Abstract: Background: The upsurge of deaths from gastroenteritis in South-East Nigeria within the last decade has become an issue of concern. Using Anambra State as a case study, this paper examined the trend of reported cases of gastroenteritis and associated fatalities among children with a view to mapping the spatial pattern and underlying causes. Data source and methods: Water samples collected from the available domestic sources in each of the selected 21 study localities were analyzed for aerobic heterotrophic count, total coliform, faecal coliform and enterococci, and regressed with gastroenteritis data sourced from the State epidemiological surveillance unit. Results: The results showed that the near-epidemic 58,269 incidents of gastroenteritis recorded in Anambra State, Southeast Nigeria between 2004 and 2008 had a spatial pattern and occurred in clusters with the highest number of 287 deaths occurring in Idemili North/South constituency. The study further showed that the consumption of contaminated water was responsible for the spread of the disease Conclusion: Hand washing practices, food hygiene, proper waste management, and the provision of basic infrastructure for improved health outcomes among the population are suggested inorder to curb the spread of gastroenteritis. Keywords: Enteritis Viruses, Epidemiology, Gastroenteritis, Heterotroph, Sustainable Development Goals.