TITLE:
Prevalence and Determinants of Diarrhea among Children under Five in Sub-Saharan Africa: Evidence from Demographic and Health Surveys of 35 Sub-Saharan Countries
AUTHORS:
Seoyeon Choi
KEYWORDS:
Diarrhea, Demographic Health Surveys, Sub-Saharan Africa, Children Under Five, Multilevel Regression
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.15 No.3,
August
15,
2025
ABSTRACT: This study provides a comprehensive analysis of diarrheal prevalence and its determinants across 35 Sub-Saharan African (SSA) countries using the latest DHS data. Weighted analyses were performed, and multilevel logistic regression was applied to account for clustering effects. The prevalence of diarrhea was 15%. Higher odds of diarrhea were associated with younger child age, suboptimal immunization, malnutrition, lower maternal education, maternal employment, and lower household wealth index. Additionally, limited media exposure was identified as a significant risk factor, highlighting the role of health communication in disease prevention. Although the cross-sectional design does not establish causality, the findings underscore the need for integrated interventions, including maternal education programs, expanded media-based public health campaigns, improved water and sanitation infrastructure, and enhanced immunization services. Strengthening media-driven health education could play a crucial role in mitigating diarrheal disease, improving child health outcomes, and supporting child survival efforts across SSA. In contrast, the study provides valuable insights into the determinants of childhood diarrhea; its cross-sectional design limits causal interpretation.