Global and national trends in diarrheal diseases due to unsafe sanitation: a comparative analysis of Türkiye, 1990–2023

5th International Conference on Modern and Advanced Research ICMAR 2026, Konya, Turkey, 7 - 08 May 2026, pp.32-39, (Full Text)

Diarrheal diseases attributable to unsafe sanitation remain a significant global public health

challenge, contributing substantially to preventable mortality and disability-adjusted life years (DALYs).

This study examined global and national trends in mortality and DALYs attributable to diarrheal diseases

caused by unsafe sanitation between 1990 and 2023, with a particular focus on Türkiye's performance

relative to global and income-stratified benchmarks. Results are presented with 95% uncertainty intervals

(UIs), and fold changes were calculated. Joinpoint regression was used to identify statistically significant

changes in trend over time. Between 1990 and 2023, mortality and DALY rates from diarrheal diseases

attributable to unsafe sanitation declined dramatically at both global and national levels. Globally, death

rates fell by 83% and DALY rates by 86%. Türkiye achieved even greater reductions — 97% in mortality

and 98% in DALYs — far outpacing high-income country averages of 61% and 84%, respectively. Lowincome

countries, despite an 80% reduction, still carried the highest burden in 2023. Joinpoint regression

analyses confirmed consistently negative annual percent changes across all groups, with Türkiye

demonstrating particularly steep declines, especially between 1995 and 2006. Joinpoint regression analyses

revealed that Türkiye's most pronounced declines occurred between 1995 and 2006, with APCs of −13.35%

and −11.81%, respectively, suggesting that targeted public health investments and sanitation infrastructure

improvements during this period were particularly impactful. These findings underscore the effectiveness

of sustained sanitation interventions while highlighting the persistent inequities between low- and highincome

settings that require continued global attention.