Association of Lifestyle and Dietary Factors of Young Children with Diarrhea in Pakistan: An Evidence from Pakistan Demographic and Health Survey 2017-2018

Background: Globally childhood diarrhea accounts for 1.7 billion cases every year according to World Health Organization (WHO) 2024 report. According to the Federal Directorate of Immunization, the incidence of diarrhea is around 24% in Pakistan according to the stats provided by WHO. In Pakistan, childhood mortality and morbidity rates are also high due to multiple reasons. Among them, lifestyle and dietary factors play a vital role. Objective: This study aims to investigate the association between lifestyle and dietary factors and the prevalence of childhood diarrhea in Pakistan. Methodology: Data from the Pakistan Demographic Health Survey (PDHS) 2017-2018 was taken to check the association between the above-mentioned independent (lifestyle and dietary factors) and dependent variables (diarrhea). Data was analyzed using SPSS and univariate, bivariate, and multivariate analysis was done using descriptive statistics, chi-square statistics, and binary logistic regression. Categorical variables were presented as frequencies and percentages. Continuous variables were checked for normal distribution using histograms, with normally distributed variables reported as means and standard deviations. Skewed data was presented using medians and interquartile ranges. Chi-square statistics were used to test associations between dietary and lifestyle factors and the outcome variable (diarrhea). Binary logistic regression was performed to identify associations between multiple independent variables (dietary and lifestyle factors) and childhood diarrhea. Results: More than half of the mothers (56%) had no formal schooling. Very few participants (2.1%) had health insurance coverage. Regarding child food diversity, about 10% of babies consumed formula, 3.8% consumed yogurt, and 22.3% consumed eggs, with other food items being less frequently consumed. Significant predictors of childhood diarrhea included maternal (p=0.013) and paternal education (p=0.029), breastfeeding duration (p<0.001), health facility visit in the last 12 months (0.023), decision maker of child healthcare (0.019) and early introduction of non-breastmilk foods (p<0.001). Conclusion: Key factors influencing childhood diarrhea include maternal education, breastfeeding practices, and healthcare access, suggesting targeted interventions that could reduce childhood morbidity.