Incidence and Determinants of Acute Diarrhoea in Malaysia: A Population-based Study

• Published in: Journal of health, population and nutrition Vol. 29; no. 2; pp. 103 - 112
• Main Authors: Gurpreet, K, Tee, G.H, Amal, N.M, Paramesarvathy, R, Karuthan, C
• Format: Journal Article
• Language: English
• Published: Bangladesh icddr,b 01-04-2011; ICDDR,B: Centre for Health and Population Research; BioMed Central Ltd; BioMed Central; International Centre for Diarrhoeal Disease Research, Bangladesh
• Subjects: Acute diseases; Adolescent; Adult; Child; Child, Preschool; Children; Cross-Sectional Studies; Cross-sectional survey; Demographics; Demography; Diarrhea; Diarrhea - epidemiology; Diarrhoea; Diarrhoea, Acute; Diseases; Educational levels; Educational Status; Epidemiology; Ethnicity; Female; Foodborne illnesses; Gastroenteritis; Household income; Households; Humans; Incidence; Infant; Interviews as Topic; Locality; Malaysia; Malaysia - epidemiology; Male; Middle Aged; Multivariate Analysis; Original Papers; Population; Population estimates; Public health; Risk Factors; Rural Population; Severity; Sociodemographic factors; Socioeconomic Factors; Studies; Surveys; Symptoms; Young Adult; Malaysia
• ISSN: 1606-0997; 2072-1315
• DOI: 10.3329/jhpn.v29i2.7814

Acute diarrhoea is a major health problem in many parts of the world,
contributing to about 1.8 million deaths globally. The objectives of
the study were to assess the incidence, determinants, and severity of
acute diarrhoea in the population. A nation-wide cross-sectional survey
involving about 57,000 respondents was conducted via face-to-face
interview among eligible respondents of all ages. An acute diarrhoeal
episode was defined as having three or more episodes of loose stools in
any 24-hour period within the past four weeks before the interview. The
severity was measured by duration of acute diarrhoea and associated
symptoms. The variables tested as determinants were age, sex,
ethnicity, the highest educational level, total monthly household
income, and locality. Univariate, bivariate and multivariate procedures
meant for complex study design were used in the analyses. The four-week
incidence of acute diarrhoea was 5% [95% confidence interval (CI)
4.8-5.2]. The incidence of acute diarrhoea among the estimated
population was the highest among young adults aged 20-29 years, Other
Bumiputras (the pre-dominant ethnic group in East Malaysia), those with
tertiary-level of education, those earning a monthly household income
of less than RM 400, and rural dwellers. Only age, ethnicity, the
highest level of education attained, and locality were significantly
associated with acute diarrhoea in bivariate analysis. In multivariate
analysis, these four variables were found to be the determinants of
acute diarrhoea. Sex and monthly household income were excluded from
the model. The mean duration of acute diarrhoea was 2.0 days (standard
deviation 1.3). Forty-six percent of the respondents reported stomach
cramps as an associated symptom. The findings revealed that acute
diarrhoea is still a major public-health concern in Malaysia and
grossly undernotified. There is a need for intensification of
public-health intervention efforts to reduce the incidence of acute
diarrhoea while improving surveillance and notification of the disease.