Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/37649
Title: Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017
Authors: REINER JR., Robert C.WIENS, Kirsten E.DESHPANDE, AniruddhaBAUMANN, Mathew M.LINDSTEDT, Paulina A.BLACKER, Brigette F.TROEGER, Christopher E.EARL, LucasMUNRO, Sandra B.ABATE, DeguABBASTABAR, HedayatABD-ALLAH, FoadABDELALIM, AhmedABDOLLAHPOUR, IbrahimABDULKADER, Rizwan SuliankatchiABEBE, GetanehABEGAZ, Kedir HusseinABREU, Lucas GuimaraesABRIGO, Michael R. M.ACCROMBESSI, Manfred Mario KokouACHARYA, DilaramADABI, MaryamADEBAYO, Oladimeji M.ADEDOYIN, Rufus AdesojiADEKANMBI, VictorADETOKUNBOH, Olatunji O.ADHAM, DavoudADHENA, Beyene MeressaAFARIDEH, MohsenAHMADI, KeivanAHMADI, MehdiAHMED, Anwar E.AHMED, Muktar BeshirAHMED, RushdiaAJUMOBI, OlufemiAKAL, Chalachew GenetAKALU, Temesgen YihunieAKANDA, Ali S.ALAMENE, Genet MelakALANZI, Turki M.ALBRIGHT, James R.RABANAL, Jacqueline Elizabeth AlcaldeALEMNEW, Birhan TameneALEMU, Zewdie AderawALI, Beriwan AbdulqadirALI, MuhammadALIJANZADEH, MehranALIPOUR, VahidALJUNID, Syed MohamedALMASI, AliALMASI-HASHIANI, AmirAL-MEKHLAFI, Hesham M.ALTIRKAWI, KhalidALVIS-GUZMAN, NelsonALVIS-ZAKZUK, Nelson J.AMARE, Azmeraw T.AMINI, SaeedAMIT, Arianna Maever LorecheANDREI, Catalina LilianaANEGAGO, Masresha TessemaANJOMSHOA, MinaANSARI, FereshtehANTONIO, Carl Abelardo T.ANTRIYANDARTI, ErnoizAPPIAH, Seth Christopher YawARABLOO, JalalAREMU, OlatundeARMOON, BahramARYAL, Krishna K.ARZANI, AfsanehASADI-LARI, MohsenASHAGRE, Alebachew FasilATALAY, Hagos TasewATIQUE, SulemanATRE, Sachin R.AUSLOOS, MarcelAVILA-BURGOS, LeticiaAWASTHI, AshishAWOKE, NefsuQUINTANILLA, Beatriz Paulina AyalaAYANO, GetinetAYANORE, Martin AmogreAYELE, Asnakew AchawAYNALEM, Yared AsmareAZARI, SamadBABAEE, EbrahimBADAWI, AlaaBAKKANNAVAR, Shankar M.BALAKRISHNAN, SenthilkumarBALI, Ayele GeletoBANACH, MaciejBARAC, AleksandraBARNIGHAUSEN, Till WinfriedBASALEEM, HudaBASSAT, QuiqueBAYATI, MohsenBEDI, NeerajBEHZADIFAR, MasoudBEHZADIFAR, MeysamBEKELE, Yibeltal AlemuBELL, Michelle L.BENNETT, Derrick A.BERBADA, Dessalegn AjemaBEYRANVAND, TinaBHAT, Anusha GanapatiBHATTACHARYYA, KrittikaBHATTARAI, SurajBHAUMIK, SoumyadeepBIJANI, AliBIKBOV, BorisBISWAS, Raaj KishoreBOGALE, Kassawmar AngawBOHLOULI, SomayehBRADY, Oliver J.BRAGAZZI, Nicola LuigiBRIKO, Andrey NikolaevichBRIKO, Nikolay IvanovichNAGARAJA, Sharath BuruginaBUTT, Zahid A.CAMPOS-NONATO, Ismael R.RINCON, Julio Cesar CampuzanoCARDENAS, RosarioCARVALHO, FelixCASTRO, FranzCHANSA, CollinsCHATTERJEE, PranabCHATTU, Vijay KumarCHAUHAN, Bal GovindCHIN, Ken LeeCHRISTOPHER, Devasahayam J.CHU, Dinh-ToiCLARO, Rafael M.CORMIER, Natalie M.COSTA, Vera M.DAMIANI, GiovanniDAOUD, FarahDANDONA, LalitDANDONA, RakhiDARWISH, Amira HamedDARYANI, AhmadDAS, Jai K.GUPTA, Rajat DasDASA, Tamirat TesfayeDAVILA, Claudio AlbertoWEAVER, Nicole DavisDAVITOIU, Dragos VirgilNEVE, Jan-Walter DeDEMEKE, Feleke MekonnenDEMIS, Asmamaw BizunehDEMOZ, Gebre TeklemariamDENOVA-GUTIERREZ, EdgarDERIBE, KebedeDESALEW, AssefaDESSIE, Getenet AyalewDHARMARATNE, Samath DhammindaDHILLON, PreetiDHIMAL, MeghnathDHUNGANA, Govinda PrasadDIAZ, DanielDING, Eric L.DIRO, Helen DeraraDJALALINIA, ShirinDO, Huyen PhucDOKU, David TeyeDOLECEK, ChristianeDUBEY, ManishaDUBLJANIN, EleonoraADEMA, Bereket DukoDUNACHIE, Susanna J.DURAES, Andre R.DURAISAMY, SenbagamEFFIONG, AndemEFTEKHARI, AzizSAYED, Iman ElZAKI, Maysaa El SayedTANTAWI, Maha ElELEMINEH, Demelash AbewaEL-JAAFARY, Shaimaa I.ELKOUT, HajerELSHARKAWY, AishaENANY, ShymaaENDALAMAW, AkliluENDALEW, Daniel AdaneESKANDARIEH, ShararehESTEGHAMATI, AlirezaETEMADI, ArashFARAG, Tamer H.FARAON, Emerito Jose A.FAREED, MohammadFARIDNIA, RoghiyehFARIOLI, AndreaFARO, AndreFARZAM, HosseinFAZAELI, Ali AkbarFAZLZADEH, MehdiFENTAHUN, NetsanetFERESHTEHNEJAD, Seyed-MohammadFERNANDES, EduardaFILIP, IrinaFISCHER, FlorianFOROUTAN, MasoudFRANCIS, Joel MsafiriFRANKLIN, Richard CharlesFROSTAD, Joseph JonFUKUMOTO, TakeshiGAYESA, Reta TsegayeGEBREMARIAM, Kidane TadesseGEBREMEDHIN, Ketema BizuworkGEBREMESKEL, Gebreamlak GebremedhnGEDEFAW, Getnet AzezeGERAMO, Yilma Chisha DeaGETA, BirhanuGEZAE, Kebede EmbayeGHASHGHAEE, AhmadGHASSEMI, FaribaGILL, Paramjit SinghGINAWI, Ibrahim AbdelmageedGOLI, SrinivasGOMES, Nelson G. M.GOPALANI, Sameer ValiGOULART, Barbara Niegia GarciaGRADA, AymanGUGNANI, Harish ChanderGUIDO, DavideGUIMARAES, Rafael AlvesGUO, YumingGUPTA, RahulGUPTA, RajeevHAFEZI-NEJAD, NimaHAILE, Michael TameneHAILU, Gessessew BugssaHAJ-MIRZAIAN, ArvinHAJ-MIRZAIAN, AryaHALL, Brian JamesHANDISO, Demelash WoldeyohannesHARIRIAN, HamidrezaHARIYANI, NinukHASABALLAH, Ahmed I.HASAN, Md. MehediHASANZADEH, AmirHASSANKHANI, HadiHASSEN, Hamid YimamHAYELOM, Desta HaftuHEIDARI, BehnamHENRY, Nathaniel J.HERTELIU, ClaudiuHEYDARPOUR, FatemehHIDRU, Hagos D. deHOANG, Chi LinhHOOGAR, PraveenHOSEINI-GHAHFAROKHI, MojtabaHOSSAIN, NazninHOSSEINI, MostafaHOSSEINZADEH, MehdiHOUSEH, MowafaHU, GuoqingHUMAYUN, AyeshaHUSSAIN, Syed AtherIBITOYE, Segun EmmanuelILESANMI, Olayinka StephenILIC, Milena D.INBARAJ, Leeberk RajaIRVANI, Seyed Sina NaghibiISLAM, Sheikh Mohammed SharifulIWU, Chinwe JulianaJACA, AnelisaBALALAMI, Nader JafariJAHANMEHR, NaderJAKOVLJEVIC, MihajloJALALI, AmirJAYATILLEKE, Achala UpendraJENABI, EnsiyehJHA, Ravi PrakashJHA, VivekanandJI, John S.JIA, PengJOHNSON, Kimberly B.JONAS, Jost B.JOZWIAK, Jacek JerzyKABIR, AliKABIR, ZubairKAHSAY, AmahaKALANI, HamedKANCHAN, TanujMATIN, Behzad KaramiKARCH, AndreKARKI, SurendraKASAEIAN, AmirKASAHUN, Gebremicheal GebreslassieKAYODE, Gbenga A.KARYANI, Ali KazemiKEIYORO, Peter NjengaKETEMA, Daniel BekeleKHADER, Yousef SalehKHAFAIE, Morteza AbdullatifKHALID, NaumanKHALIL, Ali TalhaKHALIL, IbrahimKHALILOV, RovshanKHAN, Md NuruzzamanKHAN, Ejaz AhmadKHAN, GulfarazKHAN, JunaidKHATAB, KhaledKHATER, AmirKHATER, Mona M.KHATONY, AlirezaKHAYAMZADEH, MaryamKHAZAEI, MohammadKHAZAEI, SalmanKHODAMORADI, EhsanKHOSRAVI, Mohammad HosseinKHUBCHANDANI, JagdishKIADALIRI, Aliasghar A.KIM, Yun JinKIMOKOTI, Ruth W.KISA, AdnanKISA, SezerKISSOON, NiranjanKONDLAHALLI, Shivakumar K. M.KOSEK, Margaret N.KOYANAGI, AiKRAEMER, Moritz U. G.KRISHAN, KewalKUGBEY, NuworzaKUMAR, G. AnilKUMAR, ManasiKUMAR, PushpendraKUSUMA, DianVECCHIA, Carlo LaBen LaceyLAL, AparnaLAL, Dharmesh KumarLAMI, Faris HasanLANSINGH, Van C.LASRADO, SavitaLEE, Paul H.LEILI, MostafaLENJEBO, Tsegaye LolasoLEVINE, Aubrey J.LEWYCKA, SoniaLI, ShanshanLINN, ShaiLODHA, RakeshLONGBOTTOM, JoshuaLOPUKHOV, Platon D.MAGDELDIN, SamehMAHASHA, Phetole WalterMAHOTRA, Narayan BahadurMALTA, Deborah CarvalhoMAMUN, Abdullah A.MANAFI, FarzadMANAFI, NavidMANDA, Ana-LauraMANSOURNIA, Mohammad AliMAPOMA, Chabila ChristopherMARAMI, DadiMARCZAK, Laurie B.MARTINS-MELO, Francisco RogerlandioMARZ, WinfriedMASAKA, AnthonyMATHUR, Manu RajMAULIK, Pallab K.MAYALA, Benjamin K.MCALINDEN, ColmMEHNDIRATTA, Man MohanMEHROTRA, RaviMEHTA, Kala M.MELES, Gebrekiros GebremichaelMELESE, AddisuMEMISH, Ziad A.MENA, Alemayehu TomaMENEZES, Ritesh G.MENGESHA, Melkamu MeridMENGISTU, Desalegn TadeseMENGISTU, GetnetMERETOJA, Tuomo J.MIAZGOWSKI, BartoszMIHRETIE, Kebadnew Mulatu M.MILLER-PETRIE, Molly K.MILLS, Edward J.MIR, Seyed MostafaMIRABI, ParvanehMIRRAKHIMOV, Erkin M.MOHAMADI-BOLBANABAD, AmjadMOHAMMAD, Dara K.MOHAMMAD, Karzan AbdulmuhsinMOHAMMAD, YousefDARWESH, Aso MohammadMEZERJI, Naser Mohammad GholiMOHAMMADIFARD, NoushinMOHAMMED, Ammas SirajMOHAMMED, Jemal AbduMOHAMMED, ShafiuMOHEBI, FarnamMOKDAD, Ali H.MOODLEY, YoshanMORADI, GhobadMORADI, MasoudMORADI-JOO, MohammadMORADI-LAKEH, MaziarMORAGA, PaulaMOSAPOUR, AbbasMOUODI, SiminMOUSAVI, Seyyed MeysamMOZAFFOR, MilivaMULUNEH, Atalay GoshuMURIITHI, Moses K.MURRAY, Christopher J. 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Citation: LANCET, v.395, n.10239, p.1779-1801, 2020
Abstract: Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54.0% (95% uncertainty interval [UI] 38.1-65.8), 17.4% (7.7-28.4), and 59.5% (34.2-86.9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health.
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Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - HC/IPq
Instituto de Psiquiatria - HC/IPq

Artigos e Materiais de Revistas Científicas - LIM/13
LIM/13 - Laboratório de Genética e Cardiologia Molecular

Artigos e Materiais de Revistas Científicas - LIM/20
LIM/20 - Laboratório de Terapêutica Experimental

Artigos e Materiais de Revistas Científicas - LIM/23
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica

Artigos e Materiais de Revistas Científicas - ODS/06
ODS/06 - Água potável e saneamento


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