Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost?

Global mortality in children younger than 5 years has fallen substantially in the past two decades from more than 12 million in 1990, to 6·9 million in 2011, but progress is inconsistent between countries. Pneumonia and diarrhoea are the two leading causes of death in this age group and have overlap...

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Vydáno v:The Lancet (British edition) Ročník 381; číslo 9875; s. 1417 - 1429
Hlavní autoři: Bhutta, Zulfiqar A, Das, Jai K, Walker, Neff, Rizvi, Arjumand, Campbell, Harry, Rudan, Igor, Black, Robert E
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Elsevier Ltd 20.04.2013
Elsevier Limited
Témata:
Anti-Bacterial Agents - therapeutic use
Antibiotics
Breast Feeding
Breastfeeding & lactation
burden of disease
Case management
Catalysts
Child mortality
Child, Preschool
Childhood
Children
Children & youth
Childrens health
Costs
death
Dehydration - complications
Dehydration - therapy
Developing countries
Diarrhea
Diarrhea - mortality
Diarrhea - prevention & control
Diarrhea - therapy
Disease
Disease prevention
Fatalities
Female
Fluid Therapy
Global Health
Health Promotion
Health Services Accessibility
Humans
Infant
Internal Medicine
LDCs
Male
Measles
Morbidity
Mortality
Nutrition research
Pneumonia
Pneumonia - mortality
Pneumonia - prevention & control
Pneumonia - therapy
Risk analysis
Risk Factors
Systematic review
Therapeutic applications
Trends
Vaccines
Zinc - deficiency
Pakistan
United States > US
Nigeria
Democratic Republic of Congo
China
India
ISSN:0140-6736, 1474-547X, 1474-547X
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Popis
Shrnutí:Global mortality in children younger than 5 years has fallen substantially in the past two decades from more than 12 million in 1990, to 6·9 million in 2011, but progress is inconsistent between countries. Pneumonia and diarrhoea are the two leading causes of death in this age group and have overlapping risk factors. Several interventions can effectively address these problems, but are not available to those in need. We systematically reviewed evidence showing the effectiveness of various potential preventive and therapeutic interventions against childhood diarrhoea and pneumonia, and relevant delivery strategies. We used the Lives Saved Tool model to assess the effect on mortality when these interventions are applied. We estimate that if implemented at present annual rates of increase in each of the 75 Countdown countries, these interventions and packages of care could save 54% of diarrhoea and 51% of pneumonia deaths by 2025 at a cost of US$3·8 billion. However, if coverage of these key evidence-based interventions were scaled up to at least 80%, and that for immunisations to at least 90%, 95% of diarrhoea and 67% of pneumonia deaths in children younger than 5 years could be eliminated by 2025 at a cost of $6·715 billion. New delivery platforms could promote equitable access and community platforms are important catalysts in this respect. Furthermore, several of these interventions could reduce morbidity and overall burden of disease, with possible benefits for developmental outcomes.
Bibliografie:http://dx.doi.org/10.1016/S0140-6736(13)60648-0
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ISSN:0140-6736
1474-547X
1474-547X
DOI:10.1016/S0140-6736(13)60648-0