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

BACKGROUND: 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...

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Autores principales: Walker, Christa L. Fischer, Friberg, Ingrid K., Binkin, Nancy, Young, Mark, Walker, Neff, Fontaine, Olivier, Weissman, Eva, Gupta, Akanksha, Black, Robert E.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062532/
https://www.ncbi.nlm.nih.gov/pubmed/21445330
http://dx.doi.org/10.1371/journal.pmed.1000428
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author Walker, Christa L. Fischer
Friberg, Ingrid K.
Binkin, Nancy
Young, Mark
Walker, Neff
Fontaine, Olivier
Weissman, Eva
Gupta, Akanksha
Black, Robert E.
author_facet Walker, Christa L. Fischer
Friberg, Ingrid K.
Binkin, Nancy
Young, Mark
Walker, Neff
Fontaine, Olivier
Weissman, Eva
Gupta, Akanksha
Black, Robert E.
author_sort Walker, Christa L. Fischer
collection PubMed
description BACKGROUND: 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. METHODS AND FINDINGS: 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. CONCLUSION: 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. Please see later in the article for the Editors' Summary
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spelling pubmed-30625322011-03-28 Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis Walker, Christa L. Fischer Friberg, Ingrid K. Binkin, Nancy Young, Mark Walker, Neff Fontaine, Olivier Weissman, Eva Gupta, Akanksha Black, Robert E. PLoS Med Research Article BACKGROUND: 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. METHODS AND FINDINGS: 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. CONCLUSION: 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. Please see later in the article for the Editors' Summary Public Library of Science 2011-03-22 /pmc/articles/PMC3062532/ /pubmed/21445330 http://dx.doi.org/10.1371/journal.pmed.1000428 Text en Fischer Walker et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Walker, Christa L. Fischer
Friberg, Ingrid K.
Binkin, Nancy
Young, Mark
Walker, Neff
Fontaine, Olivier
Weissman, Eva
Gupta, Akanksha
Black, Robert E.
Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title_full Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title_fullStr Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title_full_unstemmed Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title_short Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis
title_sort scaling up diarrhea prevention and treatment interventions: a lives saved tool analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062532/
https://www.ncbi.nlm.nih.gov/pubmed/21445330
http://dx.doi.org/10.1371/journal.pmed.1000428
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