A Meta-Analisis of Correlation between Diarrhea and Stunting in Children Under Five
DOI:
https://doi.org/10.26911/jepublichealth.2023.08.01.08Abstract
Background: Diarrhea is an infectious disease that can cause children to experience appetite disturbances, resulting in reduced nutritional intake, while the nutrients consumed also fail to be properly absorbed by the body. If this condition is not balanced with appropriate food intake, it can have an impact on cognitive development disorders and height growth, namely stunting. This study aimed to determine whether there was a relationship between a history of diarrhea and the incidence of stunting in toddlers, through a meta-analysis of primary studies conducted by previous authors.
Subjects and Method: This study was conducted using a systematic review and meta-analysis with PICO namely, Population: under five, Intervention; diarrhea, comparison: no diarrhea, outcome: stunting. By searching for articles in 2 databases, namely PubMed and Google Scholar, which were published from 2017 to 2022, following keywords "Diarrhea" AND "Stunting" AND "adjusted Odds Ratio" OR "aOR". The included article is a full-text cross-sectional study design for 2017-2022 and reports the adjusted odds ratio (aOR) in multivariate analysis. Articles were selected using prism flow with inclusion criteria, namely, and data analysis using the Review Manager 5.3 application.
Results: In total there were 9 articles using a cross-sectional study design with a total sample of 69,549 children under five from Ethiopia, Uganda, Indonesia, Pakistan which had been carried out systematic review and meta-analysis. The data that has been processed shows that toddlers with a history of diarrhea have a risk of experiencing stunting 1.21 times compared to toddlers without a history of diarrhea (aOR= 1.57; 95% CI= 1.20 to 2.05; p< 0.001).
Conclusion: Toddlers with a history of diarrhea have a risk of experiencing stunting compared to toddlers without a history of diarrhea.
Keywords: diarrhea, stunting, toddlers
Correspondence:
Reza Ramadhana Tahta Firmansyah, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: ramadhanatahta@gmail.com. Mobile: +6282228390930.
References
Abeway S, Gebremichael, Murugan R, Assefa M, Adinew YM (2018). Stun-ting and its determinants among children aged 6–59 months in northern ethiopia: a cross-sectional study. J Nutr Metab. 2: 1-8. doi: 10.1155/2018/1078480.
Ademas A, Adane M, Keleb A, Berihun G, Tesfaw G (2021). Water, sanitation, and hygiene as a priority intervention for stunting in under-five children in northwest ethiopia: a community-based cross-sectional study. Ital J Pediatr. 47(174): 1-11. doi: 10.1186/s1-3052-021-01128-y.
Amoako GA, Karamagi C, Nangendo J, Okiring J, Kiirya Y, Aryeetey R, Mupere E, et al. (2020). Factors associated with concurrent wasting and stunting among children 6–59 months in karamoja, uganda. Child Care Health Dev. doi: 10.1111/mcn.13074.
Badriyah L, Syafiq A (2017). The association between sanitation, hygiene, and stunting in children under two years. Makara J Health Res. 21(2): 35-41. doi: 10.7454/msk.v21i2.6002.
Desyanti C, Nindya TS (2017). Hubungan riwayat penyakit diare dan praktik higiene dengan kejadian stunting pada balita usia 24-59 bulan di wilayah kerja puskesmas simolawang, Surabaya. Amerta Nutrition J. 2(1):243-251. doi: 10.20473/amnt.v1i3.6251.
Choiroh ZM, Windari EN, Proborini A (2020). Hubungan antara frekuensi dan durasi diare dengan kejadian stun-ting pada balita usia 24-36 bulan di desa Kedungrejo kecamatan Pakis (The relationship between the frequency and duration of diarrhea and the incidence of stunting in toddlers aged 24-36 months in Kedungrejo village, Pakis sub-district). J Issue Midwifery. 4 (3):131-141. doi: 10.21776/ub.JOIM.2020.004.03.4.
Dake SK, Solomon FB, Bobe K, Tesfahun M, Tekle HA, Tufa EG (2019). Predictors of stunting among children 6–59 months of age in sodo zuria district, south Ethiopia: a community-based cross-sectional study. BMC Nutr. 5 (23). doi:10.1186/s40795-019-0287-6.
Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, Sania A, et al. (2016). Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 13(11): 1-18. doi: 10.1371/journal.pmed.1002164.
Kemenkes RI (2021). Buku saku hasil studi status gizi indonesia (ssgi). Jakarta: Litbang Kemenkes RI.
Kemenko PMK (2022) Kejar target! per tahun prevalensi stunting harus turun 3 persen, Kementerian Koordinator Bidang Pembangunan Manusia dan Kebudayaan.
Khan S, Zaheer S, Safdar NF (2019). Determinants of stunting, underweight and wasting among children <5 years of age: evidence from 2012-2013 pakistan demographic and health survey. BMC Nutr. 19(358): 1-15. doi: 10.1186/s12889-019-6688-2.
Lestari MEP, Siwiendrayanti A (2021). Kon-tribusi kondisi fisik lingkungan rumah dengan kejadian diare dan hubung-annya terhadap kejadian stunting. Indones J Hum Nutr. 1(3): 355-361. doi: 10.15294/IJPHN.V1I3.47482.
Lukman TNE, Anwar F, Riyadi H, Harjomidjojo H, Martianto D (2021) Birth weight and length associated with stunting among children under-five in Indonesia. J Pangan, Gizi dan Kesehatan. 16(1): 99–108.
Mekonen J, Addisu S, Mekonnen H (2019). Prevalence and associated factors of chronic undernutrition among under five children in Adama town, central Ethiopia: a cross sectional study design. BMC Res Notes. 12(532): 1-6. doi: 10.1186/s13104-019-4552-1.
Murti B (2018). Prinsip dan metode riset epidemiologi (5th ed). Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Sartika AN, Khoirunnisa M, Meiyetriani E, Ermayani E, Pramesthi IL, Nur AAJ (2021) Prenatal and postnatal determinants of stunting at age 0–11 months: A cross-sectional study in Indonesia. PLoS ONE. 16(7). doi: 10.1371/journal.pone.0254662.
Sema B, Azage M, Tirfie M. Childhood stun-ting and associated factors among irrigation and non-irrigation user north-west, Ethiopia: a comparative cross-sectional study. Ital J Pediatr. 47(1). doi: 10.1186/s13052-021-01048-x.
Soboksa NE, Gari SR, Hailu AB, Alemu BM (2021). Childhood malnutrition and the association with diarrhea, water supply, sanitation, and hygiene practices in kersa and omo nada districts of jimma zone, Ethiopia. SAGE Open. doi: 10.1177/1178630221999635
Verma S, Zaheer S, Safdar NF (2019). Determinants of stunting, under-weight and wasting among children <5 years of age: evidence from 2012-2013 pakistan demographic and health survey. BMC Nutr. 19(358): 1-15. doi: 10.1186/s12889-019-6688-2.
WHO (2021). Stunting prevalence among children under 5 years of age (%) (model-based estimates). World Health Organization.
