Abstract
BackgroundDespite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia.MethodsInternational databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model.ResultsAfter reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea.ConclusionIn this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.
Highlights
Childhood diarrhea is defined as the passage of three or more loose or watery stools per 24 hours or an increase in stool frequency or liquidity that is considered abnormal by the mother [1, 2]
The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%Confidence Interval (CI): 19, 25%)
Lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea
Summary
Childhood diarrhea is defined as the passage of three or more loose or watery stools per 24 hours or an increase in stool frequency or liquidity that is considered abnormal by the mother [1, 2]. Despite remarkable progress in the reduction of under-five mortality, childhood diarrheal disease is still a leading cause of mortality and morbidity [3, 4]. In Ethiopia, diarrheal diseases are major contributors to under-five mortality. According to the 2016 Ethiopia Demographic and Health Survey report,12% of under-five children had a diarrheal episode in the 2 weeks before the survey [10]. More than half of under-five child deaths are attributable to diseases that are preventable and treatable through simple, cost effective, and affordable interventions. In 2015, the United Nation adopted the Sustainable Development Goals (SDGs) to reduce child mortality and to promote well-being for all children. The SDG goal #3 Target 3.2 aims to end preventable deaths of newborns and under-five children by 2030 [7]. The Ethiopian government implemented various strategies, such as the Health Extension Program, to prevent and control infectious diseases like diarrhea [11]
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