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National Health And Morbidity Survey 2016 : Maternal And Child Health (MCH) Volume II : Findings

4.3 Care of Illness (Diarrhoea & Acute Respiratory Infections)

Contributors : Norhafizah Mohd Sahril, Sayan Pan, Fazly Azry Abdul Aziz, Azriman Rosman, Rozita Ab. Rahman, Norazizah
Ibrahim Wong, Tahir Aris

4.3.1 Introduction

UNICEF reported that diarrhoea is a leading killer of children, accounting for nine percent of all deaths
1
among children under age 5 worldwide in 2015. Diarrhoeal disease is the second leading cause of
death in children under five years old. It is both preventable and treatable. Globally there are nearly
1.7 billion cases of diarrhoeal diseases every year and diarrhoea is the leading cause of malnutrition
2
in children under five years old. Diarrhoea can have a detrimental impact on childhood growth and
3
cognitive development. About 88% of diarrhoea-associated deaths are attributable to unsafe water,
inadequate sanitation, and poor hygiene. 4,5 Acute respiratory infection (ARI) in children less than 5
years old is considered as one of the major public health problems and it is recognized as the leading
cause of mortality and morbidity in many developing countries. In young children, ARI is responsible
for an estimated 3.9 million deaths worldwide, with 90% deaths due to bacterial pneumonia. In the
developing countries, seven out of 10 deaths happen due to ARI in under 5-year age group. 6

4.3.2 Findings

4.3.2.1. Socio-demographic characteristics of children

There were 15,188 eligible respondents aged 0-59 months in this study. More than
half of respondents were males (51.9%) and 58.7% were children aged 24-59 months.
By ethnicity, the majority were Malays (62.3%), followed by Chinese (15.9%), other
Bumiputras (14.7%), and other ethnicities (2.2%). 36.2% of respondents were from
high income families of more than RM5000 followed by 17.9% from families with
income range from RM1000-RM1999, 13.5% from RM2000-RM2999 and the lowest
7.5% from income less than RM1000 (Table 4.3.2.1).

4.3.2.2. Diarrhoea

The prevalence of diarrhoea in the past two weeks preceding the survey among
children aged 0-59 months was 4.4%. No significant difference in prevalence between
gender was observed. Children aged 12-23 months were reported to have had higher
prevalence of diarrhoea (7.1%) as compared to children aged 0-11 months (5.2%) and
24-59 months (3.2%), but the difference was not statistically significant. The Other
Bumiputras had the highest prevalence at 8.8%, followed by Indians (5.3%), Others
(5.0%), Malays (3.6%), and lastly, Chinese (3.3%). The prevalence was slightly higher
among Permanent Residents/ Non Malaysians (5.0%) compared to Malaysian citizens
at 4.4%. Children whose parents received no formal education/primary were reported
to have higher prevalence of diarrhoea. Those children from the lowest household
income (less than RM1000) were reported to have had higher prevalence of diarrhoea
(7.3%) compared to others. As expected, the prevalence of diarrhoea among children
from households with untreated water was highest at 12.5%, followed by unsanitary

1. http://data.unicef.org/child-health/diarrhoeal-disease.html
2. http://www.who.int/mediacentre/factsheets/fs330/en/
3. http://www.who.int/mediacentre/factsheets/fs330/en/
4. Bowen A, Agboatwalla M, Luby S, Tobery T, Ayers T, Hoekstra RM. Association between intensive handwashing and child development in Karachi,
Pakistan: A cluster controlled trial. Arch Pediatr Adolesc Med. 2012 Sep
4. UNICEF. Progress for children: A report card on water and sanitation. Number 5, September 2006.
5. Black RE, Morris S, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226-34.
6. Park K. Epidemiology of Communicable Diseases. Park′s Textbook of Preventive and Social Medicine. 21 st ed. Jabalpur: M/S Banarsidas Bhanot
Publishers; 2011. p. 156.