Sarker Abdur Razzaque, Hasan Anik, Nawar Nuzhat, Islam Rasedul
Population Studies Division, Bangladesh Institute of Development Studies, Dhaka, Bangladesh.
BMJ Public Health. 2025 Aug 10;3(2):e001909. doi: 10.1136/bmjph-2024-001909. eCollection 2025.
Despite advancements in water sanitation and vaccination, childhood diarrhoeal diseases (CDDs) continue to pose significant public health challenges, especially in South Asia. This study aims to estimate the pooled prevalence of CDDs in South Asia and identify the key factors contributing to its persistence, providing crucial insights for future policy and intervention strategies.
This study utilised data from the most recent Demographic Health Surveys conducted between 2015 and 2022 in Afghanistan, Bangladesh, India, Nepal, the Maldives and Pakistan, focusing on children under 5 years old. Descriptive statistics were used to measure the prevalence of CDDs and multivariable logistic regression was performed to identify significant factors. A p value of <0.05 was considered as the level of significance.
The overall pooled prevalence of CDDs was 10.13% (95% CI 9.83 to 10.45). Afghanistan had the highest rate of childhood diarrhoea in the South Asian region, with a prevalence of 29.15% (95% CI 28.01% to 30.31%), while the Maldives had the lowest prevalence at 4.17% (95% CI 3.20% to 5.42%). Higher odds of CDDs were associated with younger children, male sex, younger mothers, mothers with little or no education, larger households, unimproved drinking water and type of toilet facilities, lack of access to antimicrobial agents for handwashing and limited electronic media access. However, these factors varied from country to country.
This study highlights the persistently high prevalence of childhood diarrhoea in South Asia. Country-specific findings underscore the urgency for focused interventions, particularly in Afghanistan and Pakistan, to effectively reduce CDDs in the region.
尽管在水卫生设施和疫苗接种方面取得了进展，但儿童腹泻疾病（CDD）仍然对公共卫生构成重大挑战，尤其是在南亚地区。本研究旨在估计南亚地区儿童腹泻疾病的综合患病率，并确定导致其持续存在的关键因素，为未来的政策和干预策略提供重要见解。
本研究利用了2015年至2022年期间在阿富汗、孟加拉国、印度、尼泊尔、马尔代夫和巴基斯坦进行的最新人口与健康调查数据，重点关注5岁以下儿童。使用描述性统计来衡量儿童腹泻疾病的患病率，并进行多变量逻辑回归以确定显著因素。p值<0.05被视为显著性水平。
儿童腹泻疾病的总体综合患病率为10.13%（95%置信区间为9.83%至10.45%）。阿富汗是南亚地区儿童腹泻发病率最高的国家，患病率为29.15%（95%置信区间为28.01%至30.31%），而马尔代夫的患病率最低，为4.17%（95%置信区间为3.20%至5.42%）。儿童腹泻疾病的较高发病率与年龄较小的儿童、男性、较年轻的母亲、受教育程度低或未受过教育的母亲、家庭规模较大、饮用水未改善、厕所设施类型、无法获得抗菌洗手液以及电子媒体使用受限有关。然而，这些因素因国家而异。
本研究强调了南亚地区儿童腹泻患病率持续居高不下的情况。各国的具体研究结果凸显了针对性干预措施的紧迫性，特别是在阿富汗和巴基斯坦，以有效减少该地区的儿童腹泻疾病。
