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.

BACKGROUND content: 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, prev...

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Autor: Disease Diarrhoea Collaborators Local Burden
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/183109
Acceso en línea:https://hdl.handle.net/2445/183109
Access Level:acceso abierto
Palabra clave:Diarrea
Infants
Diarrhea
Children
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spelling 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.Disease Diarrhoea Collaborators Local BurdenDiarreaInfantsDiarrheaChildrenBACKGROUND content: 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. - Label: METHODS content: "We used Bayesian model-based geostatistics and a geolocated dataset comprising 15\xE2\x80\x88072\xE2\x80\x88746 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." - Label: FINDINGS content: "The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54\xC2\xB70% (95% uncertainty interval [UI] 38\xC2\xB71-65\xC2\xB78), 17\xC2\xB74% (7\xC2\xB77-28\xC2\xB74), and 59\xC2\xB75% (34\xC2\xB72-86\xC2\xB79) 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." - Label: INTERPRETATION content: 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. - Label: FUNDING content: Bill & Melinda Gates Foundation.Lancet Publishing Group2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/183109Articles publicats en revistes (ISGlobal)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: http://dx.doi.org/10.1016/S0140-6736(20)30114-8Lancet, 2020, vol 395, num 10239, p. 1779-1801http://dx.doi.org/ 10.1016/S0140-6736(20)30114-8cc by (c) Disease Diarrhoea Collaborators Local Burden, 2020http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1831092026-05-27T06:46:51Z
dc.title.none.fl_str_mv 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.
title 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.
spellingShingle 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.
Disease Diarrhoea Collaborators Local Burden
Diarrea
Infants
Diarrhea
Children
title_short 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.
title_full 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.
title_fullStr 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.
title_full_unstemmed 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.
title_sort 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.
dc.creator.none.fl_str_mv Disease Diarrhoea Collaborators Local Burden
author Disease Diarrhoea Collaborators Local Burden
author_facet Disease Diarrhoea Collaborators Local Burden
author_role author
dc.subject.none.fl_str_mv Diarrea
Infants
Diarrhea
Children
topic Diarrea
Infants
Diarrhea
Children
description BACKGROUND content: 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. - Label: METHODS content: "We used Bayesian model-based geostatistics and a geolocated dataset comprising 15\xE2\x80\x88072\xE2\x80\x88746 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." - Label: FINDINGS content: "The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54\xC2\xB70% (95% uncertainty interval [UI] 38\xC2\xB71-65\xC2\xB78), 17\xC2\xB74% (7\xC2\xB77-28\xC2\xB74), and 59\xC2\xB75% (34\xC2\xB72-86\xC2\xB79) 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." - Label: INTERPRETATION content: 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. - Label: FUNDING content: Bill & Melinda Gates Foundation.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/183109
url https://hdl.handle.net/2445/183109
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1016/S0140-6736(20)30114-8
Lancet, 2020, vol 395, num 10239, p. 1779-1801
http://dx.doi.org/ 10.1016/S0140-6736(20)30114-8
dc.rights.none.fl_str_mv cc by (c) Disease Diarrhoea Collaborators Local Burden, 2020
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Disease Diarrhoea Collaborators Local Burden, 2020
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Lancet Publishing Group
publisher.none.fl_str_mv Lancet Publishing Group
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
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