Ali Hamse Arab, Nuh Abdulkadir Mohamed, Abdi Hamse Adam, Muse Abdisalam Hassan
Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University , Borama, Somaliland.
Department of Nutrition and Dietetics, Addis-ababa Medical University College, Hargeisa, Somaliland.
BMC Public Health. 2025 Jan 17;25(1):202. doi: 10.1186/s12889-025-21435-x.
Diarrheal diseases remain a critical public health challenge, particularly for children under five in low- and middle-income countries such as Somalia. This study aimed to assess the prevalence and determinants of diarrhea in this vulnerable population, utilizing data from the 2020 Somalia Demographic and Health Survey.
This investigation employed secondary data from the 2020 Somalia Demographic and Health Survey. The analysis involved the extraction and cleaning of variables using STATA version 17. The primary outcome variable was childhood diarrhea, analyzed alongside 19 explanatory variables encompassing sociodemographic and environmental factors. Descriptive statistics, chi-square tests, and multilevel logistic regression models were employed to elucidate associations.
The study identified a diarrhea prevalence of 5.24%. Notably, sociodemographic factors significantly influenced this prevalence. Families within the second wealth category exhibited reduced odds of diarrhea (AOR = 0.699; 95% CI: 0.522-0.936), with those in the middle wealth category experiencing even lower odds (AOR = 0.524; CI: 0.391-0.702). Vitamin A supplementation was found to be critical; children lacking recent supplementation had increased odds of diarrhea (AOR = 1.790; CI: 1.440-2.225). Furthermore, feeding practices indicated that children not using bottle nipples faced higher odds of diarrhea (AOR = 1.377; CI: 1.172-1.617). Maternal age also played a significant role, with mothers aged 45-49 presenting higher odds of their children experiencing diarrhea (AOR = 7.650; CI: 1.762-33.184). Institutional births were associated with lower odds of diarrhea (AOR = 0.693; CI: 0.568-0.847), while children of educated fathers exhibited increased odds (AOR = 1.414; CI: 1.090-1.833). Additionally, lack of deworming medication significantly heightened the odds of diarrhea (AOR = 4.450; CI: 3.619-5.482).
The prevalence of diarrhea among children under five relatively high in Somalia. Key determinants include vitamin A supplementation, feeding with bottle, household wealth, age of mothers, place of delivery, paternal education, and deworming medication. Public health interventions should focus on enhancing household economic status, and ensuring regular deworming. Increasing the coverage and frequency of vitamin A supplementation could enhance children's immune systems and reduce diarrhea incidence. Moreover, targeted economic support, health care programs for older mothers are essential to mitigate the adverse effects of socioeconomic factors on child health, ultimately leading to a substantial reduction in diarrheal diseases among young children.
腹泻病仍然是一项严峻的公共卫生挑战，对于索马里等低收入和中等收入国家的五岁以下儿童而言尤为如此。本研究旨在利用2020年索马里人口与健康调查的数据，评估这一弱势群体中腹泻的患病率及其决定因素。
本调查采用了2020年索马里人口与健康调查的二手数据。分析过程包括使用STATA 17版本提取和清理变量。主要结局变量为儿童腹泻，并与19个解释变量一起进行分析，这些变量涵盖社会人口统计学和环境因素。采用描述性统计、卡方检验和多水平逻辑回归模型来阐明相关性。
该研究确定腹泻患病率为5.24%。值得注意的是，社会人口统计学因素对这一患病率有显著影响。第二财富类别的家庭腹泻几率降低（调整优势比[AOR]=0.699；95%置信区间[CI]：0.522-0.936），中等财富类别的家庭腹泻几率更低（AOR=0.524；CI：0.391-0.702）。发现维生素A补充剂至关重要；近期未补充维生素A的儿童腹泻几率增加（AOR=1.790；CI：1.440-2.225）。此外，喂养方式表明，不使用奶瓶奶嘴的儿童腹泻几率更高（AOR=1.377；CI：1.172-1.617）。母亲年龄也起着重要作用，45至49岁的母亲其子女腹泻几率更高（AOR=7.650；CI：1.762-33.184）。机构分娩与较低的腹泻几率相关（AOR=0.693；CI：0.568-0.847），而父亲受过教育的儿童腹泻几率增加（AOR=1.414；CI：1.090-1.833）。此外，缺乏驱虫药物显著增加了腹泻几率（AOR=4.450；CI：3.619-5.482）。
索马里五岁以下儿童腹泻患病率相对较高。关键决定因素包括维生素A补充剂、奶瓶喂养、家庭财富、母亲年龄、分娩地点、父亲教育程度和驱虫药物。公共卫生干预措施应侧重于提高家庭经济状况并确保定期驱虫。提高维生素A补充剂的覆盖率和频率可以增强儿童的免疫系统并降低腹泻发病率。此外，有针对性的经济支持、针对高龄母亲的医疗保健项目对于减轻社会经济因素对儿童健康的不利影响至关重要，最终可大幅降低幼儿腹泻病的发病率。
