Updated Estimates of Childhood Diarrheal Morbidity in 11 Sub‐Saharan African Countries Using the Latest Demographic and Health Surveys (2021–2024): A Multilevel Modified Poisson Regression Analysis.
Background: Diarrheal disease remains a leading cause of morbidity among children under 5 years of age in sub‐Saharan Africa, yet many estimates rely on outdated data. Using the most recent Demographic and Health Survey (DHS) datasets, this study is aimed at providing updated estimates of childhood...
| Publicado en: | BioMed Research International Vol. 2026; pp. 1 - 17 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
7/13/2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195340213&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195340213 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23146133 FT2T jtl: BioMed Research International issn: 23146133 maglogo: N pubinfo: dt: 7/13/2026 vid: 2026 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 195340213 195340213 195340213 10.1155/bmri/2495286 195340213 ppf: 1 ppct: 16 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Updated Estimates of Childhood Diarrheal Morbidity in 11 Sub‐Saharan African Countries Using the Latest Demographic and Health Surveys (2021–2024): A Multilevel Modified Poisson Regression Analysis. aug: au: Wondmeneh, Temesgen Gebeyehu Banerjee, Baisakhi affil: Department of Public Health, , College of Medical and Health Sciences, , Samara University, , Semera, Ethiopia, su.edu.et sug: subj: Diarrhea Epidemiology Demography Surveys Risk Assessment Africa South of the Sahara Human Male Female Child, Preschool Multimethod Studies Poisson Distribution Regression Adult Maternal Age Sex Factors Age Factors Health Literacy Socioeconomic Factors Insurance, Health Measles Vaccine Malnutrition Thinness Wasting Syndrome Health Services Accessibility Prenatal Care Postnatal Care Rotavirus Vaccines Anthelmintics Communications Media Child, Preschool: 2-5 years Adult: 19-44 years Male Female ab: Background: Diarrheal disease remains a leading cause of morbidity among children under 5 years of age in sub‐Saharan Africa, yet many estimates rely on outdated data. Using the most recent Demographic and Health Survey (DHS) datasets, this study is aimed at providing updated estimates of childhood diarrheal morbidity and at identifying associated factors to inform monitoring and targeted interventions. Methods: This study analyzed pooled DHS data collected between 2021 and 2024 from 11 sub‐Saharan African countries, focusing on diarrheal morbidity among 124,167 children under 5 years of age. A multilevel modified Poisson regression model was employed to estimate adjusted prevalence ratios (APRs) and corresponding 95% confidence intervals (CIs), accounting for the hierarchical structure of the data, including clustering at household and community levels. Statistical significance was declared at p < 0.05. Results: The prevalence of diarrheal morbidity among children under 5 years of age was 13.8% (95% CI: 13.6%–14.0%), with significant variation across the included sub‐Saharan African countries. Lower prevalence was observed among children born to mothers aged 25–34 years (APR = 0.89; 95% CI: 0.85–0.92) and 35–49 years (APR = 0.82; 95% CI: 0.78–0.86), female children (APR = 0.93; 95% CI: 0.91–0.96), children aged 37–59 months (APR = 0.42; 95% CI: 0.40–0.44), children of literate mothers (APR = 0.86; 95% CI: 0.82–0.89), those from wealthier households (APR = 0.84; 95% CI: 0.79–0.88), children covered by health insurance (APR = 0.89; 95% CI: 0.83–0.95), and those who had received measles vaccination (APR = 0.95; 95% CI: 0.90–0.99). Conversely, distance to health facilities as a big problem (APR = 1.09; 95% CI: 1.05–1.13), underweight status (APR = 1.17; 95% CI: 1.10–1.24), and wasting (APR = 1.17; 95% CI: 1.09–1.26) were associated with a higher prevalence of diarrheal morbidity. Positive associations were also observed for media exposure, improved toilet facilities, four or more antenatal care visits, postnatal checkups, vitamin A supplementation, rotavirus vaccination, and deworming treatment. These associations should be interpreted cautiously, as they are unlikely to be causal and may reflect reverse causation, residual confounding, or reporting and detection bias. Conclusion: Childhood diarrhea remains a major public health concern in sub‐Saharan Africa, with substantial variation across the included countries. Diarrheal morbidity among children under 5 years of age was associated with a range of biological, socioeconomic, nutritional, and health service–related factors. Lower diarrheal morbidity was associated with older maternal age, female sex, older child age, maternal literacy, higher household wealth, health insurance coverage, and measles vaccination, whereas undernutrition and barriers to healthcare access were associated with higher morbidity. Counterintuitive associations observed for several health service and infrastructure variables likely reflect reverse causation and reporting bias rather than harmful effects. These findings underscore the need for integrated interventions aimed at improving child nutrition, reducing socioeconomic inequalities, and expanding equitable access to quality healthcare services. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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