4.4% from typhoid fever. And another study that reported 30% of malaria cases in 6-59 months. This suggests that malaria remains the leader among waterborne diseases in Cameroon 9. A higher proportion of malaria cases than in our study was found by Somé 1 which was 64% in 2014 in Burkina Faso.In 2018, in Cameroon 247 cases of malaria per 1000 inhabitants (WHO). In another study, we note according to Djoudébbe, the prevalence of diarrhea was high from 1996 to 2006.

Malaria is due to the bite of a female anopheles that has a predilection for stagnant and sunny pools of water. The south has a high rainfall, which justifies this prevalence. Regarding diarrhea the 2018 DHS confirms a higher proportion of diarrhea cases in the South and in Yaoundé among children under 5 years old. Diarrhea according to Maurage et olives 2002 in great majority is of infectious origin even if this origin is not always proven. Rotavirus is the most incriminated in children under 3 years of age according to Aubry and Bernard-Alex in 2011 7. This high proportion of cases has been recalled in several studies confirming the need to address it. Although diarrhea and dysentery cause 80% of deaths in 0–2-year-olds, our study did not report any deaths. Many of these children received treatment. Bilharzia is 9.54% which is much lower than the prevalence found by Tchouanguem et al in 2016 in Santchou, Cameroon among children aged 8 to 16 years who have easy contact with river water. As well as that of Solofianiaina JM who had found a prevalence of 0.7% to 69.90% in Madagascar in 2017.But the proportion that we found is in the range proposed by Solofianaina.

Scabiosis 1.94% is quite a low proportion compared to the figure of 5-10% (WHO) and 2.6% in 2018 (HRE). Dysenteria 0.71% is a low proportion, Typhoid fever 0.71% is quite low compared to the result of Ashaondu 9 in Cameroon in 2016 which was 4.4%. Regarding Pytiriasis versicolor 0.35% is a lower proportion compared to the 17% of cases in dermatological consultations in Tunisia, and against 5.21% of cases of mycoses in 0 to 13 years in Ebolowa (HRE) in 2018. But prevention measures for all these water-related pathologies should nevertheless be strengthened. The proportion of boys who suffered from waterborne diseases was 67.21%. This result is different from that of Some 1 in the sense that in his study girls (5.6%) were more affected by these water-related diseases than boys (4.95%) in Kofando, Burkina Faso. But similar to the study of Ndong in 2001. Figure 1

The proportion of waterborne diseases was 97% (549/566) among the children aged 0-5 years examined. Children with water-related illnesses had a median age of 36 months (24; 60). The proportion of boys who suffered from water-related diseases was 67.21% (369/549) and that of girls was 37.79% (180/549). This calls for new strategies to combat these waterborne diseases taking these factors into account in 2021.