Bantie Getnet Yirsaw

Title: Pooled prevalence of diarrheal disease and its determinants among under five children in east africa: Systematic review and meta analysis

Abstract

Introduction: Diarrhea is the public health challenge leading cause of malnutrition, morbidity, and mortality for under five children globally. The disease is more common in low and middle income countries such as Asia and Africa. While number of studies were conducted on burden of diarrheal disease among children under five, but none of them showed the pooled prevalence of diarrheal disease. Therefore, the objective of this study was to determine the pooled prevalence and its determinants of diarrhea among children aged under five in East Africa.

Methods: We searched articles published between January 01/2020 to October 31/2024 on prevalence of diarrheal disease among under five children using different databases such as PubMed, Scopus, ScienceDirect, and Google Scholar. We included studies that were published only in English language and report the prevalence of diarrhea disease among under five children in East African countries. We checked quality of each study using Newcastle Ottawa Scale (NOS) quality assessment scale and we performed the analysis by random effect model using statistical software STATA version 17 and R-version 4.4.2.

Result: A total of 162,388 children under five years were included in this review. About 93.33% of studies were conducted using cross-sectional study designs. The overall pooled prevalence of diarrhea among under five children in East Africa was 24.6%(95% CI: 22.7%, 26.6%). Improper waste disposal mechanism (OR = 1.67, 95% CI: 1.10, 2.53), large family size (OR = 1.38, 95% CI: 1.10, 1.72), two and above children under five years (OR = 1.6, 95% CI: 1.27, 2.03), unprotected source of water (OR=1.92, 95% CI: 1.39, 2.65), not vaccinated from rotavirus (OR = 2.06, 95% CI: 1.10, 3.85), unprotected toilet type (OR = 1.11, 95% CI: 1.01, 1.21), and households who spent more than thirty minutes to fetch water (OR = 1.35 95% CI: 1.05, 1.73) were risk factors responsible for the burden of diarrheal disease among children under five years.

Conclusions: The pooled prevalence of diarrhea among under five children in East Africa is still at high level. The finding of this study recommends intervention on family planning initiatives, improving sanitation practices, increase access to healthcare, providing access to clean water, rotavirus vaccination, and well established waste disposal mechanisms are critical issues to reduce the burden of diarrheal disease among children under five years.