Systematic review of diarrhea duration and severity in children and adults in low- and middle-income countries

Background Diarrhea is a leading cause of morbidity and mortality globally; yet the overall burden of diarrhea in terms of duration and severity has not been quantified. As improvements in treatment lead to decreases in diarrhea mortality, it is important to understand the substantial impact of diar...

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Bibliographic Details
Published in:BMC public health Vol. 12; no. 1; p. 276
Main Authors: Lamberti, Laura M, Fischer Walker, Christa L, Black, Robert E
Format: Journal Article
Language:English
Published: London BioMed Central 06.04.2012
Springer Nature B.V
BMC
Subjects:
Adolescent
Adult
Biostatistics
Child
Child, Preschool
Children & youth
Confidence intervals
Dehydration
Developed Countries
Developing Countries
Diarrhea
Diarrhea - physiopathology
Disease
Environmental Health
Epidemiology
Estimates
Hospitals
Humans
Infant, Newborn
Low income groups
Medicine
Medicine & Public Health
Morbidity
Mortality
Public Health
Research Article
Severity of Illness Index
Studies
Vaccine
Demographic Health Survey
Diarrhea
Severe Dehydration
Moderate Case
Severity Outcome
ISSN:1471-2458, 1471-2458
Online Access:Get full text
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Summary:Background Diarrhea is a leading cause of morbidity and mortality globally; yet the overall burden of diarrhea in terms of duration and severity has not been quantified. As improvements in treatment lead to decreases in diarrhea mortality, it is important to understand the substantial impact of diarrhea morbidity on disability among children and adults worldwide. Methods We conducted a systematic review to generate estimates of duration and severity outcomes for individuals 0-59 mos, 5-15 yrs, and ≥ 16 yrs, and for 3 severity indexes: mild, moderate, and severe. Results We estimate that among children under-five, 64.8% of diarrheal episodes are mild, 34.7% are moderate, and 0.5% are severe. On average, mild episodes last 4.3 days, and severe episodes last 8.4 days and cause dehydration in 84.6% of cases. We estimate that among older children and adults, 95% of episodes are mild; 4.95% are moderate; and 0.05% are severe. Among individuals ≥ 16 yrs, severe episodes typically last 2.6 days and cause dehydration in 92.8% of cases. Conclusions Moderate and severe episodes constitute a substantial portion of the total envelope of diarrhea among children under-five (35.2%; about 588 million episodes). Among older children and adults, moderate and severe episodes account for a much smaller proportion of the total envelope of diarrhea (5%), but the absolute number of such episodes is noteworthy (about 21.5 million episodes among individuals ≥ 16 yrs). Hence, the global burden of diarrhea consists of significant morbidity, extending beyond episodes progressing to death.
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ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-12-276