Burden of diarrhea in the eastern mediterranean region, 1990-2013: Findings from the global burden of disease study 2013

Khalil, I. and Colombara, D.V. and Forouzanfar, M.H. and Troeger, C. and Daoud, F. and Moradi-Lakeh, M. and El Bcheraoui, C. and Rao, P.C. and Afshin, A. and Charara, R. and Abate, K.H. and Abd El Razek, M.M. and Abd-Allah, F. and Abu-Elyazeed, R. and Kiadaliri, A.A. and Akanda, A.S. and Akseer, N. and Alam, K. and Alasfoor, D. and Ali, R. and AlMazroa, M.A. and Alomari, M.A. and Salem Al-Raddadi, R.M. and Alsharif, U. and Alsowaidi, S. and Altirkawi, K.A. and Alvis-Guzman, N. and Ammar, W. and Antonio, C.A.T. and Asayesh, H. and Asghar, R.J. and Atique, S. and Awasthi, A. and Bacha, U. and Badawi, A. and Barac, A. and Bedi, N. and Bekele, T. and Bensenor, I.M. and Betsu, B.D. and Bhutta, Z. and Abdulhak, A.A.B. and Butt, Z.A. and Danawi, H. and Dubey, M. and Endries, A.Y. and Faghmous, I.M.D.A. and Farid, T. and Farvid, M.S. and Farzadfar, F. and Fereshtehnejad, S.-M. and Fischer, F. and Anderson Fitchett, J.R. and Gibney, K.B. and Mohamed Ginawi, I.A. and Gishu, M.D. and Gugnani, H.C. and Gupta, R. and Hailu, G.B. and Hamadeh, R.R. and Hamidi, S. and Harb, H.L. and Hedayati, M.T. and Hsairi, M. and Husseini, A. and Jahanmehr, N. and Javanbakht, M. and Jibat, T. and Jonas, J.B. and Kasaeian, A. and Khader, Y.S. and Khan, A.R. and Khan, E.A. and Khan, G. and Khoja, T.A.M. and Kinfu, Y. and Kissoon, N. and Koyanagi, A. and Lal, A. and Abdul Latif, A.A. and Lunevicius, R. and Abd El Razek, H.M. and Majeed, A. and Malekzadeh, R. and Mehari, A. and Mekonnen, A.B. and Melaku, Y.A. and Memish, Z.A. and Mendoza, W. and Misganaw, A. and Ibrahim Mohamed, L.A. and Nachega, J.B. and Nguyen, Q.L. and Nisar, M.I. and Peprah, E.K. and Platts-Mills, J.A. and Pourmalek, F. and Qorbani, M. and Rafay, A. and Rahimi-Movaghar, V. and Ur Rahman, S. and Rai, R.K. and Rana, S.M. and Ranabhat, C.L. and Rao, S.R. and Refaat, A.H. and Riddle, M. and Roshandel, G. and Ruhago, G.M. and Saleh, M.M. and Sanabria, J.R. and Sawhney, M. and Sepanlou, S.G. and Setegn, T. and Sliwa, K. and Sreeramareddy, C.T. and Sykes, B.L. and Tavakkoli, M. and Tedla, B.A. and Terkawi, A.S. and Ukwaja, K. and Uthman, O.A. and Westerman, R. and Wubshet, M. and Yenesew, M.A. and Yonemoto, N. and Younis, M.Z. and Zaidi, Z. and El Sayed Zaki, M. and Al Rabeeah, A.A. and Wang, H. and Naghavi, M. and Vos, T. and Lopez, A.D. and Murray, C.J.L. and Mokdad, A.H. (2016) Burden of diarrhea in the eastern mediterranean region, 1990-2013: Findings from the global burden of disease study 2013. American Journal of Tropical Medicine and Hygiene, 95 (6). pp. 1319-1329.

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Abstract

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6 of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low-and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95 uncertainty interval UI = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. Copyright © 2016 by The American Society of Tropical Medicine and Hygiene.

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