Burden, etiology, and risk factors of diarrheal diseases among neonates in Eastern sub-Saharan Africa from 1990 to 2023
Wolyu Korma, Lechisa Asefa, Miesa Gelchu, Abraham Geremew, Anteneh Berhane, Maleda Tefera Ifa, Haymanot Mezmur, Abadi Hailay Atsbaha, Abadi Kidanemariam Berhe, Yemane Berhane Tesfau, Embaba Tekelaye Welesemayat, Embay Amare Alemseged, Yonas Angaw, Belda Negesa Beyene, Kebebew Lemma, Anteneh Fikrie Tekola, Sebsibe TadesseBackground
Diarrheal disease is the leading cause of child morbidity and mortality. However, there are only limited studies available in Africa. This study determined magnitude, burden, etiology, and risk factors of diarrheal disease among neonates (aged 0–27 days) in the Eastern Sub-Saharan African (ESSA) region from 1990 to 2023.
Method
The Global burden of Diseases 2023 estimates and methods were used. The incidence rate estimated was the cumulative incidence over the entire neonatal period (0–28 days), representing the total number of diarrheal episodes per 100,000 neonates during this period.
Results
There were an estimated 215,343 cumulative new cases of diarrheal disease per 100,000 neonates (95% UI: 186,566–240,723) in 2023. The highest incidence and prevalence rates were estimated in South Sudan, Madagascar, and Malawi, whereas the lowest prevalence rate was estimated in Mozambique. The highest years of life lost and disability-adjusted life years rates were estimated in Somalia, whereas the lowest were estimated in Uganda and Tanzania. Rotavirus, adenovirus, and shigella were the common causes of diarrheal disease, whereas unsafe water, poor sanitation, no access to hand-washing facilities, low birth weight, short gestation, and suboptimal breastfeeding were the leading risk factors.
Conclusion
This study has revealed that there was substantial reduction in the burden of diarrheal diseases among neonates in the ESSA region in 2023 compared to 1990. However, the rates remain high and heterogeneous across the region. Therefore, prevention activities should target high-risk populations, improving water, sanitation, and hygiene, infant nutrition, and vaccination.