ArticleJournal of global health2026
Pathogen-specific predicting factors of childhood diarrhoea and their seasonality: evaluation from Rohingya refugees and host population in Cox's Bazar, Bangladesh.
Article in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Bangladesh observed a sudden massive influx of Rohingya refugees in August 2017. This large migrant population relative to a smaller host community placed a burden and threat on the public health sector. Due to the lack of pathogen-specific predicting factors and the influence of seasonal variation on childhood diarrhoeal pathogens in a densely populated area, we aimed to explore the same among Rohingya refugees and the host population. Methods: We collected data from under-five children of Rohingya refugees and hosts between 2018 and 2023 from the Diarrhea Treatment Center (DTC)-based surveillance system that served our study population. We collected and tested stool samples to detect enteric pathogens. We performed a multiple logistic regression analysis to identify factors associated with individual pathogens. Results: Out of 3534 children, 1479 (41.9%) were Rohingya refugees, and 2055 (58.1%) were host children who visited DTCs. Bacterial pathogens were identified in 15% (n/N = 533/3534) of children, and rotavirus in 58% (n/N = 1492/2564). We found higher odds of Vibrio cholerae (adjusted odds ratio (aOR) = 2.12; 95% confidence interval (CI) = 1.21-3.74), non-typhoidal Salmonella (NTS) (aOR = 4.45; 95% CI = 2.04-9.68), and lower odds of rotavirus infection (aOR = 0.72; 95% CI = 0.59-0.89) during the wet season compared to the cold season. Lack of handwashing with soap before feeding the child increased the risk of Aeromonas infection (aOR = 1.85; 95% CI = 1.21-2.81). Drinking tube well water lowers the risk of Vibrio cholerae (95% CI = 0.24-0.71), rotavirus (95% CI = 0.57-0.86), and Aeromonas (95% CI = 0.36-0.75) infection. We found that the recent intake of vitamin A was a protective factor for Vibrio cholerae (95% CI = 0.26-0.76), Aeromonas (95% CI = 0.44-0.89), and NTS (95% CI = 0.12-0.56) enteric infections. Conclusions: Our results underscore the necessity of reinforcing routine diarrhoea surveillance for early detection of epidemics, vitamin A supplementation for children under five, and health education to prevent diarrhoea in vulnerable areas such as refugee camps.
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