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Diarrhea kills 1.8 million children under five in developing countries. This figure, however, allied gases pheonix az is an improvement from 4.5 million deaths in last 20 years.

Annual incidence of diarrheal disease episodes in children less than five years old in developing countries thus stands at 2 billion diarrheal episodes globally with a median incidence rate of 3.2 episodes per child.

In community based studies the ratio between male children under five to female children under five suffering from acute diarrhea in 1.2 and 1.4 respectively. It is however important to note that some countries (e.g., in South Asia) have greater care seeking for boys than girls.

The identified microbes from diarrhea patients in community studies and health care facility studies respectively include:-

Percentage of identification of selected enteropathogens from children with diarrhea in 61 community-based studies

EnteropathogenPercentage %
Enterotoxigenic Escherichia coli14
Enteropathogenic Escherichia coli9

Percentage identification of selected enteropathogens from children with diarrhea in 107 health facility-based studies

EnteropathogenPercentage %
Enteropathogenic Escherichia coli16
Enterotoxigenic Escherichia coli10

Apart from bacterial causes there are several viruses and parasites that may cause diarrheal diseases. Diarrheal diseases in 56.67 % of cases have a viral cause.

In the United States for example some agents are more important than others. A comparison of the relative importance of these viruses and bacteria in causing diarrheal diseases show:-

Etiologic agentDeveloping countryU.S.
RotavirusImportantVery Important
NorovirusesProbably ImportantImportant
Enteric adenovirusesMinorProbably Important

Comparison of bacterial etiologic agents of diarrhea in developing countries and the United States include:-

Etiologic agentDeveloping countryU.S.
Enterotoxigenic Escherichia coliVery ImportantMinor
Enterohem. Escherichia coliMinorImportant

Comparison of parasitic etiologic agents of diarrhea in developing countries and the United States show:-

Etiologic agentDeveloping countryU.S.
Entamoeba histolyticaMinorMinor

Seasonal variations are common. While bacterial diarrhea episodes are most common during summer and rains the viral diarrhoeas peak during winters. Transmission of diarrheal infections however is present throughout the year.

Viral diarrhoeas are more common in Europe, America and Asia and the Russia Federation. Of these the more important ones include rotaviruses and adenoviruses.

Diarrhea incidence rates by WHO region for 2010
Episodes of Diarrhea per child year (Uncertainty bounds)
Region0-5 months6-11 months12-23 months24-59 months0-59 months
Africa3.4 (2.1, 5.6)5.1 (3.4, 8.1)4.2 (2.7, 6.4)2.7 (1.7, 4.2)3.3 (2.2, 5.1)
Americas4.1 (2.9, 5.2)6.2 (4.7, 7.5)5.0 (3.9, 5.8)3.2 (2.3, 4.0)4.0 (3.1, 4.7)
Eastern Mediterranean3.1 (1.5, 5.2)4.7 (2.4, 7.0)3.8 (1.9, 5.4)2.4 (1.3, 3.6)3.0 (1.6, 4.4)
Europe4.1 (3.0, 5.3)6.3 (4.8, 7.6)5.1 (3.9, 5.9)3.2 (2.3, 4.1)4.0 (3.1, 4.7)
South East Asian2.4 (1.4, 4.0)3.7 (2.2, 5.6)3.0 (1.8, 4.3)1.9 (1.2, 2.6)2.4 (1.5, 3.3)
Western Pacific2.3 (1.3, 3.1)3.5 (2.0, 4.4)2.9 (1.6, 3.3)1.8 (1.1, 2.2)2.3 (1.3, 2.6)
Global2.9 (2.1, 4.3)4.5 (3.4, 5.7)3.6 (2.8, 4.4)2.3 (1.8, 2.8)2.9 (2.3, 3.4)

According to the World Health Organization between 1990 to 2010 while diarrhea incidence has declined from an estimated 3.4 episodes/child year in1990 to 2.9 episodes/child year in 2010, the highest burden of disease has remained consistent with respect to age.

The incidence is highest among children under 5 years of age living in low- and middle-income countries.



Further Reading

  • All Diarrhea Content
  • What is Diarrhea?
  • Diarrhea Treatment
  • Diarrhea Symptoms
  • Diarrhea Causes

Last Updated: Jun 4, 2019

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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