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

Abstract

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 under-notified. 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.

Acute gastrointestinal illness in adults in Germany: a population-based telephone survey

“…From neighbouring European Union member-state countries Denmark reported higher incidence in younger adults but the same in the elderly (from I annual = 2·0 in the 20-29 years age group to I annual = 0·75 in those aged 5 70 years) [15], Italy reported lower incidence in the elderly (from I annual = 1·11 in the 10-24 years age group to I annual = 0·33 in those aged 5 75 years) [18] and Poland almost the same incidence (I annual = 0·9 in the 15-64 years age group) [6] as in Germany. Furthermore, reported incidence of AGI seem to be generally in the same range as in the USA [11], Canada [16], Hong Kong [12] and Australia [10], lower than in New Zealand [4], Cuba [5] and Norway [14], respectively, but higher than in Great Britain [21], Malta [7], Ireland [17] and Malaysia [9].…”

“…The methodology for community surveys has improved over the years and a common case definition was established to ensure international comparability [1][2][3]. These efforts resulted in cross-sectional studies for estimates for the burden of AGI from various countries [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and additionally a few population-based cohort studies [19][20][21].…”

Deteksi Diarrhoegenic E. coli pada Sampel Feses Penderita Diare di Puskesmas Batulicin dan Pagatan Kabupaten Tanah Bumbu dengan Metode Polymerase Chain Reaction (PCR)

“…Penelitian lain menyebutkan bahwa diare akut pada umumnya diderita oleh orang dewasa berusia 20-29 tahun. (Gurpreet et al, 2011)…”

Food safety in developing countries: an overview

“…In contrast, a community study estimated at least 13 million episodes of acute diarrhoea annually; most of which are likely to be the result of these notifiable diseases. The figures indicate that cases of acute diarrhoea in Malaysia are grossly under-reported, with less than 0.1% of cases being captured by the national surveillance system annually (Gurpreet et al, 2011 …”