Um Samnang, Phan Channnarong, Sakha Sok, Dany Leng
National Institute of Public Health (NIPH), Phnom Penh, Cambodia.
The Elite Angkor Clinic, Siem Reap, Cambodia.
PLoS One. 2025 Jan 23;20(1):e0316155. doi: 10.1371/journal.pone.0316155. eCollection 2025.
Diarrhea is a global public health problem that is the third leading cause of death in under five years, with an estimated 1.7 billion cases in 2023 and 1.8 million deaths from diarrhea diseases every year. To better understand child diarrhea in Cambodia, we examined to describe temporal and geospatial trends of diarrhea and used multiple logistic regression to analyze its association with individual and household characteristics and diarrhea among children aged 0-59 months using combined data from the Cambodia Demographic and Health Survey for 2005 to 2022. This study included 29,742 weighted children aged 0-59 months; there were 7,220 in 2005, 7,758 in 2010, 7,010 in 2014, and 7,754 in 2022, respectively. The prevalence of diarrhea among children aged 0-59 months decreased from 19.7% in 2005 to 6.2% in 2022. The highest prevalence of childhood diarrhea was observed in Kampong Cham (30.1%), in Mondul Kiri/Ratanak Kiri (24.6%), Battambang/Pailin (20.9%), and Mondul Kiri/Ratanak Kiri (12.9%) for the years 2005, 2010, 2014 and 2022. After adjusting for other variables, factors independently associated with a protective effect against childhood diarrhea included mothers aged 25-34 years (adjusted odds ratio (AOR) = 0.68; 95% CI: 0.48-0.96), 35-49 years (AOR = 0.60; 95% CI: 0.42-0.87), completed higher education (AOR = 0.61; 95% CI: 0.41-0.91), and employed (AOR = 0.79; 95% CI: 0.72-0.96). Children were less likely to have diarrhea if they were older than 36 months, belonged to the richest households (AOR = 0.69; 95% CI: 0.55-0.86), or lived in coastal region (AOR = 0.53; 95% CI: 0.41-0.69). Conversely, children born to mothers who smoke had increased odds of diarrhea (AOR = 1.61; 95% CI: 1.25-2.08), had barrier access to healthcare services (AOR = 1.20; 95% CI: 1.07-1.35), or children aged 6-23 months. Diarrhea remains highly prevalent among children in Cambodia. Public health interventions and policies to alleviate diarrhea should be prioritized to address these factors across geographical.
腹泻是一个全球性的公共卫生问题，是五岁以下儿童死亡的第三大主要原因，2023年估计有17亿例病例，每年有180万人死于腹泻疾病。为了更好地了解柬埔寨儿童腹泻情况，我们进行研究以描述腹泻的时间和地理空间趋势，并使用多因素逻辑回归分析其与0至59个月儿童的个人和家庭特征以及腹泻之间的关联，数据来自2005年至2022年柬埔寨人口与健康调查的合并数据。本研究纳入了29,742名加权的0至59个月儿童；2005年有7,220名，2010年有7,758名，2014年有7,010名，2022年有7,754名。0至59个月儿童腹泻患病率从2005年的19.7%降至2022年的6.2%。2005年、2010年、2014年和2022年，儿童腹泻患病率最高的分别是干丹省（30.1%）、蒙多基里省/腊塔纳基里省（24.6%）、马德望省/拜林市（20.9%）和蒙多基里省/腊塔纳基里省（12.9%）。在对其他变量进行调整后，与预防儿童腹泻保护作用独立相关的因素包括年龄25至34岁的母亲（调整后的优势比（AOR）=0.68；95%置信区间：0.48-0.96）、35至49岁的母亲（AOR =
0.60；95%置信区间：0.42-0.87）、完成高等教育（AOR = 0.61；95%置信区间：0.41-0.91）以及就业（AOR = 0.79；95%置信区间：0.72-0.96）。如果儿童年龄超过36个月、属于最富裕家庭（AOR = 0.69；95%置信区间：0.55-0.86）或居住在沿海地区（AOR = 0.53；95%置信区间：0.41-0.69），则患腹泻的可能性较小。相反，母亲吸烟的儿童患腹泻的几率增加（AOR = 1.61；95%置信区间：1.25-2.08），获得医疗保健服务存在障碍（AOR = 1.20；95%置信区间：1.07-1.35），或者是6至23个月的儿童。腹泻在柬埔寨儿童中仍然非常普遍。应优先采取公共卫生干预措施和政策来缓解腹泻，以应对这些地理区域内的因素。
