Burden and Determinants of Diarrheal Disease Among Children Under Five in East Java, Indonesia: Findings From SSGI 2024

Diarrhea is one of the leading causes of morbidity among children under five in Indonesia and remains a major public health concern, particularly in the province East Java, which has the second-highest disease burden in the country. Unfortunately, evidence for provincial-level predictors of childhood diarrhea using recent national data is limited. This study aimed to estimate the burden of diarrhea among children under five and identify its associated factors to support targeted child health interventions. A cross-sectional analysis was conducted utilizing data from the 2024 Indonesian Nutrition Status Survey (SSGI). Data on children under five residing in East Java with complete data were observed. The outcome was diarrhea during the month preceding the survey. Explanatory variables included child characteristics, nutritional status, breastfeeding history, use of health insurance, residential area, and environmental factors. Survey-weighted descriptive analyses and logistic regression were conducted, and the results are presented as adjusted odds ratios (aORs) with 95% confidence intervals. Among children under five in Indonesia, the prevalence of diarrhea was 4.6%. Increased likelihood of diarrhea was identified in children aged 6 months or older (AOR = 5.18; 95% CI: 2.95 – 9.12), stunted children (aOR = 1.70; 95% CI: 1.00–2.87), those who were never breastfed (aOR = 1.76; 95% CI: 1.01–3.07), and those using high-risk drinking water sources (aOR = 6.60; 95% CI: 1.07–40.57). Reduced odds were observed in children from households that did not utilize health insurance in the year preceding the survey (aOR = 0.56; 95% CI: 0.41–0.77). In conclusion, childhood diarrhea in East Java is associated with age, nutritional status, breastfeeding history, health insurance utilization, and drinking water quality, highlighting the need for integrated interventions across these domains.