Burden of Childhood Diarrhea and Its Associated Factors in Ethiopia: A Review of Observational Studies

IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
B. Sahiledengle, D. Atlaw, Lillian Mwanri, Pammla Petrucka, A. Kumie, Yohannes Tekalegn, F. Desta, Demisu Zenbaba, Telila Mesfin, Degefa Gomora, Kingsley Emwinyore Agho
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引用次数: 0

Abstract

Objectives: This systematic review and meta-analysis aimed to: i) determine the pooled prevalence of acute diarrhea; and ii) synthesize and summarize current evidence on factors of acute diarrheal illnesses among under-five children in Ethiopia.Methods: A comprehensive systematic search was conducted in PubMed, SCOPUS, HINARI, Science Direct, Google Scholar, Global Index Medicus, Directory of Open Access Journals (DOAJ), and the Cochrane Library. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The methodological quality of each included article was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional and case-control studies. A random-effect meta-analysis model was used to estimate the pooled prevalence of diarrheal illnesses. Heterogeneity and publication bias were assessed using I2 test statistics and Egger’s test, respectively. The statistical analysis was done using STATA™ software version 14.Results: Fifty-three studies covering over 27,458 under-five children who met the inclusion criteria were included. The pooled prevalence of diarrhea among under-five children in Ethiopia was found to be 20.8% (95% CI: 18.69–22.84, n = 44, I2 = 94.9%, p < 0.001). Our analysis revealed a higher prevalence of childhood diarrhea in age groups of 12–23 months 25.42% (95%CI: 21.50–29.35, I2 = 89.4%, p < 0.001). In general, the evidence suggests that diarrheal risk factors could include: i) child level determinants (child’s age 0–23 months, not being vaccinated against rotavirus, lack of exclusive breastfeeding, and being an under-nourished child); ii) parental level determinants {mothers poor handwashing practices [pooled odds ratio (OR) = 3.05; 95% CI:2.08–4.54] and a history of maternal recent diarrhea (pooled OR = 3.19, 95%CI: 1.94–5.25)}; and iii) Water, Sanitation and Hygiene (WASH) determinants [lack of toilet facility (pooled OR = 1.56, 95%CI: 1.05–2.33)], lack handwashing facility (pooled OR = 4.16, 95%CI: 2.49–6.95) and not treating drinking water (pooled OR = 2.28, 95% CI: 1.50–3.46).Conclusion: In Ethiopia, the prevalence of diarrhea among children under the age of five remains high and is still a public health problem. The contributing factors to acute diarrheal illnesses were child, parental, and WASH factors. A continued focus on improving access to WASH facilities, along with enhancing maternal hygiene behavior will accelerate reductions in diarrheal disease burden in Ethiopia.
埃塞俄比亚儿童腹泻的负担及其相关因素:观察研究综述
目标:本系统综述和荟萃分析旨在:i) 确定急性腹泻的总体流行率;ii) 综合并总结有关埃塞俄比亚五岁以下儿童急性腹泻疾病因素的现有证据:在 PubMed、SCOPUS、HINARI、Science Direct、Google Scholar、Global Index Medicus、Directory of Open Access Journals (DOAJ) 和 Cochrane Library 中进行了全面系统的搜索。本系统综述和荟萃分析遵循《系统综述和荟萃分析首选报告项目》(PRISMA)指南。采用乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的横断面和病例对照研究质量评估工具对每篇纳入文章的方法学质量进行了评估。采用随机效应荟萃分析模型估算腹泻疾病的总体患病率。异质性和发表偏倚分别使用 I2 检验统计量和 Egger 检验进行评估。统计分析采用 STATA™ 软件 14 版:符合纳入标准的 53 项研究涵盖了超过 27,458 名五岁以下儿童。研究发现,埃塞俄比亚五岁以下儿童腹泻的总患病率为 20.8%(95% CI:18.69-22.84,n = 44,I2 = 94.9%,p < 0.001)。我们的分析显示,12-23 个月年龄组的儿童腹泻发病率较高,为 25.42%(95%CI:21.50-29.35,I2 = 89.4%,p <0.001)。总体而言,证据表明腹泻风险因素可能包括:i) 儿童层面的决定因素(儿童年龄为 0-23 个月、未接种轮状病毒疫苗、缺乏纯母乳喂养、营养不良);ii) 家长层面的决定因素{母亲洗手习惯差[合计几率比(OR)=3.05;95%CI:2.08-4.54],以及母亲近期有腹泻史[合计几率比(OR)=3.05;95%CI:2.08-4.54]。54]和母亲近期有腹泻史(合计 OR = 3.19,95%CI:1.94-5.25)};以及 iii) 水、环境卫生和个人卫生(WASH)决定因素[缺乏厕所设施(合计 OR = 1.56,95%CI:1.05-2.33)]、缺乏洗手设施(合计 OR = 4.16,95%CI:2.49-6.95)和未处理饮用水(合计 OR = 2.28,95%CI:1.50-3.46):在埃塞俄比亚,5 岁以下儿童的腹泻发病率仍然很高,这仍然是一个公共卫生问题。导致急性腹泻病的因素包括儿童、父母和讲卫生运动。继续重视改善讲卫生运动设施的使用,同时加强产妇的个人卫生行为,将加速减轻埃塞俄比亚的腹泻疾病负担。
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来源期刊
International Journal of Public Health
International Journal of Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.20
自引率
2.20%
发文量
269
审稿时长
12 months
期刊介绍: The International Journal of Public Health publishes scientific articles relevant to global public health, from different countries and cultures, and assembles them into issues that raise awareness and understanding of public health problems and solutions. The Journal welcomes submissions of original research, critical and relevant reviews, methodological papers and manuscripts that emphasize theoretical content. IJPH sometimes publishes commentaries and opinions. Special issues highlight key areas of current research. The Editorial Board''s mission is to provide a thoughtful forum for contemporary issues and challenges in global public health research and practice.
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