Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

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

Tue Jul 5 17:26:18 2022

(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. Lancet. pp. 1779-1801. ISSN 0140-6736

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Abstract

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54.0 (95 uncertainty interval UI 38.1-65.8), 17.4% (7.7-28.4), and 59.5% (34.2-86.9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

Item Type: Article
Creators:
CreatorsEmail
Reiner, R. C.UNSPECIFIED
Wiens, K. E.UNSPECIFIED
Deshpande, A.UNSPECIFIED
Baumann, M. M.UNSPECIFIED
Lindstedt, P. A.UNSPECIFIED
Blacker, B. F.UNSPECIFIED
Troeger, C. E.UNSPECIFIED
Earl, L.UNSPECIFIED
Munro, S. B.UNSPECIFIED
Abate, D.UNSPECIFIED
Abbastabar, H.UNSPECIFIED
Abd-Allah, F.UNSPECIFIED
Abdelalim, A.UNSPECIFIED
Abdollahpour, I.UNSPECIFIED
Abdulkader, R. S.UNSPECIFIED
Abebe, G.UNSPECIFIED
Abegaz, K. H.UNSPECIFIED
Abreu, L. G.UNSPECIFIED
Abrigo, M. R. M.UNSPECIFIED
Accrombessi, M. M. K.UNSPECIFIED
Acharya, D.UNSPECIFIED
Adabi, M.UNSPECIFIED
Adebayo, O. M.UNSPECIFIED
Adedoyin, R. A.UNSPECIFIED
Adekanmbi, V.UNSPECIFIED
Adetokunboh, O. O.UNSPECIFIED
Adham, D.UNSPECIFIED
Adhena, B. M.UNSPECIFIED
Afarideh, M.UNSPECIFIED
Ahmadi, K.UNSPECIFIED
Ahmadi, M.UNSPECIFIED
Ahmed, A. E.UNSPECIFIED
Ahmed, M. B.UNSPECIFIED
Ahmed, R.UNSPECIFIED
Ajumobi, O.UNSPECIFIED
Akal, C. G.UNSPECIFIED
Akalu, T. Y.UNSPECIFIED
Akanda, A. S.UNSPECIFIED
Alamene, G. M.UNSPECIFIED
Alanzi, T. M.UNSPECIFIED
Albright, J. R.UNSPECIFIED
Rabanal, J. E. A.UNSPECIFIED
Alemnew, B. T.UNSPECIFIED
Alemu, Z. A.UNSPECIFIED
Ali, B. A.UNSPECIFIED
Ali, M.UNSPECIFIED
Alijanzadeh, M.UNSPECIFIED
Alipour, V.UNSPECIFIED
Aljunid, S. M.UNSPECIFIED
Almasi, A.UNSPECIFIED
Almasi-Hashiani, A.UNSPECIFIED
Al-Mekhlafi, H. M.UNSPECIFIED
Altirkawi, K.UNSPECIFIED
Alvis-Guzman, N.UNSPECIFIED
Alvis-Zakzuk, N. J.UNSPECIFIED
Amare, A. T.UNSPECIFIED
Amini, S.UNSPECIFIED
Amit, A. M. L.UNSPECIFIED
Andrei, C. L.UNSPECIFIED
Anegago, M. T.UNSPECIFIED
Anjomshoa, M.UNSPECIFIED
Ansari, F.UNSPECIFIED
Antonio, C. A. T.UNSPECIFIED
Antriyandarti, E.UNSPECIFIED
Appiah, S. C. Y.UNSPECIFIED
Arabloo, J.UNSPECIFIED
Aremu, O.UNSPECIFIED
Armoon, B.UNSPECIFIED
Aryal, K. K.UNSPECIFIED
Arzani, A.UNSPECIFIED
Asadi-Lari, M.UNSPECIFIED
Ashagre, A. F.UNSPECIFIED
Atalay, H. T.UNSPECIFIED
Atique, S.UNSPECIFIED
Atre, S. R.UNSPECIFIED
Ausloos, M.UNSPECIFIED
Avila-Burgos, L.UNSPECIFIED
Awasthi, A.UNSPECIFIED
Awoke, N.UNSPECIFIED
Quintanilla, B. P. A.UNSPECIFIED
Ayano, G.UNSPECIFIED
Ayanore, M. A.UNSPECIFIED
Ayele, A. A.UNSPECIFIED
Aynalem, Y. A.UNSPECIFIED
Azari, S.UNSPECIFIED
Babaee, E.UNSPECIFIED
Badawi, A.UNSPECIFIED
Bakkannavar, S. M.UNSPECIFIED
Balakrishnan, S.UNSPECIFIED
Bali, A. G.UNSPECIFIED
Banach, M.UNSPECIFIED
Barac, A.UNSPECIFIED
Barnighausen, T. W.UNSPECIFIED
Basaleem, H.UNSPECIFIED
Bassat, Q.UNSPECIFIED
Bayati, M.UNSPECIFIED
Bedi, N.UNSPECIFIED
Behzadifar, M.UNSPECIFIED
Behzadifar, M.UNSPECIFIED
Bekele, Y. A.UNSPECIFIED
othersUNSPECIFIED
Keywords: sex-specific mortality systematic analysis africa territories cholera water General & Internal Medicine
Divisions:
Page Range: pp. 1779-1801
Journal or Publication Title: Lancet
Journal Index: ISI
Volume: 395
Number: 10239
Identification Number: https://doi.org/10.1016/s0140-6736(20)30114-8
ISSN: 0140-6736
Depositing User: مهندس مهدی شریفی
URI: http://eprints.medilam.ac.ir/id/eprint/3077

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