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Meta-Analysis
. 2018 Jun 28;13(6):e0199684.
doi: 10.1371/journal.pone.0199684. eCollection 2018.

Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis

Animut Alebel  1 , Cheru Tesema  1 , Belisty Temesgen  2 , Alemu Gebrie  1 , Pammla Petrucka  3   4 , Getiye Dejenu Kibret  1
Affiliations
Meta-Analysis

Prevalence and determinants of diarrhea among under-five children in Ethiopia: A systematic review and meta-analysis

Animut Alebel et al. PLoS One. .

Abstract

Background: Despite remarkable progress in the reduction of under-five mortality, childhood diarrhea is still the leading cause of mortality and morbidity in this highly susceptible and vulnerable population. In Ethiopia, study findings regarding prevalence and determinants of diarrhea amongst under-five children have been inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of diarrhea and its determinants among under-five children in Ethiopia.

Methods: International databases, including PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library, were systematically searched. All identified observational studies reporting the prevalence and determinants of diarrhea among under-five children in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. STATA Version 13 statistical software was used. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. A random effects model was computed to estimate the pooled prevalence of diarrhea. Moreover, the associations between determinant factors and childhood diarrhea were examined using the random effect model.

Results: After reviewing of 535 studies, 31studies fulfilled the inclusion criteria and were included in the meta-analysis. The findings from the 31 studies revealed that the pooled prevalence of diarrhea among under-five children in Ethiopia was 22% (95%CI: 19, 25%). Subgroup analysis of this study revealed that the highest prevalence was observed in Afar region (27%), followed by Somali and Dire Dawa regions (26%), then Addis Abeba (24%). Lack of maternal education (OR: 2.5, 95% CI: 1.3, 2.1), lack of availability of latrine (OR: 2.0, 95%CI: 1.3, 3.2), urban residence (OR: 1.9, 95%CI: 1.2, 3.0), and maternal hand washing (OR: 2.2, 95%CI: 2.0, 2.6) were significantly associated with childhood diarrhea.

Conclusion: In this study, diarrhea among under-five children in Ethiopia was significantly high. Lack of maternal education, lack of availability of latrine, urban residence, and lack of maternal hand washing were significantly associated with childhood diarrhea.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection for systematic review and meta-analysis of the prevalence and determinants of diarrhea among under-five children in Ethiopia.
Fig 2
Fig 2. Forest plot of the pooled prevalence of diarrhea among under-five children in Ethiopia.
Fig 3
Fig 3. Funnel plot with 95% confidence limits of the pooled prevalence of diarrhea among under-five children in Ethiopia.
Fig 4
Fig 4. The pooled odds ratio of the association between maternal education and childhood diarrhea in Ethiopia.
Fig 5
Fig 5. The pooled odds ratio of the association between latrine availability and childhood diarrhea in Ethiopia.
Fig 6
Fig 6. The pooled odds ratio of the association between residence and childhood diarrhea in Ethiopia.
Fig 7
Fig 7. The pooled odds ratio of the association between maternal hand washing practices and childhood diarrhea in Ethiopia.
See this image and copyright information in PMC

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