Diarrhea Disease Among Under-Five Children in Africa (2015-2024): a systematic review and meta-analysis

Abstract

This systematic review explores the determinants of diarrheal diseases among children under five in Africa between January 2015 and December 2024. Drawing on 102 studies from 22 countries, it identifies significant socioeconomic, environmental, and behavioral risk factors. Key findings highlight the influence of maternal education, household income, water source quality, sanitation facilities, and vaccination coverage. Evidence suggests that combining preventive measures—such as breastfeeding promotion, household water treatment, and proper waste management—can significantly reduce the incidence of childhood diarrhea. However, persistent inequalities, especially between urban and rural settings, limit the effectiveness of existing interventions. Consequently, policymakers, healthcare practitioners, and researchers should prioritize integrated, multisectoral approaches to address both immediate and structural determinants. Strengthening local research capacity, fostering cross-border collaborations, and ensuring sustained funding for vaccines and infrastructure are crucial for long-term success. Although currently under-researched, emerging factors such as climate change, media exposure, and potential reductions in international aid are increasingly recognized as important determinants that may significantly influence the future burden of diarrheal diseases. This review aims to guide more equitable and sustainable strategies to mitigate the burden of pediatric diarrheal diseases in Africa and improve outcomes for vulnerable populations.