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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| Vydáno v: | BMC public health Ročník 12; číslo 1; s. 220 |
|---|---|
| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
London
BioMed Central
21.03.2012
BioMed Central Ltd Springer Nature B.V BMC |
| Témata: | |
| ISSN: | 1471-2458, 1471-2458 |
| On-line přístup: | Získat plný text |
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| Abstract | 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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| AbstractList | 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. Abstract 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. 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. 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. 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. 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. Doc number: 220 Abstract 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. 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. 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. 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. 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. 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. 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.BACKGROUNDDiarrhea 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.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.METHODSWe 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.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.RESULTSWe 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.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.CONCLUSIONSAlthough 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. |
| ArticleNumber | 220 |
| Audience | Academic |
| Author | Aryee, Martin J Black, Robert E Boschi-Pinto, Cynthia Fischer Walker, Christa L Perin, Jamie |
| AuthorAffiliation | 3 Department of Child and Adolescent Health and Development, World Health Organization, Avenue Avia 20, Geneva 27, Switzerland 2 Division of Biostatistics, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland 21205, USA 1 Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615 N. Wolfe St, Baltimore, MD 21205, USA |
| AuthorAffiliation_xml | – name: 2 Division of Biostatistics, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland 21205, USA – name: 3 Department of Child and Adolescent Health and Development, World Health Organization, Avenue Avia 20, Geneva 27, Switzerland – name: 1 Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615 N. Wolfe St, Baltimore, MD 21205, USA |
| Author_xml | – sequence: 1 givenname: Christa L surname: Fischer Walker fullname: Fischer Walker, Christa L email: cfischer@jhsph.edu organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health – sequence: 2 givenname: Jamie surname: Perin fullname: Perin, Jamie organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health – sequence: 3 givenname: Martin J surname: Aryee fullname: Aryee, Martin J organization: Division of Biostatistics, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University – sequence: 4 givenname: Cynthia surname: Boschi-Pinto fullname: Boschi-Pinto, Cynthia organization: Department of Child and Adolescent Health and Development, World Health Organization – sequence: 5 givenname: Robert E surname: Black fullname: Black, Robert E organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22436130$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1093/ije/dyp159 10.1186/1471-2458-11-S3-S15 10.1177/15648265090301S103 10.2307/2527783 10.1002/(SICI)1097-0258(20000515)19:9<1141::AID-SIM479>3.0.CO;2-F 10.1016/S0140-6736(10)60549-1 10.1093/ije/dyn099 10.1191/096228097675663031 10.1016/S0140-6736(10)60356-X 10.1214/ss/1063994968 10.1111/j.2517-6161.1977.tb01600.x 10.1093/oxfordjournals.aje.a113909 10.1093/oxfordjournals.aje.a117401 |
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| References_xml | – volume: 38 start-page: 766 year: 2009 end-page: 772 ident: CR15 article-title: Recent diarrhoeal illness and risk of lower respiratory infections in children under the age of 5 years publication-title: Int J Epidemiol doi: 10.1093/ije/dyp159 – volume: 120 start-page: 449 year: 1984 end-page: 455 ident: CR16 article-title: Intervention studies and the definition of dominant transmission routes publication-title: Am J Epidemiol – volume: 11 start-page: S15 issue: Suppl 3 year: 2011 ident: CR2 article-title: Breastfeeding and the risk for diarrhea morbidity and mortality publication-title: BMC Public Health doi: 10.1186/1471-2458-11-S3-S15 – volume: 30 start-page: S12 year: 2009 end-page: S40 ident: CR3 article-title: Preventive zinc supplementation among infants, preschoolers, and older prepubertal children publication-title: Food Nutr Bull doi: 10.1177/15648265090301S103 – volume: 60 start-page: 605 year: 1992 end-page: 613 ident: CR6 article-title: The magnitude of the global problem of acute diarrhoeal disease: a review of active surveillance data publication-title: Bull World Health Organ – volume: 14 start-page: 174 year: 1958 end-page: 194 ident: CR10 article-title: Maximum likelihood estimation from incomplete-data publication-title: Biometrics doi: 10.2307/2527783 – volume: 19 start-page: 1141 year: 2000 end-page: 1164 ident: CR13 article-title: Bootstrap confidence intervals: when, which, what? 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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... 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... 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... Doc number: 220 Abstract Background: Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and... Abstract Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income... |
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| SubjectTerms | 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 |
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| Title | Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review |
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