Published in PLOS One on 2026-08-28, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Gerald P. Mwing’a, Mariana Shayo, Patrick Kimu, Melkiory Beti, Boaz Wadugu, Lameck Pashet, Masoud A. Juma, Laura Shirima, Davis Kuchaka, Happiness Kumburu, Lucas Matemba, Paul E. Kazyoba, Calvin Sindato, Angelina M. Lutambi, Florida Muro, Blandina T. Mmbaga, Michael Alifrangis, Frank M. Aarestrup, Tolbert Sonda
Source: PLOS One • DOI 10.1371/journal.pone.0357174
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Childhood Diarrhea remains one of the leading causes of morbidity and mortality among children under five in Tanzania. Although meteorological factors are known to influence childhood diarrhea, evidence on their short-term associations across different regions of Tanzania remains limited. This study aimed to determine the seasonal prevalence of childhood diarrhea and its short-term associations with meteorological factors among children under five years in Tanzania between 1 May 2023 and 30 April 2024.
This retrospective analysis of repeated cross-sectional surveillance data included children under five years attending 10 selected healthcare facilities across seven regions of Tanzania between 1 May 2023 and 30 April 2024. Routinely collected health data from the Seq-Tanzania project, stored in the District Health Information System 2 (DHIS2), were linked with meteorological data obtained from the Tanzania Meteorological Authority (TMA). A multilevel mixed-effects Poisson regression model with a log link and robust standard errors was fitted to identify the short-term associations between meteorological and sociodemographic factors and childhood diarrhea.
A total of 898 children under five were included in the analysis, with a median age (IQR) of 13.9 (8.8–25.3) months. The prevalence of childhood diarrhea was highest during the dry season (58%) in regions experiencing unimodal rainfall patterns and during the wet season (41%) in the regions experiencing bimodal rainfall patterns. In the final multilevel mixed-effects Poisson regression model, higher average monthly temperature, increased total monthly rainfall, younger child age, and maternal primary education were significantly associated with the prevalence of childhood diarrhea.
Average monthly temperature and total monthly rainfall were significantly associated with the prevalence of childhood diarrhea across regions with both unimodal and bimodal rainfall patterns in Tanzania. These findings highlight the importance of integrating meteorological information into diarrheal disease surveillance and public health planning to support timely interventions aimed at reducing childhood diarrhea.
Background
Diarrheal diseases remain a major public health challenge and are the second leading cause of childhood mortality worldwide, accounting for about 1.7 billion cases and 525,000 deaths in children under five, annually [1]. The disease contributes to approximately 9% of all under-five mortality worldwide, with nearly 90% occurring in Sub-Saharan Africa [2]. In Tanzania, diarrhea accounts for approximately 9% of all under-five mortality, positioning the country at number 10 among the 15 nations with the highest burden of diarrhea-related fatalities among children under five [3]. Children under five are particularly vulnerable because of their immature immune systems, increased exposure to environmental contaminants, and limited ability to protect themselves from adverse environmental conditions [4]. They are also less knowledgeable about the health effects of climate change, with less ability to remove themselves from the threat [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Gerald P. Mwing’a, Mariana Shayo, Patrick Kimu, Melkiory Beti, Boaz Wadugu, Lameck Pashet, Masoud A. Juma, Laura Shirima, Davis Kuchaka, Happiness Kumburu, Lucas Matemba, Paul E. Kazyoba, Calvin Sindato, Angelina M. Lutambi, Florida Muro, Blandina T. Mmbaga, Michael Alifrangis, Frank M. Aarestrup, Tolbert Sonda. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Spatial disparities and multilevel determinants of childhood diarrhea in Mozambique: Evidence from the 2022–2023 Demographic and Health Survey (DHS)
- Evidence brief: Exploring the association between home delivery and under-five mortality in Ethiopia: A bivariate multilevel mixed-effects analysis
- Evidence brief: Magnitude of childhood immunization and its associated factors in Sub-Saharan Africa: A mixed effect count regression analysis
