Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017

Local Burden of Disease Diarrhoea Collaborators, (2020) Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. The Lancet, 395. 10239. pp. 1779-1801.

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Abstract

Across low-income and middle-income countries (LMICs), diarrhoea causes more than half a million childhood deaths annually. In addition to this staggering loss of life, more than 910 million childhood cases of diarrhoea per year2 are distributed unequally across the population, causing not only acute morbidity but also long-term disability in children who suffer repeatedly with enteric infections. National-level analyses of the burden of childhood diarrhoea, measured by both death rates and incidence, have exposed substantial variation. In LMICs in 2017, the incidence of diarrhoea ranged from less than one episode per child per year to more than four episodes per child per year. In the same population, the case-fatality rate of diarrhoea can vary from one per 10 000 infections to more than 20 per 10 000 infections.

WHO's integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD) identified three approaches to reduce the burden of diarrhoea: protect, prevent, and treat. Healthy children are less likely to have severe diarrhoea episodes, so diarrhoeal burden can be reduced by prioritising good health practices from birth. As such, reducing general health risk factors, such as child growth failure (CGF) indicators of stunting, wasting, and underweight, can protect a child from diarrhoea. Preventing illness by promoting vaccination and improved water, sanitation, and hygiene (WASH) can similarly reduce diarrhoeal burden. Finally, appropriate treatment, such as oral rehydration solution (ORS), the efficacy of which exceeds 90%,10 can substantially reduce death resulting from disease-associated dehydration.

Item ID: 63804
Item Type: Article (Research - C1)
ISSN: 0140-6736
Copyright Information: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Additional Information:

Richard Franklin is part of the Global Burden of Disease Collaborators group. All collaborators are listed at the end of the article.

Funders: Bill and Melinda Gates Foundation
Date Deposited: 16 Jul 2020 01:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920405 Environmental Health @ 100%
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