Does seasonal variation affect diarrhoea prevalence among children in India? An analysis based on spatial regression models

Abstract

Abstract Diarrhoea is the eighth leading cause of childhood mortality and is responsible for 1.6 million deaths/year in children under five years of age. This study aims to explore the effect of seasonal variation over diarrhoea prevalence among children in India. Data from the National Family Health Survey was used, which was conducted in 2015–16 in India (N = 259,627). Spatial regression analysis (ordinary least square, spatial lag model and spatial error model) was done across 640 districts of India to carve out the results. Moran’s I value for diarrhoea prevalence was 0.375, which indicates high spatial auto-correlation in diarrhoea over the districts of India. Diarrhoea prevalence is highly concentrated in the northern region of India, i.e. in the state of Uttarakhand, Punjab, Haryana, Delhi, Himachal Pradesh, Uttar-Pradesh, Bihar and north part of Madhya Pradesh, Jharkhand, and Chhattisgarh. The spatial error models indicate that the 10% point increase in birth order four and above will increase the diarrhoea prevalence by 1.18% in a respective district. Similarly, if open defecation and unsafe stool disposal in a district increases by 10% points than the prevalence of diarrhoea will increase by 0.71% and 0.48% in the respective district. Additionally, if the length of the spring season increases by 10% points the prevalence of diarrhoea increases by 0.10% points. Therefore, the study concludes that seasonal variation had an impact on diarrhoea prevalence among children in India. Therefore, identifying the risk areas would undoubtedly help in designing effective interventions to reduce diarrhoea among children in these areas and seasons when the risk of diarrhoea is high.