The Role of Malnutrition in Increasing the Risk of Diarrheal Diseases: A Meta-Analysis of Case-Control Studies
Abstract
Background: Diarrheal diseases remain a significant global health burden, particularly in resource-limited settings. Malnutrition and diarrhea often coexist, potentially reinforcing each other in a vicious cycle. However, the extent to which malnutrition increases the risk of diarrheal diseases across different populations and contexts remains unclear.
Aims: This meta-analysis aimed to evaluate the association between malnutrition and diarrheal diseases across age groups, and assess its impact on disease severity and outcomes.
Methods: We conducted a systematic review and meta-analysis of case-control studies examining the relationship between malnutrition and diarrheal disease. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Forty-two studies comprising 68,423 participants (27,369 cases, 41,054 controls) were included. The overall pooled OR was 1.84 (95% CI: 1.3-2.4), indicating a significant association between malnutrition and diarrheal disease. The strongest associations were observed in children under 5 years (OR: 1.94, 95% CI: 1.3-2.4) and in African studies (OR: 2.16, 95% CI: 1.7-2.4). Among malnutrition assessment methods, wasting showed the strongest association (OR: 2.25, 95% CI: 1.7-2.3).
Conclusion: This meta-analysis provides robust evidence that malnutrition significantly increases the risk of diarrheal diseases, with the impact varying across age groups, geographical regions, and types of malnutrition. These findings underscore the importance of integrating nutritional interventions into diarrheal disease prevention and control strategies, particularly in vulnerable populations and resource-limited settings.
Keywords: Malnutrition; diarrheal diseases; meta-analysis; case-control studies; global health; nutritional status