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Environmental and Sociodemographic Factors Associated with Reported Diarrhea in East Kalimantan, Indonesia: A Secondary Analysis of 2023 Indonesian Health Survey

1Department of Environmental Health, Faculty of Public Health, Universitas Mulawarman, Samarinda City, Indonesia, Indonesia

2Master Program in Biomedical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia, Indonesia

Received: 24 Jun 2026; Revised: 17 Aug 2026; Accepted: 18 Aug 2026; Available online: 31 Aug 2026; Published: 31 Aug 2026.
Open Access Copyright (c) 2026 The authors. Published by Faculty of Public Health, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Introduction: Diarrhea is a major global public health concern that contributes substantially to morbidity and mortality. Environmental factors, including inadequate sanitation infrastructure and poor hygiene practices, have been associated with diarrhea. This study aimed to analyze the associations between environmental and sociodemographic factors and diarrhea occurrence in East Kalimantan Province.

Methods: This cross-sectional study used secondary data from 15,854 respondents in the East Kalimantan subset of 2023 SKI. The variables included gender, age, education, drinking water sources, water quality and treatment, storage containers, raw water sources, wastewater disposal, waste management, sanitation access, and hygiene practices. Data were analyzed using chi-square and multivariable binary logistic regressions. Survey weights, strata, and primary sampling units were incorporated to account for the complex sampling designs.

Results: The weighted prevalence of diarrhea was 2.1%. Bivariate analysis showed associations between diarrhea occurrence and age group, education, drinking water source, physical quality of drinking water, raw water source, waste management, and sanitation hygiene (p<0.05). The higher-risk age group (<5 and >70 years) was associated with higher odds of diarrhea than the lower-risk age group (aged 5–70 years) (AOR=2.933; 95% CI: 2.105–4.098; P <0.001). Unmet physical quality standards drinking water was also associated with higher odds of diarrhea (AOR=2.078; 95% CI: 1.254–3.443; p=0.005).

Conclusion: Higher-risk age groups and drinking water that unmet physical quality standards drinking water were associated with diarrhea. Efforts to improve water quality and provide greater protection for vulnerable age groups may contribute to broader diarrheal prevention strategies in East Kalimantan Province.

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Keywords: Diarrhea, East Kalimantan, Environmental Factors, Indonesian Health Survey, Logistic regression.

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  1. Zhao WZ, Wang JY, Zhang MN, Wu SN, Dai WJ, Yang XZ, et al. Global burden of diarrhea disease in the older adult and its attributable risk factors from 1990 to 2021: a comprehensive analysis from the global burden of disease study 2021. Front Public Health. 2025;13:1–12
  2. Xie M, Song Y, Tao J, Jiang M, Liu Y, Cheong IH, et al. Global trends, age-period-cohort analysis, and future projections of diarrhea burden: Findings from the Global Burden of Disease Study 2021. Biosaf Health. 2025;7:295–305
  3. World Health Organization. Diarrhoeal disease. 2024;
  4. Sumolang PP, Nurjana MA, Widjaja J. Analisis Air Minum dan Perilaku Higienis dengan Kejadian Diare pada Lansia di Indonesia. Media Penelitian dan Pengembangan Kesehatan. 2019;29:99–106
  5. Salma TT, Santik YDP. Determinan manajemen diare pada balita di Indonesia Determinants of diarrhea management among children under five in Indonesia. SAGO: Gizi dan Kesehatan. 2024;5:320–9
  6. Situmeang IRVO. DIARE PADA ANAK. IKRAITH-HUMANIORA. 2024;8:471–6
  7. Irawan A, Hastuty HSB. Kualitas Fisik Air, Kejadian Diare Dengan Stunting Pada Balita di Puskesmas Arso Kota. Jurnal Kesehatan Komunitas. 2022;8:130–4
  8. Desyanti C, Nindya TS. Hubungan Riwayat Penyakit Diare dan Praktik Higiene dengan Kejadian Stunting pada Balita Usia 24-59 Bulan di Wilayah Kerja Puskesmas Simolawang, Surabaya. Amerta Nutrition. 2017;3:243–51
  9. Kasmara DP, Sarli D. Faktor - Faktor yang Berhubungan dengan Kejadian Diare pada Balita. JIK JURNAL ILMU KESEHATAN. 2023;7:93–
  10. Siramaneerat I, Agushybana F, Sunthrayuth P. A mixed-effects multilevel Poisson regression analysis of diarrhea prevalence among under-five children in Indonesia. J Health Popul Nutr. 2026 Jan 28;45(1):82
  11. Fitrah MA, Saefurrohim MZ, Firmansyah YW. Exploring environmental risk factors for diarrhea: Evidence from the Indonesian Health Survey, 2023. Environ Anal Health Toxicol. 2026;41:e2026001
  12. Yudo S, Hernaningsih T. KEBUTUHAN AIR BERSIH MASYARAKAT DI DAERAH PERDESAAN NELAYAN Di Wilayah Pesisir Kabupaten Pasir, Kalimantan Timur. Jurnal Air Indonesia. 2018;2:128–38
  13. Badan Pusat Statistik. Statistik Air Bersih Provinsi Kalimantan Timur. Vol. 23. Samarinda: Badan Pusat Statistik Provinsi Kalimantan Timur; 2024. 1–58 p
  14. Kementerian Lingkungan Hidup dan Kehutanan. Timbulan Sampah Tahun 2025. Jakarta; 2025
  15. Susanto N. Factors water characteristic as predicting diarrhea under 5 years. Jurnal Riset Kesehatan. 2021;10:12–8
  16. Azwari F, Siahaya ME, Hadidjah K, Supriadi A, Benedicta CE. Analisis Kualitas Air Sungai Sepaku sebagai Penyedia Air Bersih di Ibu Kota Nusantara (IKN), Kalimantan Timur. Jurnal Nusa Sylva. 2025;25:33–41
  17. BPS. Statistik Air Bersih Provinsi Kalimantan Timur 2023. Badan Pusat Statistik Provinsi Kalimantan Timur, editor. Badan Pusat Statistik Provinsi Kalimantan Timur; 2024
  18. Girma M, Hussein A, Norris T, Genye T, Tessema M, Bossuyt A, et al. Progress in Water, Sanitation, and Hygiene (WASH) coverage and potential contribution to the decline in diarrhea and stunting in Ethiopia. Matern Child Nutr. 2024;20
  19. Claudine U, Kim JY, Kim EM, Yong TS. Association between sociodemographic factors and diarrhea in children under 5 years in Rwanda. Korean Journal Parasitol. 2021;59:61–5
  20. Cha YE, Fu YZ, Yao W. Knowledge, practice of personal hygiene, school sanitation, and risk factors of contracting diarrhea among rural students from five western provinces in China. Int J Environ Res Public Health. 2021;18
  21. Desta BK, Assimamaw NT, Ashenafi TD. Knowledge, Practice, and Associated Factors of Home-Based Management of Diarrhea among Caregivers of Children Attending Under-Five Clinic in Fagita Lekoma District, Awi Zone, Amhara Regional State, Northwest Ethiopia, 2016. Nurs Res Pract. 2017;2017:1–8
  22. McClelland PH, Kenney CT, Palacardo F, Roberts NLS, Luhende N, Chua J, et al. Improved Water and Waste Management Practices Reduce Diarrhea Risk in Children under Age Five in Rural Tanzania: A Community-Based, Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 2022;19:4218
  23. Kitole FA, Ojo TO, Emenike CU, Khumalo NZ, Elhindi KM, Kassem HS. The Impact of Poor Waste Management on Public Health Initiatives in Shanty Towns in Tanzania. Sustainability 2024, 16, 10873. 2024;16:10873
  24. Kementerian Lingkungan Hidup dan Kehutanan. Kementerian Lingkungan Hidup dan Kehutanan.2024;
  25. Purnomo CW. Solusi Pengelolaan Sampah Kota Edisi Kedua. Edisi Kedua. Sleman: Gadjah Mada University Press; 2024
  26. Hidayah NN, Prabamurti PN, Handayani N. Determinan Penyebab Perilaku Pengelolaan Sampah Rumah Tangga dalam Pencegahan DBD oleh Ibu Rumah Tangga di Kelurahan Sendangmulyo. Media Kesehatan Masyarakat Indonesia. 2021;20:229–39
  27. Irawan DE, Puradimaja DJ, Yeni D, Kuntoro AA, Julian MM. Decreasing groundwater quality at Cisadane riverbanks: groundwater-surface water approach. 2016;
  28. Khasanah K, Setiyabudi R. The Relationship of STBM with the Event of Diarrhea Children in Maos Health Centre, Cilacap Regency. Pancasakti Journal of Public Health Science and Research. 2023;3:55–61
  29. Badan Pusat Statistik (BPS), Badan Kependudukan dan Keluarga Berencana Nasional (BKKBN), Kementerian Kesehatan. Laporan Survei Demografi dan Kesehatan 2017. 2018;
  30. Ikhsan AN, Thohira MC, Daniel D. Analysis of packaged drinking water use in Indonesia in the last decades: trends, socio-economic determinants, and safety aspect. Water Policy. IWA Publishing; 2022. p. 1287–305

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