Socioeconomic factors associated with dysentery in children under-five years from developing countries

Objective Dysentery represents 10% of all causes of acute diarrhea in the world and recognizing the implied proximal and distal social factors at different levels would impact on every related outcome. Our purpose is to identify mother, household and country characteristics that favor the presence of dysentery in children under 5 years old.

Methods We conducted a multilevel analysis of data from phase V of the Demographic and Health Survey and the World Bank, which included 38,762 children from 33 countries.

Results Prevalence of dysentery was 14.74%. GDP per-capita was negative associated (OR= 0.75; 95% CI 0.71-0.78) and Gini index was positive associated (OR= 1.23; 95% CI 1.19-1.28). Additionally, child age (OR= 0.99; 95% CI 0.99-1.00), mother age (OR= 1.01; 95% CI 1.00-1.01), employed mother (OR= 1.11; 95% CI 1.02-1.20), and number of household members (OR= 1.02; 95% CI 1.01-1.03) have significant positive associations with the presence of dysentery, while complete immunization schedule (OR= 0.88; 95% CI 0.81-0.96), duration of breastfeeding (OR= 0.81; 95% CI 0.75-0.89), and type of residence (OR= 0.87; 95% CI 0.79-0.97) have significant negative associations with having the illness. Finally, each of the categories of wealth index showed a significant association with dysentery (p-value < 0.001).

Conclusions Lower per capita GDP and higher Gini coefficient are associated with the development of dysentery, regardless of characteristics of children, their mother, and household. Future and present public health programs should address these issues in order to impact on the occurrence of this illness.

Author summary Dysentery represents 10% of all causes of acute diarrheal disease. Diarrhea is the fifth cause of worldwide death in children under five years old. It is particularly important to assess and prevent this condition because the early years of life are critical since it is the period when the brain develops most rapidly and has a high capacity for change. Complications associated with dysentery such as malnutrition and convulsive episodes could have a negative effect in this aspect.

Our purpose is to identify the country proximal and distal socioeconomic factors that favor the presence of dysentery in children under five years old from low and middle-income developing countries in order to impact on the occurrence of this illness and its related outcomes. Studying associated factors with developing dysentery during an episode of acute diarrhea could be the base upon which we can diminish mortality from this illness through national policies to impact on national, community and household aspects.