Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis

Abstract

Background Worldwide, diarrhea is the second most common cause of death and morbidity among under -five years’ children. In sub-saran Africa, access to water, sanitation, and hygiene are very scanty and the burden of diarrhea diseases is countless relative to the rest of the world. Prior studies conducted in East Africa vary in design, sample size, and other data collection tools. Through those studies, it is hard to make regional comparisons. Combining datasets that are studied on similar people and having common variable identified enhances statistical power due to the large sample size, advance the ability to compare outcomes, and create the opportunity to develop new indicators. Hence, this study aimed to assess the prevalence and associated factors of diarrhea among under five years’ children using the most recent national representative Demographic and Health Surveys from 12 East African countries. The information generated from this pooled datasets will give good insight into the sub-regional prevalence of diarrhea. Methods This study utilized secondary data from 12 East African countries’ most recent demographic health survey. Variables were extracted and appended together to assess the pooled prevalence of diarrhea and associated factors. A total of 90,263 under-five years of age children were encompassed in this study. STATA version was used to cross-tabulate and fit the models. To account for the hierarchical nature of the demographic health survey, multilevel logistic regression was calibrated. BIC, AIC, deviance, and LLR were used as Model comparison parameters. Variables with a p-value of <0.2 were considered for multivariable analysis. Adjusted odds ratio with 95% CI and p-value <0.05 were used to declare statistical significances of factors. Results The pooled prevalence of diarrhea in under five years children was 14.28% [95%CI; 14.06%, 14.51%]. Being child whose mother age is 15–24 years [AOR = 1.41, 95% CI; 1.33, 1.49], 25–34 years[AOR = 1.17, 95%CI; 1.10, 1.23], being 7–12 months child [AOR = 3.10, 95%CI; 2.86, 3.35], being 12–24 months child [AOR = 2.56, 95%CI; 2.38, 3.75], being 25–59 months child [AOR = 0.88, 95%CI; 0.82, 0.95], being child from poor household [AOR = 1.16, 95%CI; 1.09, 1.23], delayed breast feeding initiation (initiated after an hour of birth) [AOR = 1.15, 95%CI; 1.10, 1.20], and being a child from community with low educational status [AOR = 1.10, 95%CI; 1.03, 1.18] were factors associated with diarrheal diseases. Conclusion The pooled prevalence of diarrhea among under five years of children in East African countries is high. Maternal age, child’s age, wealth status of the household, the timing of breast feeding initiation, sex of the child, community level of educational status, working status of the mother, and the number of under five children were factors that were associated with diarrheal diseases. Scaling up of maternal and child health services by government and other concerned bodies should consider those economically marginalized communities. Additionally, awareness should be created for those uneducated mothers concerning the nature of childhood diarrhea.

Prevalence of Diarrhea, Intestinal Parasites, and Associated Factors Among Under-Five Children in Dabat District, Northwest Ethiopia: Multicenter Cross-sectional Study

“…30,33,36 The likely hood of developing diarrhea disease was 3.9 times higher among children whose families did not access a private latrine as compared to children whose families those private latrines (AOR = 3.9; 95% CI: 1.23-9). This study is consistent with a study conducted in East Africa, 4 in Malaysia. 37 Children who were without access to clean latrines had an increased chance of contamination with microorganisms due to possible contact with fecal materials, which result in an increased chance to dispose of diarrhea disease.…”

“…This study was comparable with the study conducted in the Jabithennan District of northwest Ethiopia (21%). 24 This result was higher as compared to the study conducted in East Africa 14.28% 4 and in Rwanda;13.2%. 25 This high prevalence might be due to the low level of personal hygiene, food hygiene, and sanitation-related knowledge on diarrhea prevention.…”

“…2 Diarrhea remains a public health problem of under-5 years old children that affects poor countries. 3,4 The leading causes of diarrhea deaths are severe dehydration and fluid loss for most people and children. 3 According to the World Health Organization, data from 2021 indicated that diarrheal disease is responsible for 8% of deaths in children under the age of 5.…”

“…2 In the world, more than 1 billion children under the age of 5 years are affected by intestinal parasitic infection due to malnutrition and living in poverty. 4 The Indian National Family Health Survey indicates that between 2016 and 2020, the nationwide prevalence of childhood diarrhea increased from 9% to 9.2%. 2 The electronic gastrointestinal clinical surveillance and reporting system in China has also revealed that there are 180 000-190 000 episodes of diarrhea overall, with 35% of those cases being infectious diarrhea.…”

Clinical characteristics and influencing factors of infectious diarrhea in preschool children: An observational study

“…These regular behaviors such as regular eating leftovers, regular intake of lactobacillus products, and regular eating out were identified as this behavior occurring with frequencies ≥3 times per week and ≥3 weeks per month. [14,15] Stool samples from all patients were sent to the laboratory for microscopic examination, including red blood cells, white blood cells, and some visible organisms under a microscope. Bacteria were diagnosed by staining, stool cultures, and serological test.…”