Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis

Diarrhea remains a leading cause of mortality among young children in low- and middle-income countries. Although the evidence for individual diarrhea prevention and treatment interventions is solid, the effect a comprehensive scale-up effort would have on diarrhea mortality has not been estimated. W...

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Veröffentlicht in:PLoS medicine Jg. 8; H. 3; S. e1000428
Hauptverfasser: Walker, Christa L. Fischer, Friberg, Ingrid K., Binkin, Nancy, Young, Mark, Walker, Neff, Fontaine, Olivier, Weissman, Eva, Gupta, Akanksha, Black, Robert E.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 01.03.2011
Public Library of Science (PLoS)
Schlagworte:
Antibiotics
Breast Feeding
Breastfeeding & lactation
Care and treatment
Child, Preschool
Children & youth
Costs
Costs and Cost Analysis
Developing countries
Diarrhea
Diarrhea - economics
Diarrhea - mortality
Diarrhea - prevention & control
Diarrhea - therapy
Drinking water
Epidemiologic Methods
Gastroenterology and Hepatology/Gastrointestinal Infections
Global Health
Humans
Hygiene
Immunization
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Infectious Diseases/Gastrointestinal Infections
Intervention
LDCs
Low income groups
Methods
Mortality
Patient outcomes
Pediatrics and Child Health
Per capita
Prevention
Public Health and Epidemiology/Health Policy
Public Health and Epidemiology/Infectious Diseases
Viruses
Water quality management
United States
United States > US
Costs & Cost Analysis
Epidemiologic Methods
Humans
Breast Feeding
Child, Preschool
Diarrhea
World Health
ISSN:1549-1676, 1549-1277, 1549-1676
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Zusammenfassung:Diarrhea remains a leading cause of mortality among young children in low- and middle-income countries. Although the evidence for individual diarrhea prevention and treatment interventions is solid, the effect a comprehensive scale-up effort would have on diarrhea mortality has not been estimated. We use the Lives Saved Tool (LiST) to estimate the potential lives saved if two scale-up scenarios for key diarrhea interventions (oral rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and breastfeeding) were implemented in the 68 high child mortality countries. We also conduct a simple costing exercise to estimate cost per capita and total costs for each scale-up scenario. Under the ambitious (feasible improvement in coverage of all interventions) and universal (assumes near 100% coverage of all interventions) scale-up scenarios, we demonstrate that diarrhea mortality can be reduced by 78% and 92%, respectively. With universal coverage nearly 5 million diarrheal deaths could be averted during the 5-year scale-up period for an additional cost of US$12.5 billion invested across 68 priority countries for individual-level prevention and treatment interventions, and an additional US$84.8 billion would be required for the addition of all water and sanitation interventions. Using currently available interventions, we demonstrate that with improved coverage, diarrheal deaths can be drastically reduced. If delivery strategy bottlenecks can be overcome and the international community can collectively deliver on the key strategies outlined in these scenarios, we will be one step closer to achieving success for the United Nations' Millennium Development Goal 4 (MDG4) by 2015.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ICMJE criteria for authorship read and met: CLFW IKF NB MY NW OF EW AG REB. Agree with the manuscript's results and conclusions: CLFW IKF NB MY NW OF EW AG REB. Designed the experiments/the study: CLFW NB MY NW REB. Analyzed the data: CLFW IKF MY EW AG. Collected data/did experiments for the study: IKF NB. Wrote the first draft of the paper: CLFW. Contributed to the writing of the paper: IKF NB MY NW OF AG REB. Helped develop the model: NW. Did cost calculations: EW.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1000428