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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/59222
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
Authors: Robert C. Reiner
Kirsten E. Wiens
Aniruddha Deshpande
Mathew M. Baumann
Paulina A. Lindstedt
Brigette F. Blacker
Christopher E. Troeger
Lucas Earl
Sandra B. Munro
Degu Abate
Hedayat Abbastabar
Foad Abd-Allah
Ahmed Abdelalim
Ibrahim Abdollahpour
Rizwan Suliankatchi Abdulkader
Getaneh Abebe
Kedir Hussein Abegaz
Lucas Guimarães Abreu
Michael R.M. Abrigo
Manfred Mario Kokou Accrombessi
Dilaram Acharya
Maryam Adabi
Oladimeji M. Adebayo
Rufus Adesoji Adedoyin
Victor Adekanmbi
Olatunji O. Adetokunboh
Davoud Adham
Beyene Meressa Adhena
Mohsen Afarideh
Keivan Ahmadi
Mehdi Ahmadi
Anwar E. Ahmed
Muktar Beshir Ahmed
Rushdia Ahmed
Olufemi Ajumobi
Chalachew Genet Akal
Temesgen Yihunie Akalu
Ali S. Akanda
Genet Melak Alamene
Turki M. Alanzi
James R. Albright
Jacqueline Elizabeth Alcalde Rabanal
Birhan Tamene Alemnew
Zewdie Aderaw Alemu
Beriwan Abdulqadir Ali
Muhammad Ali
Mehran Alijanzadeh
Vahid Alipour
Syed Mohamed Aljunid
Ali Almasi
Amir Almasi-Hashiani
Hesham M. Al-Mekhlafi
Khalid Altirkawi
Nelson Alvis-Guzman
Nelson J. Alvis-Zakzuk
Azmeraw T. Amare
Saeed Amini
Arianna Maever Loreche Amit
Catalina Liliana Andrei
Masresha Tessema Anegago
Mina Anjomshoa
Fereshteh Ansari
Carl Abelardo T. Antonio
Ernoiz Antriyandarti
Seth Christopher Yaw Appiah
Jalal Arabloo
Olatunde Aremu
Bahram Armoon
Krishna K. Aryal
Afsaneh Arzani
Mohsen Asadi-Lari
Alebachew Fasil Ashagre
Hagos Tasew Atalay
Suleman Atique
Sachin R. Atre
Marcel Ausloos
Leticia Avila-Burgos
Ashish Awasthi
Nefsu Awoke
Beatriz Paulina Ayala Quintanilla
Getinet Ayano
Martin Amogre Ayanore
Asnakew Achaw Ayele
Yared Asmare Aynalem
Samad Azari
Ebrahim Babaee
Alaa Badawi
Shankar M. Bakkannavar
Senthilkumar Balakrishnan
Ayele Geleto Bali
Maciej Banach
Aleksandra Barac
Till Winfried Barnighausen
Huda Basaleem
Quique Bassat
Mohsen Bayati
Neeraj Bedi
Masoud Behzadifar
Meysam Behzadifar
Yibeltal Alemu Bekele
Health Human Resources Research Center (SUMS)
Lincoln Medical School
Preventive Medicine and Public Health Research Center
IUMS Health Management and Economics Research Center
Woldia University
Ethiopian Public Health Institute
Social Determinants of Health Research Center
Advanced Diagnostic and Interventional Radiology Research Center
University of Health and Allied Sciences, Ghana
Erbil Polytechnic University
Aksum University
Debre Berhan University
Wolaita Sodo University
Madda Walabu University
Debre Markos University
South Australian Health and Medical Research Institute
Bucharest University of Economic Studies
Universidad de la Costa
Saveh University of Medical Sciences
Jazan University
Instituto de Salud Global de Barcelona
Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune
Mekelle University
University of Hail
Imam Abdulrahman Bin Faisal university
Dongguk University, Gyeongju
Birmingham City University
Institute for Health Metrics and Evaluation
University of Gondar
University of Aden
Sana'a University
Instytut Centrum Zdrowia Matki Polki
Kwame Nkrumah University of Science and Technology
Kathmandu University
University of Gezira
University of the Philippines Manila
Haramaya University
Jimma University
Bahar Dar University
Addis Ababa University
Klinicki Centar Srbije
Universitas Sebelas Maret
University of Belgrade
Quaid-i-Azam University
Universidad de Cartagena
University of Kuwait
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
University of Leicester
Institució Catalana de Recerca i Estudis Avançats
Ministry of Health Saudi Arabia
Harvard T.H. Chan School of Public Health
Arak University of Medical Sciences
Curtin University
Tabriz University of Medical Sciences
Universidade Federal de Minas Gerais
Ludwig-Maximilians-Universität München
University of Washington School of Medicine
Agence de la santé publique du Canada
Endocrinology and Metabolism Research Institute (TUMS)
Qazvin University of Medical Sciences
Ardabil University of Medical Sciences
Babol University of Medical Sciences
Ahvaz Jundishapur University of Medical Sciences
Iran University of Medical Sciences
Cardiff University
Instituto Nacional de Salud Pública. México
Isfahan University of Medical Sciences
University College Hospital, Ibadan
University of New England Australia
Universität Heidelberg
University of Toronto
Manipal Academy of Higher Education
Lorestan University of Medical Sciences
Rafsanjan University of Medical Sciences
King Saud University
Obafemi Awolowo University
University of Rhode Island
Cairo University
International Centre for Diarrhoeal Disease Research Bangladesh
Kermanshah University of Medical Sciences
BRAC University
Hong Kong Polytechnic University
Iranian Ministry of Health and Medical Education
La Trobe University
Hamadan University of Medical Sciences
Medical University of Lodz
National Institutes of Health (NIH)
Johns Hopkins University
Wageningen University & Research
Universiti Kebangsaan Malaysia
University of Nevada, Reno
Stellenbosch University
Gandhi Medical College
Education and Extension Organization (AREEO)
Ishik University
Indian Institute of Public Health
Bénin Clinical Research Institute (IRCB)
Abt Associates Nepal
Philippine Institute for Development Studies
Federal Ministry of Health
Keywords: Medicine
Issue Date: 6-Jun-2020
Citation: The Lancet. Vol.395, No.10239 (2020), 1779-1801
Abstract: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. 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.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/59222
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85086298953&origin=inward
ISSN: 1474547X
01406736
Appears in Collections:Scopus 2020

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