Childhood diarrhoeal disease in South Asian countries: a population-based analysis.

abstractIntroduction: Despite advancements in water sanitation and vaccination, childhood diarrhoeal diseases (CDDs) continue to pose significant public health challenges, especially in South Asia. This study aims to estimate the pooled prevalence of CDDs in South Asia and identify the key factors contributing to its persistence, providing crucial insights for future policy and intervention strategies. Methods: This study utilised data from the most recent Demographic Health Surveys conducted between 2015 and 2022 in Afghanistan, Bangladesh, India, Nepal, the Maldives and Pakistan, focusing on children under 5 years old. Descriptive statistics were used to measure the prevalence of CDDs and multivariable logistic regression was performed to identify significant factors. A p value of <0.05 was considered as the level of significance. Results: The overall pooled prevalence of CDDs was 10.13% (95% CI 9.83 to 10.45). Afghanistan had the highest rate of childhood diarrhoea in the South Asian region, with a prevalence of 29.15% (95% CI 28.01% to 30.31%), while the Maldives had the lowest prevalence at 4.17% (95% CI 3.20% to 5.42%). Higher odds of CDDs were associated with younger children, male sex, younger mothers, mothers with little or no education, larger households, unimproved drinking water and type of toilet facilities, lack of access to antimicrobial agents for handwashing and limited electronic media access. However, these factors varied from country to country. Conclusion: This study highlights the persistently high prevalence of childhood diarrhoea in South Asia. Country-specific findings underscore the urgency for focused interventions, particularly in Afghanistan and Pakistan, to effectively reduce CDDs in the region.