Khalil, Ibrahim, Colombara, Danny V., Forouzanfar, Mohammad Hossein, Troeger, Christopher, Daoud, Farah, Moradi-Lakeh, Maziar, El Bcheraoui, Charbel, Rao, Puja C., Afshin, Ashkan, Charara, Raghid, Abate, Kalkidan Hassen, Abd El Razek, Mohammed Magdy, Abd-Allah, Foad, Abu-Elyazeed, Remon, Kiadaliri, Aliasghar Ahmad, Akanda, Ali Shafqat, Akseer, Nadia, Alam, Khurshid, Alasfoor, Deena, Ali, Raghib, AlMazroa, Mohammad A., Alomari, Mahmoud A., Salem Al-Raddadi, Rajaa Mohammad, Alsharif, Ubai, Alsowaidi, Shirina, Altirkawi, Khalid A., Alvis-Guzman, Nelson, Ammar, Walid, Antonio, Carl Abelardo T., Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Awasthi, Ashish, Bacha, Umar, Badawi, Alaa, Barac, Aleksandra, Bedi, Neeraj, Bekele, Tolesa, Bensenor, Isabela M., Betsu, Balem Demtsu, Bhutta, Zulfiqar, Bin Abdulhak, Aref A., Butt, Zahid A., Danawi, Hadi, Dubey, Manisha, Endries, Aman Yesuf, Faghmous, Imad D.A., Farid, Talha, Farvid, Maryam S., Farzadfar, Farshad, Fereshtehnejad, Seyed Mohammad, Fischer, Florian, Anderson Fitchett, Joseph Robert, Gibney, Katherine B., Ginawi, Ibrahim Abdelmageem Mohamed, Gishu, Melkamu Dedefo, Gugnani, Harish Chander, Gupta, Rahul, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hamidi, Samer, Harb, Hilda L., Hedayati, Mohammad T., Hsairi, Mohamed, Husseini, Abdullatif, Jahanmehr, Nader, Javanbakht, Mehdi, Jibat, Tariku, Jonas, Jost B., Kasaeian, Amir, Khader, Yousef Saleh, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khan, Gulfaraz, Khoja, Tawfik Ahmed Muthafer, Kinfu, Yohannes, Kissoon, Niranjan, Koyanagi, Ai, Lal, Aparna, Abdul Latif, Asma Abdul, Lunevicius, Raimundas, Magdy Abd El Razek, Hassan, Majeed, Azeem, Malekzadeh, Reza, Mehari, Alem, Mekonnen, Alemayehu B., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Misganaw, Awoke, Ibrahim Mohamed, Layla Abdalla, Nachega, Jean B., Nguyen, Quyen Le, Nisar, Muhammad Imran, Peprah, Emmanuel Kwame, Platts-Mills, James A., Poumalek, Farshad, Qorbani, Mostafa, Rafay, Anwar, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rana, Saleem M., Ranabhat, Chhabi L., Rao, Sowmya R., Refaat, Amany H., Riddle, Mark, Roshandel, Gholamreza, Ruhago, George Mugambage, Saleh, Muhammad Muhammad, Sanabria, Juan R., Sawney, Monika, Sepanlou, Sadaf G., Setegn, Tesfaye, Sliwa, Karen, Sreeramareddy, Chandrashekhar T., Sykes, Bryan L., Tavakkoli, Mohammad, Tedla, Bemnet Amare, Terkawi, Abdullah S., Ukwaja, Kingsley, Uthman, Olalekan A., Westerman, Ronny, Wubshet, Mamo, Yenesew, Muluken A., Yonemoto, Naohiro, Younis, Mustafa Z., Zaidi, Zoubida, Zaki, Maysaa El Sayed, Al Rabeeah, Abdullah A., Wang, Haidong, Naghavi, Mohsen, Vos, Theo, Lopez, Alan D., Murray, Christopher J.L., and Mokdad, Ali H. (2016) Burden of diarrhea in the eastern mediterranean region, 1990-2013: findings from the global burden of disease study 2013. American Journal of Tropical Medicine and Hygiene, 95 (6). pp. 1319-1329.

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Abstract

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low-and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.

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