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2010). Acute diarrhea can lead to severe dehydration; persistent diarrhea can predispose children to
malnutrition and make them more vulnerable to other infectious diseases (Briend, 1990; Peterson Zwane
and Kremer, 2007). HIV status; the socioeconomic status of the family; and community factors such as
immunization coverage, health care access, and the quality of water and the availability of sanitation
services all can have great impact on diarrheal mortality and childhood nutrition (Kosek et al., 2003).
Findings from randomized, controlled trials suggested that vaccination, breastfeeding, and micronutrient
supplementation can reduce the incidence of diarrhea, and, when diarrhea occurs, oral rehydration therapy
can reduce the risk of dehydration (Peterson Zwane and Kremer, 2007).
As Table 3.3 indicates, in the two weeks before the survey, the prevalence of diarrhea among
children less than age 5 was quite different across countries, ranging from 8% in Madagascar to 25% in
Burundi. Seven countries—Burundi, Cameroon, Ghana, Liberia, Niger, Senegal, and Uganda—
experienced a level of child diarrhea above 20% (see Map 3.2).
Sex and geographic disparities
Overall, we did not find child’s sex disparities related to child diarrhea (see Figure 3.7). However,
in Guinea (males: 18% and females: 15%) and Zimbabwe (males: 15% and females: 13%), the prevalence
of diarrhea was two percentage points higher for boys than for girls (see Table 3.3).
In half of the countries, the prevalence of diarrhea among children less than age 5 was higher in
rural areas than in urban areas (see Figure 3.8). Five countries had a diarrhea prevalence that was at least
four percentage points higher in rural areas than in urban areas—Burundi (urban: 22% and rural: 26%),
Cameroon (urban: 19% and rural: 24%), Ghana (urban: 18% and rural: 22%), Mali (urban: 10% and rural:
15%), and Niger (urban: 18% and rural: 22%). In contrast, in Senegal (urban: 24% and rural: 20%) and
Tanzania (urban: 19% and rural: 14%), the prevalence of diarrhea was at least four percentage points
higher in urban areas (see Table 3.3).
The role of the household head’s sex and age
In 13 of 23 countries, the diarrhea prevalence was higher for children living with a female
household head than for children living with a male household head (see Figure 3.9). This difference was
more than 3 percentage points higher in three countries—Rwanda (13% versus 16%), Senegal (21%
versus 24%), and Tanzania (15% versus 17%) (see Table 3.3). The inverse situation occurred in Nigeria
and Cameroon. In Nigeria the prevalence of diarrhea was 3 percentage points higher among children
living with a male household head (11% versus 8%). This difference was more extreme in Cameroon,
where the diarrhea prevalence was 23% for children living with a male household head and 17% for
children living with a female household head, a difference of 7 percentage points.
In Burundi, Kenya, and Uganda, the age of the household head played an important role in the
prevalence of diarrhea among children less than age 5 (see Figure 3.10). As Table 3.3 shows, in Burundi
the percentage who had had diarrhea in the past two weeks was 25% for children whose head of
household was younger than age 50 and 31% for children whose head of household was at least age 50 (a
difference of 6 percentage points). In Uganda 24% of children who lived with a household head younger
than age 50 had had diarrhea recently, compared with 30% of those who lived with an older head of
household—a difference of 6 percentage points.
Variations during the last 13 years
Six countries—Cameroon, Ghana, Kenya, Namibia, Tanzania, and Zimbabwe—have experienced
an increase in the prevalence of diarrhea among children less than age 5 (see Table 3.2). This increase
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