Prevalence of diarrheal disease and its determinants among children under five in East Africa: systematic review and meta-analysis
Bibliographic record
Abstract
INTRODUCTION: Diarrhea is a public health challenge, the leading cause of malnutrition, morbidity, and mortality for children under five years globally. The disease is more common in low and middle-income countries such as Asia and Africa. While several studies were conducted on the prevalence of diarrheal disease among children under five, none of them showed the pooled prevalence of diarrheal disease. Therefore, this study aimed to determine the pooled prevalence and its determinants of diarrhea among children under five in East Africa. METHODS: We searched articles published between January 01/2020, to October 31/2024, on the prevalence of diarrheal disease among children under five years old using different databases such as PubMed, Scopus, Science Direct, and Google Scholar. We included studies that were published only in the English language and report the prevalence of diarrhea among children under five in East African countries. To get the total number of children under the age of five in our study, we summed the sample sizes from chosen studies.We checked the quality of each study using the 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 children under five 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 prevalence of diarrheal disease among children under five years. CONCLUSIONS: The pooled prevalence of diarrhea among children under five in East Africa is still at a high level. The finding of this study recommends intervention on family planning initiatives, improving sanitation practices, increasing access to healthcare, providing access to clean water, rotavirus vaccination, and well-established waste disposal mechanisms, which could be the critical issues to reduce the prevalence of diarrheal disease among children under five years.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.035 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.030 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".