NDLI: Diarrhea and its associated factors among children aged under five years in Madagascar, 2024: a multilevel logistic regression analysis

Content Provider	Springer Nature : BioMed Central
Author	Lakew, Gebeyehu Yirsaw, Amlaku Nigusie Bogale, Eyob Ketema Andarge, Getnet Alemu Getachew, Demis Getachew, Eyob Tareke, Abiyu Abadi
Abstract	Background Diarrhea, defined as three or more loose stool per day, is a major cause of child mortality. Exploring its prevalence, and influencing factors is crucial for public health decision and targeted interventions. This study aimed to investigate these aspects using 2021 Madagascar demographic health survey data. Method This study employed a cross-sectional design, analyzing data from a total of 8,740 weighted under-five children. The dependent variable was the occurrence of diarrhea, which was measured based on caregiver-reported incidents within the previous two weeks prior to the survey. To identify factors associated with diarrhea, a multilevel logistic regression model was utilized, allowing for the examination of both individual and contextual factors. Statistical significance was determined at a p-value of less than 0.05. Results The analysis identified several significant factors associated with diarrhea in children under five. Children aged 7–12 months had a significantly higher risk of diarrhea (OR = 2.699, 95% CI: 2.028–3.591, p < 0.001) compared to those aged 0–6 months, while those aged 13–24 months were also at increased risk (OR = 2.079, 95% CI: 1.579–2.737, p < 0.001). Children using improved water sources had a lower likelihood of diarrhea (OR = 0.742, 95% CI: 0.583–0.944, p = 0.015). Female children were less likely to experience diarrhea compared to males (OR = 0.823, 95% CI: 0.708–0.956, p = 0.011). Mothers aged 25–34 years (OR = 0.741, 95% CI: 0.626–0.878, p = 0.001) and 35–49 years (OR = 0.628, 95% CI: 0.502–0.787, p = 0.03) had lower odds of their children having diarrhea compared to younger mothers (15–24 years). Primary maternal education was associated with a lower risk of diarrhea (OR = 0.77, 95% CI: 0.622–0.958, p = 0.019). Children from poorer (OR = 0.744, 95% CI: 0.591–0.937, p = 0.012) and middle-income households (OR = 0.732, 95% CI: 0.564–0.949, p = 0.019) had lower odds of diarrhea compared to those from the poorest households. Media exposure was significantly associated with higher odds of diarrhea (OR = 1.462, 95% CI: 1.208–1.769, p < 0.001). Conclusion Maternal age over 25 years, child age between 7 months to 2 years, and media access are risk factors for diarrhea. In contrast, medium or low wealth levels, the mother’s educational status, the child’s sex, and the source of drinking water seem to be protective factors. Public health interventions should prioritize improving access to clean water and sanitation facilities, along with promoting handwashing with soap. Educational campaigns targeted towards mothers, especially those with lower education levels, can significantly improve hygiene practices, safe water handling, and early symptom recognition of diarrhea.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20374-3.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-024-20374-3
Journal	BMC Public Health
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-10-21
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Children under five Madagascar Diarrheal diseases Multilevel logistic analysis Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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