Incidence, Mortality, and Burden of Acute Watery Diarrhea and Its Geographical Distribution in Iran during 2009-2016

Background: Diarrhea is a major cause of public health burden, especially in children under 5 yr of age. This study aimed at estimating the incidence, mortality, burden, and geographical distribution of Acute Watery Diarrhea (AWD) in Iran from 2009 to 2016. Methods: This study was conducted in 2018. The data on the incidence and mortality from 2009 to 2016 was obtained from AWD surveillance system of the Centre for Communicable Diseases Control (CCDC), Ministry of Health and Medical Education (MOHME) of Iran. Disability Adjusted Life Years (DALYs) was used to estimate the burden of AWD. The DALYs-related AWD was calculated using a method developed by WHO. The average duration of the disease and its disability weight, respectively, were set at 5 d (0.0137 years) and 0.093 for all age groups. Results: The incidence of AWD had an ascending trend over the studied period. Forty cases of deaths from AWD were reported. The lowest and highest burdens of AWD, respectively, were 436.1 DALYs in 2010 and 975.9 DALYs in 2015. The incidence and burden of AWD did not have an equal distribution across the country, between the provinces. Conclusion: The incidence of AWD had an ascending trend over the studied period that can be attributed to the improvements in the disease surveillance system. Moreover, the incidence, mortality, and burden of AWD did not have an equal distribution in Iran. Hence, it is recommended to strengthen AWD surveillance system. In addition, it is suggested to adopt proper interventions for controlling the disease in areas with a high burden of AWD.