Cargando…

Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030

BACKGROUND: Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low- and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child death...

Descripción completa

Detalles Bibliográficos
Autores principales: Black, Robert, Fontaine, Olivier, Lamberti, Laura, Bhan, Maharaj, Huicho, Luis, El Arifeen, Shams, Masanja, Honorati, Walker, Christa Fischer, Mengestu, Tigest Ketsela, Pearson, Luwei, Young, Mark, Orobaton, Nosa, Chu, Yue, Jackson, Bianca, Bateman, Massee, Walker, Neff, Merson, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Edinburgh University Global Health Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815873/
https://www.ncbi.nlm.nih.gov/pubmed/31673345
http://dx.doi.org/10.7189/jogh.09.020801
_version_ 1783463274887512064
author Black, Robert
Fontaine, Olivier
Lamberti, Laura
Bhan, Maharaj
Huicho, Luis
El Arifeen, Shams
Masanja, Honorati
Walker, Christa Fischer
Mengestu, Tigest Ketsela
Pearson, Luwei
Young, Mark
Orobaton, Nosa
Chu, Yue
Jackson, Bianca
Bateman, Massee
Walker, Neff
Merson, Michael
author_facet Black, Robert
Fontaine, Olivier
Lamberti, Laura
Bhan, Maharaj
Huicho, Luis
El Arifeen, Shams
Masanja, Honorati
Walker, Christa Fischer
Mengestu, Tigest Ketsela
Pearson, Luwei
Young, Mark
Orobaton, Nosa
Chu, Yue
Jackson, Bianca
Bateman, Massee
Walker, Neff
Merson, Michael
author_sort Black, Robert
collection PubMed
description BACKGROUND: Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low- and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur. METHODS: We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction. RESULTS: Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level. CONCLUSIONS: Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030.
format Online
Article
Text
id pubmed-6815873
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Edinburgh University Global Health Society
record_format MEDLINE/PubMed
spelling pubmed-68158732019-10-31 Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030 Black, Robert Fontaine, Olivier Lamberti, Laura Bhan, Maharaj Huicho, Luis El Arifeen, Shams Masanja, Honorati Walker, Christa Fischer Mengestu, Tigest Ketsela Pearson, Luwei Young, Mark Orobaton, Nosa Chu, Yue Jackson, Bianca Bateman, Massee Walker, Neff Merson, Michael J Glob Health Research Theme 4: Control of Childhood Diarrhea Mortality BACKGROUND: Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low- and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur. METHODS: We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction. RESULTS: Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level. CONCLUSIONS: Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030. Edinburgh University Global Health Society 2019-12 2019-10-22 /pmc/articles/PMC6815873/ /pubmed/31673345 http://dx.doi.org/10.7189/jogh.09.020801 Text en Copyright © 2019 by the Journal of Global Health. All rights reserved. http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Theme 4: Control of Childhood Diarrhea Mortality
Black, Robert
Fontaine, Olivier
Lamberti, Laura
Bhan, Maharaj
Huicho, Luis
El Arifeen, Shams
Masanja, Honorati
Walker, Christa Fischer
Mengestu, Tigest Ketsela
Pearson, Luwei
Young, Mark
Orobaton, Nosa
Chu, Yue
Jackson, Bianca
Bateman, Massee
Walker, Neff
Merson, Michael
Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title_full Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title_fullStr Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title_full_unstemmed Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title_short Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
title_sort drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030
topic Research Theme 4: Control of Childhood Diarrhea Mortality
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815873/
https://www.ncbi.nlm.nih.gov/pubmed/31673345
http://dx.doi.org/10.7189/jogh.09.020801
work_keys_str_mv AT blackrobert driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT fontaineolivier driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT lambertilaura driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT bhanmaharaj driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT huicholuis driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT elarifeenshams driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT masanjahonorati driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT walkerchristafischer driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT mengestutigestketsela driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT pearsonluwei driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT youngmark driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT orobatonnosa driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT chuyue driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT jacksonbianca driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT batemanmassee driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT walkerneff driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030
AT mersonmichael driversofthereductioninchildhooddiarrheamortality19802015andinterventionstoeliminatepreventablediarrheadeathsby2030