Childhood diarrhea in sub-Saharan Africa: Stalled progress and failure to meet the sustainable development goal 3.2 under-five mortality target by 2030 - A pooled analysis of 1.3 million children from 40 countries
In brief
Childhood diarrhea will hit ~15% of SSA under-fives by 2030
After falling from 20% to 14% in 2015, diarrhea rates in sub-Saharan African children under five have plateaued and are projected to rise to about 15% by 2030-nearly 50% above the Sustainable Development Goal target of 10%. Higher household wealth and maternal education lower risk, while infants 12-23 months face the greatest odds, underscoring the need for intensified WASH, immunisation and nutrition programmes.
- Journal
- Preventive medicine (Q1)
- Published
- 22 September 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Joseph Opeolu Ashaolu, Oluwafemi A Idowu, Oluremi A Saliu, Sylvain Y M Some
- PMID
- 42772700
- DOI
- 10.1016/j.ypmed.2026.108670
Why clinicians should know about it
- Picked for Pediatrics and Child Health (paper of the day, 26 September 2026): Pooled analysis of childhood diarrhea trends in SSA
Abstract
OBJECTIVE: To determine trends in childhood diarrhea prevalence among children under five years in sub-Saharan Africa (SSA) (2000-2024), identify associated demographic and socioeconomic factors, project prevalence to 2030, and evaluate whether SSA will meet the Sustainable Development Goal (SDG) 3.2 under-five mortality target (10% benchmark). METHODS: Data was pooled from 148 Demographic and Health Surveys (DHS) (2000-2024) across 40 SSA countries. Weighted prevalence was computed, and survey-weighted logistic regression identified associated factors. Logit-transformed linear models using 2015-2024 data projected prevalence to 2030. Sensitivity analyses excluded conflict-affected countries and tested alternative intervals. RESULTS: Continental prevalence declined from 19.5% in 2000 to 13.5% in 2015 (31% reduction) but plateaued thereafter. The post-2015 slope was -0.04 percentage points per year (95% Confidence Interval [CI]: -0.12, 0.04). Projected 2030 prevalence is 14.8% (95% prediction interval [PI]: 12.5, 17.4), 48% above the 10% benchmark, with no region on track. Wealth (odds ratio [OR] = 0.78) and higher education (OR = 0.67) were associated with lower odds; children aged 12-23 months had the highest odds (adjusted odds ratio [aOR] = 1.59). Sensitivity analyses confirmed robustness. CONCLUSIONS: SSA will miss the 10% benchmark by 2030. Urgent, context-specific investments in water, sanitation, and hygiene (WASH), immunization, nutrition, and conflict-sensitive programmes are required.
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.