Health education in the prevention and management of infectious diarrhea in childhood: A systematic review of randomized controlled trials
- Journal
- PLoS neglected tropical diseases (Q1)
- Published
- 23 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Arthur Santos Lima, Pedro Silva Dantas, Ana Beatriz Cazé-Cerón, Leonardo Paiva Farias, Natalia Machado Tavares, Viviane Sampaio Boaventura
- PMID
- 42490684
- DOI
- 10.1371/journal.pntd.0014442
Why clinicians should know about it
- Picked for Health Policy (top studies of the week, 26 July 2026).
- Picked for Pediatrics and Child Health (top studies of the week, 26 July 2026): Ranked by evidence level and journal quartile
- Picked for Infectious Diseases (top studies of the week, 26 July 2026).
Abstract
BACKGROUND: Childhood diarrhea remains a leading cause of morbidity and mortality in low- and middle-income countries. Educational interventions targeting caregivers may promote preventive behaviors, but the overall evidence base has not yet been comprehensively synthesized. This systematic review evaluates the effectiveness and types of community-based educational interventions in caregivers of children under five years of age to prevent diarrhea. METHODS AND FINDINGS: We systematically searched MEDLINE/PubMed, EMBASE, Cochrane Library and LILACS with relevant keywords and MeSH terms from inception to December 2025. Of 1,917 records screened, 15 controlled trials (1985-2018) from Asia, Africa, and Latin America met inclusion criteria. Interventions included home visits, audiovisual materials, group education sessions, and behavior change communication (BCC) strategies. The primary outcomes were diarrhea incidence and prevention and hygiene-related behavioral changes. Risk of bias was assessed using RoB-2 for all studies. Most interventions reported positive outcomes, such as reduced diarrhea incidence and improved caregiver knowledge and enhanced hygiene behaviors. Multicomponent approaches, especially those combining home visits with audiovisual tools and BCC, were particularly effective. However, heterogeneity in follow-up periods, population characteristics, and settings limited comparability. Several studies had high or unclear risk of bias, often due to inadequate reporting of randomization or lack of blinding. CONCLUSION: Community-based educational strategies show potential for reducing childhood diarrhea, particularly when tailored to local contexts and combined multicomponent approaches. Future high-quality, standardized RCTs are needed to build a more robust evidence base and guide policy and program development.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.