Dear HIFA and CHIFA colleagues,
Here is a new paper in today's print issue of The Lancet. Citation, extracts and a comment from me below.
CITATION: 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
Local Burden of Disease Diarrhoea Collaborators.
The Lancet 2020 Open Access, Articles| volume 395, issue 10239, p1779-1801, june 06, 2020
Published: May 06, 2020
DOI:https://doi.org/10.1016/S0140-6736(20)30114-8
EXTRACTS
'We present the first high-resolution subnational estimates of diarrhoeal morbidity and mortality from 2000 to 2017 in LMICs... Our estimates show considerable subnational variation in the diarrhoeal burden for children younger than 5 years...
'Implications of all the available evidence:... We have identified countries and locations that are still most in need of preventive and protective measures. Our results indicate that regions with the highest burden had varied exposure to select risk factors; however, similar to previous studies, most high-burden areas showed some combination of poor WASH, high CGF, and low oral rehydration solution coverage. In view of the limited resources in many LMICs, quantification of both the local burden of diarrhoea and its drivers is important to maximise impact.'
COMMENT (NPW): More than half a million children die from diarrhoea each year, while the number of cases is estimated at 910 million: a global case fatality of around one in 2000. The vast majority of those deaths are preventable, but we do not have a clear picture of the decisions and actions taken by families and health workers, and how these impact on the case fatality rate. We know for example that many parents incorrectly believe they should withhold fluids from a child with diarrhoea, thereby tragically making it more likely they will become a fatality. To complement the statistical data from the Global Burden of Disease Study, we need a better understanding of quality of care, from home through all levels of the health system.
Best wishes, Neil
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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org
