Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 Sep 20;16(9):e0257522. doi: 10.1371/journal.pone.0257522. eCollection 2021.
Diarrhea is responsible for the death of more than 90% of under-five children in low and lower-middle income countries. Regionally, South Asia and sub-Saharan Africa accounted for 88% of deaths with the same age group. Therefore, the aim of this study was to determine the prevalence and associated factors of diarrhea among children under-five years in sub-Saharan Africa.
The appended, most recent demographic and health survey datasets of 34 sub-Saharan African countries were used to determine the prevalence and associated factors of diarrhea among under-five children in the region. A total weighted sample of 330,866 under-five children were included in the study. Both bivariable and multivariable multilevel logistic regression were done to determine the associated factors of diarrhea among under five children in sub-Saharan Africa. The Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated for those potential factors included in the final model.
The overall prevalence of diarrhea in this study was 15.3% (95% CI: 15.1-15.4). Those children of mothers aged 15-24 (AOR = 1.26; 95% CI: 1.23, 1.30) and 25-34 years (AOR = 1.15; 95%CI: 1.12, 1.18), those children of mothers with no education (AOR = 1.69; 95%CI: 1.57-1.82), primary education (AOR = 1.73; 95%CI: 1.61-1.86) and secondary education (AOR = 1.49; 95%CI: 1.38-1.59) had higher odds of having diarrhea. Those children from poorest (AOR = 1.14; 95%CI: 1.10, 1.19), poorer (AOR = 1.12; 95%CI: 1.08-1.17), middle (AOR = 1.06; 95%CI: 1.02, 1.10), and richer (AOR = 1.14; 95%CI: 1.04-1.12) households had higher chance of having diarrhea compared to their counterparts.
This study found that the prevalence of childhood diarrhea morbidity in sub-Saharan Africa was high. Maternal age, wealth index, maternal education, maternal occupation, age of child, time of initiation of breast feeding and time to get water source were significantly associated with diarrhea. Therefore, intervention through health education and health promotion for mothers/caretakers who are poor, less educated, and young should be designed to prevent diarrhea in the region.
腹泻是导致低和中低收入国家 5 岁以下儿童死亡的主要原因，超过 90%。在区域层面上，南亚和撒哈拉以南非洲地区占 5 岁以下儿童死亡人数的 88%。因此，本研究旨在确定撒哈拉以南非洲地区 5 岁以下儿童腹泻的患病率及其相关因素。本研究使用附录中最近的 34 个撒哈拉以南非洲国家的人口和健康调查数据集，以确定该地区 5 岁以下儿童腹泻的患病率及其相关因素。共有 330866 名 5 岁以下儿童被纳入本研究。采用双变量和多变量多水平逻辑回归来确定撒哈拉以南非洲地区 5 岁以下儿童腹泻的相关因素。对最终模型中包含的潜在因素进行了比值比（OR）和 95%置信区间（CI）的计算。
本研究中腹泻的总体患病率为 15.3%（95%CI：15.1-15.4）。母亲年龄在 15-24 岁（AOR=1.26；95%CI：1.23，1.30）和 25-34 岁（AOR=1.15；95%CI：1.12，1.18），母亲未受过教育（AOR=1.69；95%CI：1.57-1.82）、小学教育（AOR=1.73；95%CI：1.61-1.86）和中学教育（AOR=1.49；95%CI：1.38-1.59）的儿童腹泻的几率更高。来自最贫困（AOR=1.14；95%CI：1.10-1.19）、较贫困（AOR=1.12；95%CI：1.08-1.17）、中等（AOR=1.06；95%CI：1.02-1.10）和较富裕（AOR=1.14；95%CI：1.04-1.12）家庭的儿童腹泻几率更高。
本研究发现，撒哈拉以南非洲地区儿童腹泻发病率较高。母亲年龄、财富指数、母亲教育程度、母亲职业、儿童年龄、开始母乳喂养时间和获得水源时间与腹泻显著相关。因此，应该针对贫困、教育程度低和年轻的母亲/照顾者开展健康教育和健康促进干预，以预防该地区的腹泻。
