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

Ibrahim Khalil, Danny V. Colombara, Mohammad Hossein Forouzanfar, Christopher Troeger, Farah Daoud, Maziar Moradi-Lakeh, Charbel El Bcheraoui, Puja C. Rao, Ashkan Afshin, Raghid Charara, Kalkidan Hassen Abate, Mohammed Magdy Abd El Razek, Foad Abd-Allah, Remon Abu-Elyazeed, Aliasghar Ahmad Kiadaliri, Ali Shafqat Akanda, Nadia Akseer, Khurshid Alam, Deena Alasfoor, Raghib AliMohammad A. AlMazroa, Mahmoud A. Alomari, Rajaa Mohammad Salem Al-Raddadi, Ubai Alsharif, Shirina Alsowaidi, Khalid A. Altirkawi, Nelson Alvis-Guzman, Walid Ammar, Carl Abelardo T. Antonio, Hamid Asayesh, Rana Jawad Asghar, Suleman Atique, Ashish Awasthi, Umar Bacha, Alaa Badawi, Aleksandra Barac, Neeraj Bedi, Tolesa Bekele, Isabela M. Bensenor, Balem Demtsu Betsu, Zulfiqar Bhutta, Aref A.Bin Abdulhak, Zahid A. Butt, Hadi Danawi, Manisha Dubey, Aman Yesuf Endries, Imad M.D.A. Faghmous, Talha Farid, Maryam S. Farvid, Farshad Farzadfar, Seyed Mohammad Fereshtehnejad, Florian Fischer, Joseph Robert Anderson Fitchett, Katherine B. Gibney, Ibrahim Abdelmageem Mohamed Ginawi, Melkamu Dedefo Gishu, Harish Chander Gugnani, Rahul Gupta, Gessessew Bugssa Hailu, Randah Ribhi Hamadeh, Samer Hamidi, Hilda L. Harb, Mohammad T. Hedayati, Mohamed Hsairi, Abdullatif Husseini, Nader Jahanmehr, Mehdi Javanbakht, Tariku Jibat, Jost B. Jonas, Amir Kasaeian, Yousef Saleh Khader, Abdur Rahman Khan, Ejaz Ahmad Khan, Gulfaraz Khan, Tawfik Ahmed Muthafer Khoja, Yohannes Kinfu, Niranjan Kissoon, Ai Koyanagi, Aparna Lal, Asma Abdul Abdul Latif, Raimundas Lunevicius, Hassan Magdy Abd El Razek, Azeem Majeed, Reza Malekzadeh, Alem Mehari, Alemayehu B. Mekonnen, Yohannes Adama Melaku, Ziad A. Memish, Walter Mendoza, Awoke Misganaw, Layla Abdalla Ibrahim Mohamed, Jean B. Nachega, Quyen Le Nguyen, Muhammad Imran Nisar, Emmanuel Kwame Peprah, James A. Platts-Mills, Farshad Pourmalek, Mostafa Qorbani, Anwar Rafay, Vafa Rahimi-Movaghar, Sajjad Ur Rahman, Rajesh Kumar Rai, Saleem M. Rana, Chhabi L. Ranabhat, Sowmya R. Rao, Amany H. Refaat, Mark Riddle, Gholamreza Roshandel, George Mugambage Ruhago, Muhammad Muhammad Saleh, Juan R. Sanabria, Monika Sawhney, Sadaf G. Sepanlou, Tesfaye Setegn, Karen Sliwa, Chandrashekhar T. Sreeramareddy, Bryan L. Sykes, Mohammad Tavakkoli, Bemnet Amare Tedla, Abdullah S. Terkawi, Kingsley Ukwaja, Olalekan A. Uthman, Ronny Westerman, Mamo Wubshet, Muluken A. Yenesew, Naohiro Yonemoto, Mustafa Z. Younis, Zoubida Zaidi, Maysaa El Sayed Zaki, Abdullah A. Al Rabeeah, Haidong Wang, Mohsen Naghavi, Theo Vos, Alan D. Lopez, Christopher J.L. Murray, Ali H. Mokdad

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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.

Original languageEnglish
Pages (from-to)1319-1329
Number of pages11
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume95
Issue number6
DOIs
Publication statusPublished - 1 Dec 2016
Externally publishedYes

Bibliographical note

Marked Copyright © 2016 by The American Society of Tropical Medicine and Hygiene and CC-BY

Keywords

  • Diarrheal diseases
  • Eastern Mediterranean Region
  • Disability-adjusted life years
  • Global Burden of Disease Study
  • disease burden

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    Khalil, I., Colombara, D. V., Forouzanfar, M. H., Troeger, C., Daoud, F., Moradi-Lakeh, M., El Bcheraoui, C., Rao, P. C., Afshin, A., Charara, R., Abate, K. H., Abd El Razek, M. M., Abd-Allah, F., Abu-Elyazeed, R., Kiadaliri, A. A., Akanda, A. S., Akseer, N., Alam, K., Alasfoor, D., ... 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), 1319-1329. https://doi.org/10.4269/ajtmh.16-0339