Under-five children (U5-children) diarrhea is a significant public health threat, where the World Health Organisation (WHO) reported it as the second leading cause of children’s death worldwide. Nearly 1.7 billion cases occur annually with varied temporal and spatial factors. Identification of the spatiotemporal pattern and hotspot areas of U5-children diarrhea can assist targeted intervention and provide an early warning for more effective response measures. This study aimed at examining spatiotemporal variability along with the detection of hotspot areas for U5-children diarrhea in the Bench Maji Zone of southwestern Ethiopia, where resources are limited and cultural heterogeneity is highest. Retrospective longitudinal data of ten years of diarrhea records from January 2008 to December 2017 were used to identify hotspot areas. The incidence rate per 1,000 per year among children was calculated along with seasonal patterns of cases. The spatiotemporal analysis was made using SaTScan version 9.4, while spatial autocorrelations and hotspot identification were generated using ArcGIS 10.5 software. A total of 90,716 U5-children diarrhea cases were reported with an annual incidence rate of 36.1 per 1,000 U5-children, indicating a relative risk (RR) of 1.6 and a log-likelihood ratio (LLR) of 1,347.32 (p < 0.001). The highest incidence of diarrhea illness was recorded during the dry season and showed incidence rate increment from October to February. The risky clusters (RR > 1) were in the districts of Bero, Maji, Surma, Minit Shasha, Guraferda, Mizan Aman Town, and Sheko with annual cases of 127.93, 68.5, 65.12, 55.03, 55.67, 54.14 and 44.97 per 1,000, respectively. The lowest annual cases reported were in the four districts of Shay Bench, South Bench, North Bench, and Minit Goldiya, where RR was less than a unit. Six most likely clusters (Bero, Minit Shasha, Surma, Guraferda, South Bench, and Maji) and one lower RR area (North Bench) were hotspot districts. The U5-children's diarrhea in the study area showed an overall increasing trend during the dry seasons with non-random distribution over space and time. The data recorded during ten years and analyzed with the proper statistical tools helped to identify the hotspot areas with risky seasons where diarrhea could increase.

五岁以下儿童（U5 儿童）腹泻是一个重大的公共卫生威胁，世界卫生组织 (WHO) 将其报告为全球儿童死亡的第二大原因。每年发生近 17 亿例病例，其时间和空间因素各不相同。识别U5儿童腹泻的时空格局和热点区域，有助于有针对性的干预，并为更有效的应对措施提供早期预警。本研究旨在研究埃塞俄比亚西南部 Bench Maji 地区 U5 儿童腹泻的时空变异性以及检测热点地区，该地区资源有限且文化异质性最高。使用2008年1月至2017年12月十年腹泻记录的回顾性纵向数据来确定热点区域。儿童每年每千人的发病率是根据病例的季节性模式计算的。使用SaTScan 9.4版本进行时空分析，同时使用ArcGIS 10.5软件生成空间自相关和热点识别。总共报告了 90,716 例 U5 儿童腹泻病例，年发病率为每 1,000 名 U5 儿童 36.1 例，表明相对风险 (RR) 为 1.6，对数似然比 (LLR) 为 1,347.32 (p < 0.001)。腹泻疾病的发病率最高发生在旱季，并且从 10 月到 2 月发病率呈上升趋势。风险集群（RR > 1）位于贝罗、马吉、苏尔马、米尼特沙沙、古拉费尔达、米赞阿曼镇和舍科地区，每年每 1,000 人中有 127.93、68.5、65.12、55.03、55.67、54.14 和 44.97 例病例，分别。年度报告病例数最低的是 Shay Bench、South Bench、North Bench 和 Minit Goldiya 四个地区，这些地区的 RR 不到一个单位。六个最有可能的集群（Bero、Minit Shasha、Surma、Guraferda、South Bench 和 Maji）和 1 个较低 RR 区域（North Bench）是热点地区。研究区U5儿童腹泻在旱季总体呈上升趋势，且在空间和时间上呈非随机分布。十年来记录的数据并使用适当的统计工具进行分析，有助于确定腹泻可能增加的危险季节的热点地区。