Research Highlight

UP, Odisha report consistently high prevalence of under-5 diarrhoea

doi:10.1038/nindia.2018.157 Published online 3 December 2018

The Indian state of Uttar Pradesh has a consistently high prevalence of diarrhoea, while Assam has the lowest, researchers have found.

Measuring the prevalence of the condition across the country, they also found that the occurrence of diarrhoea was associated with the state of sanitation facilities and the educational status of mothers 1.

Diarrhoea, despite being preventable, is the third leading cause of mortality in children under five years of age. The prevalence is very heterogenous, ranging from 0.6 per cent to 29 per cent in different states.

Researchers from the Manipal Academy of Higher Education analysed and compared the data from the third round of the District Level Health Survey conducted in 2007-2008 and the fourth round of the National Family Health Survey (NFHS-4) of 2015-2016.

According to 2007-08 data, the hotspots of diarrhoea prevalence were in Haryana, UP, Maharashtra and Odisha. In 2015-2016 the hotspots were found in Uttarakhand, UP, Madhya Pradesh, Odisha and Meghalaya.

Maharashtra, Punjab and Haryana displayed several hotspots of diarrhoea prevalence in 2007-08 that were no longer significant in 2015-16. The authors propose that this decrease could stem from several initiatives started by the state government, including the Punjab rural water sanitation project, solid waste disposal concessions, and the efforts of social service organisation Sulabh International.

However, the states of UP and Odisha showed no significant improvement despite similar schemes.

The researchers found that, for every unit increase in awareness of diarrhoea among women, in improved water supply and in the condition of sanitation facilities, the prevalence of diarrhoea is expected to decrease by 0.09 per cent, 0.03 per cent and 0.05 per cent, respectively.

Identifying the hotspots and risk factors can help in planning customised strategies in a region-specific manner to manage diarrhoea, they conclude.


1.  Nilima et al. Prevalence, patterns, and predictors of diarrhea: a spatial-temporal comprehensive evaluation in India. BMC Public Health (2018) doi: 10.1186/s12889-018-6213-z