Global epidemiology of diarrhea among internally displaced populations and refugee camp populations an evidence-based systematic review and meta-analysis

Abstract

Background

Diarrhea remains a significant health burden among populations affected by inadequate water and sanitation, particularly in internally displaced persons (IDPs) and refugee camp populations. This systematic review and meta-analysis aim to quantify the global prevalence of diarrhea in these vulnerable groups. The findings will inform targeted interventions and policy decisions to mitigate the health impacts in these settings.

Methods

Systematic searches were conducted from PubMed, Epistemonikos, ScienceDirect, Scopus, Web of Science, and Embase, encompassing studies published up to June 10, 2024. Microsoft Excel 2021 was used for data extraction and STATA version 17 for statistical analyses. Newcastle-Ottawa Scale (NOS) assessed the methodological quality of included studies. The random-effects model was utilized to estimate the pooled prevalence. Publication bias was evaluated through funnel plots and Egger’s regression test, while heterogeneity was measured using the I² statistic. The review protocol is registered with PROSPERO (registration number: CRD42024554686).

Results

The comprehensive search yielded 23 eligible articles, representing 121,037 samples. The pooled prevalence of diarrhea was 29% (95% CI: 24%, 33%). Subgroup analyses by continents revealed notable regional variations, the pooled prevalence in Asia was 35% (95% CI: 24%, 45%), Africa 28% (95% CI: 21%, 35%), and North America 9% (95% CI: 7%, 11%). Subgroup analysis by subcontinent showed that Southeast Asia with 74% (95% CI: 66%, 81%) and South-central Asia with 54% (95% CI: 44%, 63%) has the highest pooled prevalence from Asia. From Africa, East Africa with 35% (95% CI: 19%, 51%) and Southeastern Africa with 35% (95% CI: 32%, 38%) has highest pooled prevalence. Furthermore, by study setting, the pooled prevalence of diarrhea was 27% (95% CI: 22%, 31%) in IDPs and 32% (95% CI: 22%, 42%) in refugee camps.

Conclusions

The results of this study underscore the significant global burden of diarrhea among IDPs and refugees living in camps. The implementation of robust health programs specifically tailored to IDPs and refugee camps, including regular screening, deworming, and comprehensive care initiatives, is critical. A multifaceted, holistic approach that addresses socio-economic, behavioral, and environmental determinants is essential to reduce the health burden of this vulnerable population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-24166-1.

Introduction

Globally the number of forcibly displaced people is growing rapidly [1]. According to the United Nations High Commission on Refugees (UNHCR) Agency report 108.4 million people are forcibly displaced worldwide at the end of 2022 as a result of persecution, conflict, violence, human rights violations or events seriously disturbing public order [2]. Among these individuals, there are two main categories: internally displaced people (IDPs) and distinguished refugees. The refugee camp people are individuals who have left their native country out of fear of persecution and are unable or unwilling to return there. IDPs depart their homes for the same reasons as refugees but stay on the territory of their nation of origin [3, 4]. The main cause of refugee displacement continues to be war leading to overcrowded settlements [5].

These IDP camps’ poor sanitation facilities increase the danger of waterborne illnesses and provide an ideal environment for the spread of diarrheal infections [6]. The residents, who frequently experience displacement as a result of environmental or armed conflicts, deal with inadequate access to clean water, cramped living circumstances, and poor hygienic facilities, all of which increase the risk of contracting diarrheal diseases.

The common health problems faced by IDPs include increased mortality and morbidity resulting from conditions such as diarrheal diseases, measles, acute respiratory infections, malaria, and other communicable diseases which account for 60%−95% of reported deaths [7–10]. The prevalence of these conditions, most of which are vaccine-preventable, is usually highest among children under the age of 5 [11, 12].

Diarrhea has become a major public health concern throughout time, particularly in developing countries such as those in Asia and sub-Saharan Africa with high rates of morbidity and mortality among the population [13, 14]. Young children in low- and middle-income countries bear a disproportionate share of the burden of diarrheal disease due to their high susceptibility to dehydration and nutritional losses which become adverse in overcrowded settings such as refugee camps and internally displaced people [15].

Numerous factors contribute to diarrheal illness such as sociodemographic factors including sex and age [16, 17], socioeconomic factors [16–20], behavioral factors [21, 22], environmental factors including water e.g. ponds, wells, rivers, lakes, sanitation, and waste disposal methods [23–29], and nutritional risk factors such as inadequate breastfeeding and zinc and vitamin-A insufficiency [30, 31]. These contributing variables are more noticeable in IDP camps, where living conditions are significantly more difficult and they thrive as hubs for endemic cholera outbreaks [32].

The collection and analysis of baseline data regarding the prevalence, distribution, and trends of diarrheal illness can provide vital insights for the effective implementation of preventive measures. Numerous publications have been published on the prevalence of diarrhea among internally displaced people (IDPs) and those living in refugee camps across the globe. To ascertain the global pooled prevalence of diarrhea among individuals living in IDP and refugee camps, it is imperative to compile and evaluate the existing research findings. To date, a comprehensive understanding of the global burden of diarrhea among IDP and refugee camp people is lacking. This study aimed to address this gap by conducting this systematic review and meta-analysis to synthesize existing data on the prevalence of diarrhea among IDP and refugee camp people. By compiling and analyzing available data on prevalence, we sought to generate reliable and current global estimates to inform the development and implementation of targeted prevention and control measures for these vulnerable populations.

Methods

Protocol and registration

This systematic review and meta-analysis were registered on PROSPERO with registration number CRD42024554686.

Search strategies

This systematic review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [33], and the review procedure was reported using the PRISMA 2020 checklist [34] (see additional file 1). All Published and peer-reviewed studies conducted until June 10, 2024, were searched in electronic databases such as Medline/PubMed, Epistemonikos, Science Direct, Embase, Scopus, and manual searching methods (google and Google Scholar) (see additional file 2). MeSH terms and entry terms were used with the following keywords “prevalence” AND “Diarrhea” OR “Acute watery diarrhea” OR “cholera” AND “internally displaced people*” OR “refugee camp population*” OR “refugee camp people*” OR “forcibly displaced people*” OR “conflict affected people*” OR “forcibly migrated people*” OR “armed conflict affected people*”. The search terms were used separately and in combination using Boolean operators “OR” and “AND”.

Eligibility criteria

Inclusion criteria

• ➢Language of publication: English.
• ➢Outcome: prevalence of diarrhea.
• ➢Population: Internally displaced people and all people in a refugee camp.
• ➢Study area: Studies conducted all over the world.
• ➢Publication year: All studies published up to the 10th of June 2024.
• ➢Study design: Observational study designs (i.e., cross-sectional, case-control, and cohort).
• ➢Publication condition: Peer-reviewed articles.

Exclusion criteria

Studies other than observational studies, studies without a full text, and those whose corresponding authors did not reply to emails twice, systematic reviews, conference abstracts, and case reports were excluded. Additionally, studies that did not report the overall prevalence of diarrhea and that were impossible to estimate based on the results as well as studies with confusing or unclear analysis results were also excluded.

Definition of diarrhea and outcome measures

The main outcome of this systematic review and meta-analysis was the estimated pooled prevalence of diarrhea among internally displaced people and refugee camp people. Diarrhea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual) [35]. The prevalence of diarrhea was defined as the proportion of positive samples to the total number of samples multiplied by 100.

Study selection

Study selection was performed independently by two reviewers (GY and LD). Endnote reference manager software version 20.5 (Thomson Reuters, Philadelphia, PA, USA) [36] was utilized for organization, duplication removal, and the removal of abstracts and titles that are not related to the research. Research was evaluated following the inclusion criteria, and duplicates and irrelevant research were eliminated. To settle the disagreement between authors that occurs during data extraction and selection, evidence-based discussion was conducted.

Data extraction and management

The Joanna Briggs Institute (JBI) data extraction checklist was used to extract the data. The data were extracted independently by GY and LD, using a Microsoft Excel 2021 spreadsheet. Data were extracted from each study, including the first author’s name, the year the study was published, the year the data was collected, the study design, the country, continent, study setting, population under study, the data collection tool, the total sample size, the response rate, the number of cases of diarrhea among IDP and Refugee camp people, the prevalence of diarrhea among IDP and refugee camp people and its standard error.

Risk of bias (Quality) assessment

Before studies were included in the final meta-analysis, a full-text review was conducted using the “Newcastle-Ottawa Scale (NOS)” quality appraisal tool, which was modified for both cross-sectional and case-control study designs [5], with a total score of 10 for cross-sectional studies and 9 for case-control studies. There is no standard score classification for case-control studies, so we gave them a score between 0 and 9. Cross-sectional studies with scores of 9–10 were deemed very good, studies with scores of 7–8 were deemed good, studies with scores of 5–6 were deemed satisfactory, and studies with scores of 0–4 were deemed unsatisfactory. The representativeness of the sample, sample size, and non-respondents determining the exposure (risk factor), subject comparability, confounding factors, statistical test, and result assessment are the components of the quality assessment for a cross-sectional study. The case definition, the representativeness of the cases, the selection and definition of the controls, the comparability of the cases and controls, the ascertainment of exposure, the ascertainment of the cases and controls, and the non-response rate are the components of the quality evaluation for the case-control study. GY and LD assessed the paper’s quality (see additional file 3). Disagreement between reviewers during the quality evaluation was resolved through discussion. The other review authors (AH, K.C., and TE) reviewed and reconciled any differences.

Data processing and analysis

The collected data were exported from Microsoft Excel 2021 to STATA version 17 (see additional file 4). Before any analysis, all articles were re-evaluated by impartial assessors, and the studies that passed the quality fit test (“Newcastle-Ottawa Scale (NOS)” quality appraisal tool) were taken for further analysis [5]. We calculated the I² statistic, which indicates the percentage of total variation between studies that can be attributed to heterogeneity rather than chance, to determine study heterogeneity. Values of 25%, 50%, and 75%, respectively, were used to indicate low, moderate, and high heterogeneity [37]. The test statistic indicated significant heterogeneity amongst the trials (I² = 99.01%, P < 0.00). Consequently, the overall impact of diarrhea among internally displaced people and those living in refugee camps was assessed using a random effect model. Prevalence and odds ratios with 95% confidence intervals were calculated using Der Simonian-Laird weights [38]. Subgroup analysis based on continent, subcontinent, study population, study setting, and publication year was carried out to reduce the heterogeneity between the point estimates of the study. Additionally, sensitivity analysis was done to determine how a particular study’s extreme outliers affected the pooled estimate. Using the visual funnel plot test and Egger’s statistical test at P < 0.05, publication bias (the small study effect) was identified [39]. To view the imputed studies, additional Trim and Fill analysis was carried out [40].

Results

A total of 23,438 articles were retrieved using electronic database searches: PubMed, Epistemonikos, Science Direct, Embase, Scopus, and manual searches of Google and Google Scholar. 17,265 duplicate articles were removed and 6126 articles were removed by title and abstract. 24 articles were excluded for being a systematic review, absence of full text, unspecified study setting, and study design. Finally, 23 articles were included in this systematic review and meta-analysis (Fig. 1).

Fig. 1.

PRISMA 2020 flow diagram of included studies to estimate the global pooled prevalence of diarrhea among internally displaced people and refugee camp people, 2024

Characteristics of the studies

This systematic review and meta-analysis included 23 papers totaling 121,037 sample size. The number of studies included in this study were from North America (n = 1), Asia (n = 7), and Africa (n = 15). Nigeria (n = 4) and Somaliland (n = 4) are the two nations with the maximum number of studies. According to the study setting, there were fourteen studies carried out in camps for internally displaced people and nine studies were conducted in refugee camps. According to population studied characteristics, there were twelve studies conducted among the entire population, eight studies among children under the age of five, two studies among children under the age of fourteen, and one study that was conducted among women and children. The sample size of studies varies from 95 in Sudan [41] to 80,564 in Bangladesh [42] (Table 1).

Table 1.

The characteristics of included articles for the systematic review and meta-analysis of the pooled prevalence of diarrhea among IDP and refugee camp people, 2024

Author (s) and Publication Year	Study location and Country	Study design	Sample size	Response rate	Cases	Prevalence
Emembolu C. et al., 2024 [43]	Anambra state, Nigeria	Cross-Sectional	19,080	100%	110	0.58%
Lafta R. et al. 2016 [44]	Kirkuk, Baghdad, and Karbala, Iraq	Cross-Sectional	4879	100%	245	5.02%
Islam MM. et al. 2019 [42]	Rohingya Refugees, Bangladesh	Cross-Sectional	80,564	100%	16,427	20.39%
Summers A. et al. 2017 [45]	Rohingya Refugees Cox’s Bazar, Bangladesh	Cross-Sectional	1827	100%	723	39.57%
Herawanto H. et al. 2020 [46]	Biromaru Refuge PHC, Indonesia	Cross-Sectional	130	100%	96	73.85%
Bukar AM. et al.,2020 [47]	Maiduguri, Borno State, Nigeria	Cross-Sectional	120	100%	51	42.50%
Jayte M. et al. 2023 [48]	Burhakaba Camps, Somaliland	Cross-Sectional	318	75.36%	53	16.70%
Isaza Nieto P. et al., 1980 [49]	Nicaraguan Refugee, Camp Luna, Honduran	Cross-Sectional	794	100%	71	8.90%
Soliman AA. 2017 [50]	Abushock IDPs Camp, Sudan	Cross-Sectional	450	100%	97	21.56%
Mubarak M. et al., 2018 [41]	Alhajaj IDPs camp, Elgeneina, Sudan	Cross-Sectional	95	100%	79	83.16%
Mekonnen GK. et al., 2019 [51]	Gambella Refugee, Ethiopia	Cross-Sectional	854	95.85%	326	38.17%
Mohamed AI. et al., 2021 [52]	Hargeisa IDPs, Somaliland	Cross-Sectional	348	90.80%	178	50.10%
Hersi MM. et al., 2019 [53]	Hodan District, Somaliland	Cross-Sectional	327	100%	68	20.80%
Usar I. et al., 2020 [54]	Nigeria IDP, Nigeria	Cross-Sectional	256	100%	22	8.59%
Mubarak MY. et al., 2016 [55]	Charahi Qambar, IDP camp, Afghanistan	Cross-Sectional	100	100%	54	54%
Feikin DR. et al., 2010 [56]	Kenya IDP, Kenya	Cross-Sectional	184	100%	3	3.90%
Peterson FA et al., 1998 [57]	Nyamithuthu Camp, Malawi	Cross-Sectional	356	87%	139	39.04%
Warsame H. 2021 [58]	Hodan District, Somaliland	Cross-Sectional	236	100%	113	47.88%
DiGennaro F. et al., 2022 [59]	Cabo Delgado Province IDP, Mozambique	Cross-Sectional	440	100%	140	31.80%
Joshua IA. et al., 2016 [60]	Camp in Jos, Nigeria	Cross-Sectional	312	100%	34	10.90%
Richardson MDA. 1998 [61]	Tibetan refugee, India	Retrospective Cross-Sectional	2921	100%	1659	56.79%
Katraschuk C. et al., 2016 [62]	UNHCR refugee camp, Dohuk, Iraq	Retrospective Cross-Sectional	3503	100%	18	0.51%
Chelwa NM. et al., 2016 [63]	Meheba refugee camp, Zambia	Retrospective Cross-Sectional	2943	100%	294	10%

*Cross-sectional studies are observational studies that analyze data from a population at a single point in time of data collection

*Retrospective cross-sectional studies where the data are collected at a single time but may refer retrospectively to experiences in the past

Meta-analysis

Global prevalence of diarrhea among internally displaced people and refugee camp people

In internally displaced people and those living in refugee camps, the global pooled prevalence of diarrhea was 29% (95% CI: 24%, 33%). A study conducted in Sudan had the highest prevalence, with 83% (95% CI: 74%, 89%) [41], while a study carried out in Nigeria [43] and Iraq [62] had the lowest prevalence, with 1% (95% CI: 0.00%, 1%). There was heterogeneity among the included studies, according to the I² test (I² = 99.91%, p-value < 0.00) (Fig. 2). So, to identify the possible sources of heterogeneity, subgroup and sensitivity analyses were carried out.

Fig. 2.

Forest plot of the global pooled prevalence of diarrhea among IDP and refugee camp people, 2024

Subgroup analysis

To estimate the subgroup analysis for the pooled prevalence of diarrhea, the continent, subcontinent, study setting, and study population characteristics were taken into account. Therefore, based on the continent of the studies, the subgroup analysis revealed that the overall pooled prevalence of diarrhea was 28% (95% CI: 21%, 35%) in Africa, 35% (95% CI: 24%, 45%) in Asia, and 9% (95% CI: 7%, 11%) in North America (Fig. 3). Additionally, the subcontinent pooled prevalence of diarrhea was 15% (95% CI: 4%, 25%) in West Africa, 39% (95% CI: 14%, 64%) in South Asia, 74% (95% CI: 66%, 81%) in Southeast Asia, 35% (95% CI: 19%, 51%) in East Africa, 9% (95% CI: 7%, 11%) in Central America, 54% (95% CI: 44%, 63%) in South-central Asia and 35% (95% CI: 32%, 38%) in Southeastern Africa, 10% (95% CI: 9%, 11%) in South-central Africa (Fig. 4). Furthermore, according to the study setting, overall pooled prevalence of diarrhea was 27% (95% CI: 22%, 31%) in IDPs and 32% (95% CI: 22%, 42%) in refugee camps (Fig. 5). In addition, according to the study population’s characteristics, the overall pooled prevalence of diarrhea was 29% (95% CI: 23%, 36%) in studies that are conducted among the general population, 5% (95% CI: 4%, 6%) in studies that are carried out among women and children, 35% (95% CI: 22%, 49%) in studies that have been done among children under the age of five, and 12% (95% CI: 10%, 13%) in studies that were conducted among children under the age of fourteen (Fig. 6). Moreover, according to the studies publication year, the overall pooled prevalence of diarrhea was 55% (95% CI: 53%, 57%) in 1998, and 43% (95% CI: 41%, 45%) in 2018 (Fig. 7). In general, during these subgroup analyses, the I² test showed there was still heterogeneity across the studies.

Fig. 3.

Forest plot of pooled prevalence of diarrhea among IDP and refugee camp people by continent, 2024

Fig. 4.

Forest plot of pooled prevalence of diarrhea among IDP and refugee camp people by sub-continent, 2024

Fig. 5.

Forest plot of pooled prevalence of diarrhea among IDP and refugee camp people by study setting, 2024

Fig. 6.

Forest plot of pooled prevalence of diarrhea among IDP and refugee camp people by study population characteristics, 2024

Fig. 7.

Forest plot of pooled prevalence of diarrhea among IDP and refugee camp people by publication year, 2024

Sensitivity analysis

To determine the impact of a single study on the pooled prevalence of diarrhea among IDP and refugee camp people, a sensitivity analysis of the twenty-three studies was carried out. Sensitivity analysis results indicated that there was no single study that had an impact on the fitted meta-analysis model of the global pooled estimate (Fig. 8).

Fig. 8.

Sensitivity analysis graph to examine the effect of a single study on the pooled prevalence of diarrhea among IDP and refugee camp people

Small study effect test (assessment of publication bias)

All twenty-three included studies were assessed for publication bias (small study effect). The presence of a possible small study effect was checked by using a funnel plot and Egger’s test. Accordingly, the funnel plot (Fig. 9) showed an asymmetric distribution and presented evidence of a small study effect. In addition, the result of Egger’s test indicates that there was evidence of publication bias (small study effect) (P-value = 0.015) (Fig. 10).

Fig. 9.

Funnel plot of the twenty-three studies included in the meta-analysis for the prevalence of diarrhea among IDP and refugee camp people, 2024

Fig. 10.

Egger’s test of the twenty-three studies included in the meta-analysis of the prevalence of diarrhea among IDP and refugee camp people, 2024

Trim and fill analysis

Bias in publications was noted in Egger’s test and funnel plot. Trim-and-fill analysis was performed to correct for publication bias by taking into consideration the results of the two tests [40]. However, according to this study, the pooled prevalence of diarrhea among IDPs and refugee camp residents was 29%, and there was no discernible difference in the global pooled prevalence of diarrhea among IDPs and refugee camp residents from the main meta-analysis (Fig. 11). Following a trim and fill analysis, the funnel plot was checked and is shown below (Fig. 12).

Fig. 11.

Trim and fill analysis of the twenty-three studies included in the meta-analysis of the prevalence of diarrhea among IDP and refugee camp people, 2024

Fig. 12.

Funnel plot after trim and fill analysis of the twenty-three studies included in the meta-analysis of pooled prevalence of diarrhea among IDP and refugee camp people, 2024

Discussion

The findings of this study revealed the pooled prevalence of diarrhea among IDP and refugee camp people. Twenty-three studies provided pertinent data that were compiled for this analysis. A total of 121,037 samples were drawn from IDP and refugee camp people. The results of this study showed a substantial variation in the prevalence of diarrhea.

The overall pooled prevalence of diarrhea among IDP and refugee camp people was 29% (95% CI: 24%, 33%). This finding is in line with research conducted in Northwest Ethiopia (29%) [64], Senegal (26%) [65], Cameron (26.1%) [66], Yemen (29.07%) [67], and Uganda (26.4%) [68]. The pooled prevalence of this study was less than the finding of a study conducted in Kenya (37.3%) [69] and Somaliland (47%) [70]. However, the pooled prevalence of this study was higher than the findings of studies conducted in Ethiopia (14.28%) [71], East Ethiopia (23%) [24], India (21.70%) [72], East Africa (14.28%) [73], Namibia (23.8%) [74], Indonesia (18.9%) [75], and Malawi (20%) [76]. Since the disease is spread by contaminated food, drink, and hands, the hygiene conditions in IDP and refugee camps may differ from those in regular homes which may contribute for the high prevalence of diarrhea in these setting [55, 77]. This could be due to inadequate personal hygiene and environmental cleanliness. Additionally, the variation may be attributed to the personal and cultural behaviors (such as the availability and usage of water, latrine, hand washing facilities, and waste disposal practices) of internally displaced persons as well as the environmental factors, socioeconomic status of camp inhabitants [16, 78–80].

The subgroup analysis revealed that the overall pooled prevalence of diarrhea among IDP and refugee camp people in Africa was 28% (95% CI: 21%, 35%) and 35% (95% CI: 24%, 45%) in Asia. Malnutrition, overcrowding, and inadequate sanitation and hygiene (WASH) conditions all contribute to the spread of disease [81]. Around 2.4 billion people globally lack access to basic sanitation and the majority of these unserved people (93%) live in Asia and Africa [82]. The main characteristics of IDP and refugee camps on these continents include overcrowding, poor sanitation, and a lack of water supply, all of which contribute to the spread of diarrheal illness among camp residents [79, 83, 84].

The overall pooled prevalence of diarrhea was 27% (95% CI: 22%, 31%) in IDPs and 32% (95% CI: 22%, 42%) in refugee camps. Internally displaced people are those individuals who do not cross the boundary of their country but leave their homes [85]. These people may adopt customs, values, and behaviors from the place they settle in even if they relocate away from home, they still share some common understanding. Furthermore, the government might show concern for those who are internally displaced individuals and provide them with internal aid, which lowers the prevalence of diarrhea as compared to those who are in refugee camps people who cross international borders where it will be challenging to adapt to the new culture, behavior, and other variables that contribute to diarrhea.

In addition, according to the study population’s characteristics, the overall global pooled prevalence of diarrhea was 35% among children under the age of five, 29% among the general population, 12% among children under the age of fourteen, and 5% among women and children who lives in the IDP and refugee camp. Children under five years old had the highest prevalence; this could be because they do not yet have a fully developed immune system, which increases their risk of contracting the disease from various WASH-related issues, and malnutrition can also be the cause [84, 86]. Moreover, this is the age at which they begin to crawl, play on floors, and become curious about the outside world, in addition, it will be challenging to regularly monitor their hygiene and health in these settings.

Strengths and limitations of the study

This comprehensive systematic review and meta-analysis provide valuable insights into the global pooled prevalence of diarrhea among internally displaced people and refugee camp people. However, the study is not without limitations. The exclusive focus on English-language publications may have resulted in the exclusion of potentially relevant studies conducted in other languages, potentially limiting the strength of the findings. In addition, as all included studies were observational, the outcome variable may have been affected by uncontrolled confounding variables. Finally, it is also important to note that this meta-analysis included data from only three continents. From these continents the number of studies in North America was limited. Future research should aim to widen the geographical scope and consider non-English language publications, and different factors that contribute to diarrheal disease in these settings to gain a more comprehensive understanding of the burden of diarrhea among IDP and refugee camp people across the world.

Conclusions and recommendations

This systematic review and meta-analysis elucidated a disturbingly high pooled prevalence of diarrhea (29%) among individuals in internally displaced persons (IDP) and refugee camps. The highest continental pooled prevalence was documented in Asia (35%), followed by Africa (28%). The pooled prevalence was 27% among IDPs and 32% among refugees. Globally, the pooled prevalence of diarrhea was 35% among children under five years of age, 29% among the general population, 12% among children under fourteen years of age, and 5% among women and children residing in IDP and refugee camps. These findings underscore the urgent necessity for comprehensive health programs in IDP and refugee camps, incorporating regular screening and deworming initiatives to enable the prompt detection and treatment of diarrhea. The result of this study provides the pooled prevalence of diarrhea amongst IDP and refugee camp peoples which are one part of the global community this will help the achievement of the aim of the Global Task Force on Cholera Control which is the global strategy on cholera control (ending cholera globally by 2030) [87]. Therefore, to achieve this goal refugee camps amongst displaced populations should be prioritized. Each nation should allocate resources to reducing the global burden of diarrhea and improving the overall health, well-being, and living conditions of people living in IDP and refugee camps. Future research should aim to widen the geographical scope by considering future publications and different factors that contribute to diarrheal disease in these settings to gain a more comprehensive understanding of the burden of diarrhea among IDP and refugee camp people across the world.

Abbreviations

CI

Confidence interval

IDP

Internally displaced people

LCI

Lower confidence interval

POR

Pooled odds ratio

PRISMA

Preferred reporting items for systematic reviews and meta-analyses

UCI

Upper confidence interval

Authors’ contributions

G.Y. was involved in the conceptual development, data abstraction, selection, data extraction, reviewing of articles, and manuscript writing. K.C. and T.E. were involved in the data extraction, data analysis, and writing of the manuscript. G.Y, A.H, and L.D were involved in guiding the work and manuscript writing. All the authors read and approved the final manuscript.

Funding

This study did not receive any funding.

Data availability

All data generated or analyzed during this study are included in this manuscript [and its supplementary information files].

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.