Final Diarrhoea Report October 2009 final (original) (raw)
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Global Epidemiology and Management of Acute Diarrhea in Children from Developing Countries
Annals of Pediatrics & Child Health, 2020
Diarrheal disease remains one of the leading causes of death in children under the age of five years in developing countries. Extensive measures have been in effect in low-and middle-income countries (LMICs), worldwide, to provide clean water, good hygiene, and sanitary living conditions. However, many survivors continue to deal with persistent diarrhea and nutrient deficiencies, affecting their growth due to their low socioeconomic status. There are over 2.5 billion diarrheal illnesses cases annually, which account for an estimated 1,400 deaths daily, according to the World Health Organization (WHO). The lack of maternal education, insufficiency or early cessation of breastfeeding, poor handwashing technique, improper storage of food and water, and limited access to proper health facilities in developing countries has resulted in children facing severe dehydration and prolonged mucosal injury that ultimately results in their death. For the patients that can access healthcare, diagnosis is achieved by stool microscopy and culture. Furthermore, polymerase chain reaction (PCR), has been used to test for Escherichia coli and norovirus to detect toxin-encoding genes, while enzyme immunoassay is used to detect other pathogens, such as Campylobacter, rotavirus, adenovirus, astrovirus, Entamoeba histolytica, Shigella, Giardia, and Cryptosporidium. Additionally, subsequent septic bacterial infections that result from inadequate care and poor management of diarrheal illness have resulted in the use of oral rehydration and antibiotics with a minimal resolution of persistent diarrhea in some patients. Several interventions that are being implemented in LMICs to combat diarrhea-related mortality, include providing educational resources to caregivers and healthcare providers, training caregivers to be able to detect early signs of deterioration in children, as well as purifying water and sanitation. Additionally, the importance of highly nutritious foods and proper breastfeeding techniques for the first six months of life have been shown to provide children with stronger immune systems to enable them to combat infections.
The Lancet Infectious Diseases
Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness.
Therapeutic advances in infectious disease, 2018
Acute diarrhoeal diseases remain a leading cause of global morbidity and mortality particularly among young children in resource-limited countries. Recent large studies utilizing case-control design, prospective sampling and more sensitive and broad diagnostic techniques have shed light on particular pathogens of importance and highlighted the previously under recognized impact of these infections on post-acute illness mortality and growth. Vaccination, particularly against rotavirus, has emerged as a key effective means of preventing significant morbidity and mortality from childhood diarrhoeal disease. Other candidate vaccines against leading diarrhoeal pathogens, such as enterotoxigenicandspp., also hold significant promise in further ameliorating the burden of enteric infections in children. Large studies are also currently underway evaluating novel and potential easy-to-implement water, sanitation and hygiene (WASH) preventive strategies. Given the ongoing global burden of this...
Journal of global health, 2013
Childhood diarrhoea remains a major public health problem responsible for the deaths of approximately 800 000 children annually, worldwide. The present study was undertaken to further define research priorities for the prevention and treatment of diarrhoea in low and middle income countries. We used the Child Health and Nutrition Research Initiative (CHNRI) process for defining research priorities. This provided a transparent, systematic method of obtaining the opinions of experts regarding research priorities in childhood diarrhoea. The present report describes the deliberations of a workshop that reviewed these research priorities by stakeholders including colleagues from: government agencies, academic institutions, major funding agencies and non-governmental organizations. The workshop included 38 participants, divided into four groups to consider issues in the categories of description, delivery, development and discovery. Each group received 20 to 23 questions/research prioriti...
Global Trends of Diarrhea Diseases in Children
Annals of Microbiology and Infectious Diseases, 2018
Diarrhea is a major cause of childhood morbidity and mortality. It results from contaminated food and water sources. Diarrhoea caused by infection is widespread throughout developing countries. This review focuses on diarrhea-related diseases in children worldwide. It looks at the pathogenesis, treatment, prevalence, and mortality rates of the major pathogens which cause diarrhea in children. The major pathogens include Rotavirus, Escherichia coli, Cholera, Shigella, Parasites (Protozoa and Helminthes), and waterborne-specific pathogens. Included are the associations between malnutrition, increased diarrheal prevalence and mortality rates, as well as Human Immunodeficiency Virus’ (HIVs) association with increased mortality rates due to diarrhea. This paper explores the current treatment and prevention methods used to decrease the incidence, prevalence and mortality associated with diarrhea, and can help to promote diarrheal awareness and education