1. Identifying residual hotspots and mapping lower respiratory infection morbidity and mortality in African children from 2000 to 2017
- Author
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Joseph Frostad, Simon I. Hay, Kirsten E. Wiens, Brigette F. Blacker, Grant Rodgers Kemp, Peter W. Gething, Roy Burstein, Nicholas Graetz, Sandra B. Munro, Ibrahim A Khalil, Robert C. Reiner, Mathew M. Baumann, Christopher J L Murray, Catherine A. Welgan, Jonathan F. Mosser, Molly K. Miller-Petrie, Samir Bhatt, David L. Smith, Paulina A. Lindstedt, Scott J. Swartz, Oliver J. Brady, Aaron Osgood-Zimmerman, Aniruddha Deshpande, Nicholas J Kassebaum, Puja C Rao, Lucas Earl, Christopher Troeger, Laura Dwyer-Lindgren, Tamer H. Farag, Laurie B. Marczak, Sarah E Ray, Daniel J. Weiss, Moritz U. G. Kraemer, Ian Davis, Jennifer M. Ross, David M. Pigott, QuynhAnh P. Nguyen, Nicole Davis Weaver, Ali H. Mokdad, and Daniel C Casey
- Subjects
Microbiology (medical) ,Change over time ,medicine.medical_specialty ,Epidemiology ,Immunology ,030204 cardiovascular system & hematology ,Disease cluster ,Applied Microbiology and Biotechnology ,Microbiology ,Policy and public health in microbiology ,Article ,03 medical and health sciences ,Health services ,0302 clinical medicine ,Environmental health ,Genetics ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Lower respiratory infection ,Respiratory Tract Infections ,Health policy ,Cause of death ,Respiratory tract diseases ,Infectious-disease epidemiology ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Infant ,Bayes Theorem ,Cell Biology ,Risk factors ,Child, Preschool ,Africa ,Public Health ,Morbidity ,business - Abstract
Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of health policies has the greatest impact. We used Bayesian geostatistical modelling to estimate LRI incidence, prevalence and mortality in children under 5 subnationally in Africa for 2000–2017, using surveys covering 1.46 million children and 9,215,000 cases of LRI. Our model reveals large within-country variation in both health burden and its change over time. While reductions in childhood morbidity and mortality due to LRI were estimated for almost every country, we expose a cluster of residual high risk across seven countries, which averages 5.5 LRI deaths per 1,000 children per year. The preventable nature of the vast majority of LRI deaths mandates focused health system efforts in specific locations with the highest burden., Geospatial modelling shows an overall decline in morbidity and mortality due to lower respiratory infections in Africa from 2000 to 2017, but also identifies subnational areas with residual high risk.
- Published
- 2019