Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review

Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify c...

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Veröffentlicht in:BMC public health Jg. 12; H. 1; S. 220
Hauptverfasser: Fischer Walker, Christa L, Perin, Jamie, Aryee, Martin J, Boschi-Pinto, Cynthia, Black, Robert E
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 21.03.2012
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Adolescent
Adult
Biostatistics
Care and treatment
Child
Child, Preschool
Children & youth
Cohort Studies
Cost of Illness
Demographic aspects
Developing Countries - statistics & numerical data
Diarrhea
Diarrhea - epidemiology
Environmental Health
Epidemiology
Estimates
Female
Genetic algorithms
Global Health
Health care access
Humans
Incidence
Income
Infant
Infant, Newborn
Literature reviews
Low income groups
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Public Health
Research Article
Risk factors
Studies
Vaccine
Switzerland
Gross National Income
Child Health Epidemiology Reference Group
Timore Leste
Incidence Rate
Oral Rehydration Solution
ISSN:1471-2458, 1471-2458
Online-Zugang:Volltext
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Zusammenfassung:Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify cohort studies that sought to quantify diarrhea incidence among any age group of children 0-59 mo of age. Methods We used the Expectation-Maximization algorithm as a part of a two-stage regression model to handle diverse age data and overall incidence rate variation by study to generate country specific incidence rates for low- and middle-income countries for 1990 and 2010. We then calculated regional incidence rates and uncertainty ranges using the bootstrap method, and estimated the total number of episodes for children 0-59 mo of age in 1990 and 2010. Results We estimate that incidence has declined from 3.4 episodes/child year in 1990 to 2.9 episodes/child year in 2010. As was the case previously, incidence rates are highest among infants 6-11 mo of age; 4.5 episodes/child year in 2010. Among these 139 countries there were nearly 1.9 billion episodes of childhood diarrhea in 1990 and nearly 1.7 billion episodes in 2010. Conclusions Although our results indicate that diarrhea incidence rates may be declining slightly, the total burden on the health of each child due to multiple episodes per year is tremendous and additional funds are needed to improve both prevention and treatment practices in low- and middle-income countries.
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ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-12-220