Temporal trends of diarrheal diseases and associated treatment responses among children aged under five: Insight from the multiple Indicator Cluster surveys from 2006 to 2019.

Background: Despite significant progress in its health sector, Bangladesh has a high burden of diarrheal mortality and morbidity in the South Asian region. Given recent major social and economic transitions in Bangladesh, it is important to examine how patterns of diarrhea and its treatment have evolved over the past few decades. The current study aims to assess the temporal changes in the frequency of diarrhea and identify the factors that influence whether affected children receive proper treatment.

Methods: The current study utilized data from three Bangladesh Multiple Indicator Cluster Surveys (MICS), 2006, 2012-13, and 2019, respectively. Binary logistic regressions were conducted, and the reported results included odds ratios (OR) and 95% confidence intervals (CIs). A p-value of <0.05 was considered statistically significant (α = 0.05).

Results: The prevalence of diarrhea in Bangladesh declined from 7.05% in 2006 to 3.91% in 2012-13, but then increased to 8.78% in 2019. The proportion of children with diarrhea who received oral rehydration therapy (ORT) was 68.91%, 77.35%, and 70.59% respectively. Binary logistic regression indicated that older children (OR:0.54; CI:0.51-0.58), females (OR:0.92; CI:0.86-0.98), children from upper quintile families, and children from mothers having primary education (OR:0.9; CI:0.83-0.98) were less likely to suffer from diarrhea. However, the odds of receiving proper treatment with ORT were higher among older children (OR:1.45; CI:1.26-1.68), children from the rich and richest quintiles (OR:1.85; CI:1.47-2.32 and OR:1.7; CI:1.32-2.2 respectively). Also, it was the same for children from mothers with primary (OR:1.19; CI:1.01-1.41) and secondary or above education (OR:1.32; CI:1.12-1.56).

Conclusion: A targeted approach is needed to reduce diarrhea and promote the use of ORT. Maternal education can be an important intervention, and steps should be taken to reduce poverty. Future policies should consider strategies focusing on socioeconomic and environmental factors.