1. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015
- Author
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Troeger, C, Forouzanfar, M, Rao, PC, Khalil, I, Brown, A, Reiner, RC, Fullman, N, Thompson, RL, Abajobir, A, Ahmed, M, Alemayohu, MA, Alvis-Guzman, N, Amare, AT, Antonio, CA, Asayesh, H, Avokpaho, E, Awasthi, A, Bacha, U, Barac, A, Betsue, BD, Beyene, AS, Boneya, DJ, Malta, DC, Dandona, L, Dandona, R, Dubey, M, Eshrati, B, Fitchett, JRA, Gebrehiwot, TT, Hailu, GB, Horino, M, Hotez, PJ, Jibat, T, Jonas, JB, Kasaeian, A, Kissoon, N, Kotloff, K, Koyanagi, A, Kumar, GA, Rai, RK, Lal, A, El Razek, HMA, Mengistie, MA, Moe, C, Patton, G, Platts-Mills, JA, Qorbani, M, Ram, U, Roba, HS, Sanabria, J, Sartorius, B, Sawhney, M, Shigematsu, M, Sreeramareddy, C, Swaminathan, S, Tedla, BA, Jagiellonian, RT-M, Ukwaja, K, Werdecker, A, Widdowson, M-A, Yonemoto, N, Zaki, MES, Lim, SS, Naghavi, M, Vos, T, Hay, SI, Murray, CJL, Mokdad, AH, Troeger, C, Forouzanfar, M, Rao, PC, Khalil, I, Brown, A, Reiner, RC, Fullman, N, Thompson, RL, Abajobir, A, Ahmed, M, Alemayohu, MA, Alvis-Guzman, N, Amare, AT, Antonio, CA, Asayesh, H, Avokpaho, E, Awasthi, A, Bacha, U, Barac, A, Betsue, BD, Beyene, AS, Boneya, DJ, Malta, DC, Dandona, L, Dandona, R, Dubey, M, Eshrati, B, Fitchett, JRA, Gebrehiwot, TT, Hailu, GB, Horino, M, Hotez, PJ, Jibat, T, Jonas, JB, Kasaeian, A, Kissoon, N, Kotloff, K, Koyanagi, A, Kumar, GA, Rai, RK, Lal, A, El Razek, HMA, Mengistie, MA, Moe, C, Patton, G, Platts-Mills, JA, Qorbani, M, Ram, U, Roba, HS, Sanabria, J, Sartorius, B, Sawhney, M, Shigematsu, M, Sreeramareddy, C, Swaminathan, S, Tedla, BA, Jagiellonian, RT-M, Ukwaja, K, Werdecker, A, Widdowson, M-A, Yonemoto, N, Zaki, MES, Lim, SS, Naghavi, M, Vos, T, Hay, SI, Murray, CJL, and Mokdad, AH
- Abstract
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide. METHODS: We estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platform shared across most causes of death in the GBD 2015 study. We modelled diarrhoeal morbidity, including incidence and prevalence, using a meta-regression platform called DisMod-MR. We estimated aetiologies for diarrhoeal diseases using a counterfactual approach that incorporates the aetiology-specific risk of diarrhoeal disease and the prevalence of the aetiology in diarrhoea episodes. We used the Socio-demographic Index, a summary indicator derived from measures of income per capita, educational attainment, and fertility, to assess trends in diarrhoeal mortality. The two leading risk factors for diarrhoea-childhood malnutrition and unsafe water, sanitation, and hygiene-were used in a decomposition analysis to establish the relative contribution of changes in diarrhoea disability-adjusted life-years (DALYs). FINDINGS: Globally, in 2015, we estimate that diarrhoea was a leading cause of death among all ages (1·31 million deaths, 95% uncertainty interval [95% UI] 1·23 million to 1·39 million), as well as a leading cause of DALYs because of its disproportionate impact on young children (71·59 million DALYs, 66·44 million to 77·21 million). Diarrhoea was a common cause of death among children under 5 years old (499 000 deaths, 95% UI 447 000-558 000). The number of deaths due to diarrhoea decreased by an estimated 20·8% (95% UI 15·4-26·1) from 2005 to 2015. Rotavirus was the leading cause of diarrhoea deaths (199 000, 95% UI 165 000-241 000), followed by Shigella spp (164 300, 85 000-278 700) and Salmonella spp (90 300, 95% UI 3
- Published
- 2017