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

• Autor(a) principal: Robert Creiner
• Data de Publicação: 2020
• Outros Autores: Degu Abate, Michelle L. Bell, Derrick A. Bennett, Dessalegn Ajema Berbada, Tina Beyranvand, Anusha Ganapati Bhat, Krittika Bhattacharyya, Suraj Bhattarai, Soumyadeep Bhaumik, Ali Bijani, Boris Bikbov, Hedayat Abbastabar, Raaj Kishore Biswas, Kassawmar Angaw Bogale, Somayeh Bohlouli, Oliver J. Brady, Nicola Luigi Bragazzi, Nikolay Ivanovich Briko, Andrey Nikolaevich Briko, Sharath Burugina Nagaraja, Zahid A. Butt, Ismael R. Campos-nonato, Foad Abd-allah, Julio Cesar Campuzano Rincon, Rosario Cárdenas, Félix Carvalho, Franz Castro, Collins Chansa, Pranab Chatterjee, Vijay Kumar Chattu, Bal Govind Chauhan, Ken Lee Chin, Devasahayam J. Christopher, Ahmed Abdelalim, Dinh-toi Chu, Rafael Moreira Claro, Natalie M. Cormier, Vera M. Costa, Giovanni Damiani, Farah Daoud, Lalit Dandona, Rakhi Dandona, Amira Hamed Darwish, Ahmad Daryani, Ibrahim Abdollahpour, Jai K. Das, Rajat Das Gupta, Tamirat Tesfaye Dasa, Claudio Alberto Davila, Nicole Davis Weaver, Dragos Virgil Davitoiu, Jan-walter de Neve, Feleke Mekonnen Demeke, Asmamaw Bizuneh Demis, Gebre Teklemariam Demoz, Rizwan Suliankatchi Abdulkader, Edgar Denova-gutiérrez, Kebede Deribe, Assefa Desalew, Getenet Ayalew Dessie, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Eric L. Ding, Getaneh Abebe, Helen Derara Diro, Shirin Djalalinia, Huyen Phuc do, David Teye Doku, Christiane Dolecek, Manisha Dubey, Eleonora Dubljanin, Bereket Duko Adema, Susanna J. Dunachie, Andre R. Durães, Kedir Hussein Abegaz, Senbagam Duraisamy, Andem Effiong, Aziz Eftekhari, Iman el Sayed, Maysaa el Sayed Zaki, Maha el Tantawi, Demelash Abewa Elemineh, Shaimaa i El-jaafary, Hajer Elkout, Aisha Elsharkawy, Lucas Guimarães Abreu, Shymaa Enany, Aklilu Endalamfaw, Daniel Adane Endalew, Sharareh Eskandarieh, Alireza Esteghamati, Arash Etemadi, Tamer H. Farag, Emerito Jose A. Faraon, Mohammad Fareed, Roghiyeh Faridnia, Michael R. M. Abrigo, Andrea Farioli, Andre Faro, Hossein Farzam, Ali Akbar Fazaeli, Mehdi Fazlzadeh, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Kirsten e Wiens, Manfred Mario Kokou Accrombessi, Masoud Foroutan, Joel Msafiri Francis, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Reta Tsegaye Gayesa, Kidane Tadesse Gebremariam, Ketema Bizuwork Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Getnet Azeze Gedefaw, Dilaram Acharya, Yilma Chisha Dea Geramo, Birhanu Geta, Kebede Embaye Gezae, Ahmad Ghashghaee, Fariba Ghassemi, Paramjit Singh Gill, Ibrahim Abdelmageed Ginawi, Srinivas Goli, Nelson G. M. Gomes, Sameer Vali Gopalani, Maryam Adabi, Bárbara Niegia Garcia Goulart, Ayman Grada, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimares, Yuming Guo, Rajeev Gupta, Rahul Gupta, Nima Hafezi-Nejad, Michael Tamene Haile, Oladimeji M. Adebayo, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Brian James Hall, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Rufus Adesoji Adedoyin, Hadi Hassankhani, Hamid Yimam Hassen, Desta Haftu Hayelom, Behnam Heidari, Nathaniel J. Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos d de Hidru, Chi Linh Hoang, Praveen Hoogar, Victor Adekanmbi, Mojtaba Hoseini-Ghahfarokhi, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Olatunji O. Adetokunboh, Milena D. Ilic, Leeberk Raja Inbaraj, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Anelisa Jaca, Nader Jafari Balalami, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Beyene Meressa Adhena, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S. ji, Peng Jia, Kimberly B. Johnson, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Mohsen Afarideh, Zubair Kabir, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Gbenga A. Kayode, Keivan Ahmadi, Ali Kazemi Karyani, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Ali Talha Khalil, Ibrahim Khalil, Rovshan Khalilov, md Nuruzzaman Khan, Aniruddha Deshpande, Mehdi Ahmadi, Ejaz Ahmad Khan, Gulfaraz Khan, Junaid Khan, Khaled Khatab, Amir Khater, Mona M. Khater, Alireza Khatony, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Anwar E. Ahmed, Ehsan Khodamoradi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A. Kiadaliri, Yun Jin Kim, Ruth W. Kimokoti, Sezer Kisa, Adnan Kisa, Niranjan Kissoon, Shivakumar km km m Kondlahalli, Muktar Beshir Ahmed, Margaret N. Kosek, Ai Koyanagi, Moritz U. G. Kraemer, Kewal Krishan, Nuworza Kugbey, G. Anil Kumar, Manasi Kumar, Pushpendra Kumar, Dian Kusuma, Carlo la Vecchia, Rushdia Ahmed, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Faris Hasan Lami, Van C. Lansingh, Savita Lasrado, Paul H. Lee, Mostafa Leili, Tsegaye Tsegaye Lolaso Lolaso Lenjebo, Aubrey J. Levine, Olufemi Ajumobi, Sonia Lewycka, Shanshan Li, Shai Linn, Rakesh Lodha, Joshua Longbottom, Platon D. Lopukhov, Sameh Magdeldin, Phetole Walter Mahasha, Narayan Bahadur Mahotra, Deborah Carvalho Malta, Chalachew Genet Akal, Abdullah A. Mamun, Navid Manafi, Farzad Manafi, Ana-Laura Manda, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Laurie B. Marczak, Francisco Rogerlândio Martins-melo, Winfried März, Temesgen Yihunie Akalu, Anthony Masaka, Manu Raj Mathur, Pallab K. Maulik, Benjamin K. Mayala, Colm Mcalinden, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M. Mehta, Gebrekiros Gebremichael Meles, Addisu Melese, Ali S. Akanda, Ziad A. Memish, Alemayehu Toma Mena, Ritesh G. Menezes, Melkamu Merid Mengesha, Desalegn Tadese Mengistu, Getnet Mengistu, Tuomo J. Meretoja, Bartosz Miazgowski, Kebadnew Mulatu m Mihretie, Molly K. Miller-Petrie, Genet Melak Alamene, Edward J. Mills, Seyed Mostafa Mir, Parvaneh Mirabi, Erkin M. Mirrakhimov, Amjad Mohamadi-Bolbanabad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Dara K. Mohammad, Aso Mohammad Darwesh, Naser Mohammad Gholi Mezerji, Turki M. Alanzi, Noushin Mohammadifard, Ammas Siraj Mohammed, Shafiu Mohammed, Jemal Abdu Mohammed, Farnam Mohebi, Ali h Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Mathew M. Baumann, James R. Albright, Maziar Moradi-Lakeh, Paula Moraga, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor Mozaffor Mozaffor, Atalay Goshu Muluneh, Moses K. Muriithi, Christopher J. L. Murray, Gvs Murthy, Jacqueline Elizabeth Alcalde Rabanal, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Farid Najafi, Vinay Nangia, Javad Nazari, Duduzile Edith Ndwandwe, Birhan Tamene Alemnew, Ionut Negoi, Josephine W. Ngunjiri, Quynhanh P. Nguyen, Trang Huyen Nguyen, Cuong Tat Nguyen, Dabere Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A. Nnaji, Marzieh Nojomi, Jean Jacques Noubiap, Zewdie Aderaw Alemu, In-hwan Oh, Oluchi Okpala, Andrew T. Olagunju, Ahmed Omar Bali, Obinna E. Onwujekwe, Doris D. V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B. Osei, Mayowa Ojo Owolabi, Mahesh P. A., Beriwan Abdulqadir Ali, Jagadish Rao Padubidri, Adrian Pana, Tahereh Pashaei, Sanghamitra Pati, Ajay Patle, George C. Patton, Kebreab Paulos, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Muhammad Ali, Konrad Pesudovs, David M. Pigott, Bakhtiar Piroozi, James A. Platts-mills, Mario Poljak, Maarten J. Postma, Hadi Pourjafar, Farshad Pourmalek, Akram Pourshams, Hossein Poustchi, Mehran Alijanzadeh, Sergio I. Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Vahid Alipour, Fatemeh Rajati, Kiana Ramezanzadeh, Saleem M. Rana, Chhabi Lal Ranabhat, Davide Rasella, Salman Rawaf, David Laith Rawaf, Lal Rawal, Giuseppe Remuzzi, Vishnu Renjith, Syed Mohamed Aljunid, Andre M. N. Renzaho, Melese Abate Reta, Satar Rezaei, Ana Isabel Ribeiro, Jennifer Rickard, Carlos Miguel Rios González, Maria Jesus Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Ali Almasi, Ali Rostami, Dietrich Rothenbacher, Enrico Rubagotti, Salvatore Rubino, Anas M. Saad, Siamak Sabour, Ehsan Sadeghi, Saeed Safari, Mahdi Safdarian, Rajesh Sagar, Paulina A. Lindstedt, Amir Almasi-Hashiani, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Farkhonde Salehi, Saleh Salehi Zahabi, Marwa R. Rashad Salem, Hosni Salem, Yahya Salimi, Hamideh Salimzadeh, Hesham M. Al-mekhlafi, Evanson Zondani Sambala, Abdallah M. Samy, Juan Sanabria, Itamar S. Santos, Sivan Yegnanarayana Iyer Saraswathy, Abdur Razzaque Sarker, Benn Sartorius, Brijesh Sathian, Maheswar Satpathy, Alyssa N. Sbarra, Khalid Altirkawi, Lauren E. Schaeffer, David C. Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Hosein Shabaninejad, Amira A. Shaheen, Masood Ali Shaikh, Ali S. Shalash, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, Nelson Alvis-Guzman, Mohammad Bagher Shamsi, Morteza Shamsizadeh, Mehdi Sharif, Muki Shehu Shey, Kenji Shibuya, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Apurba Shil, Jae Il Shin, Rahman Shiri, Nelson J. Alvis-Zakzuk, Reza Shirkoohi, Si Si, Soraya Siabani, Jasvinder A. Singh, Narinder Pal Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L. Smith, Mohammad Reza Sobhiyeh, Azmeraw T. Amare, Anton Sokhan, Moslem Soofi, Joan B. Soriano, Muluken Bekele Sorrie, Ireneous N. Soyiri, Chandrashekhar T. Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Saeed Amini, Koku Sisay Tamirat, Aberash Abay Tassew, Nuno Taveira, Bineyam Taye, Arash Tehrani-Banihashemi, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Arianna Maever Loreche Amit, Sathish Thirunavukkarasu, Nihal Thomas, Kenean Getaneh Tlaye, Boikhutso Tlou, Marcos Roberto Tovani-palone, Eugenio Traini, Khanh Bao Tran, Indang Trihandini, Irfan Ullah, Bhaskaran Unnikrishnan, Catalina Liliana Andrei, Sahel Valadan Tahbaz, Pascual R. Valdez, Santosh Varughese, Yousef Veisani, Francesco S. Violante, Sebastian Vollmer, Theo Vos, Fiseha Wadilo Wada, Yasir Waheed, Yafeng Wang, Masresha Tessema Anegago, Yuan-Pang Wang, Girmay Teklay Weldesamuel, Catherine A. Welgan, Ronny Westerman, Taweewat Wiangkham, Tissa Wijeratne, Charles Shey Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Brigette F. Blacker, Mina Anjomshoa, Ai-Min Wu, Gelin xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Muluken Azage Yenesew, Alex Yeshaneh, Mekdes Tigistu Yilma, Ebrahim M. Yimer, Fereshteh Ansari, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Mustafa Z. Younis, Hebat-Allah Salah a Yousof, Chuanhua Yu, Hasan Yusefzadeh, Mohammad Zamani, Carlos Zambrana-Torrelio, Carl Abelardo T. Antonio, Hamed Zandian, Ayalew Jejaw Zeleke, Nejimu Biza Zepro, Taye Abuhay Zewale, Dongyu Zhang, Yunquan Zhang, Xiu-ju Zhao, Arash Ziapour, Sanjay Zodpey, Simon I. Hay, Ernoiz Antriyandarti, Seth Christopher Yaw Appiah, Jalal Arabloo, Olatunde Aremu, Bahram Armoon, Krishna K. Aryal, Afsaneh Arzani, Christopher E. Troeger, Mohsen Asadi-Lari, Alebachew Fasil Ashagre, Hagos Tasew Atalay, Suleman Atique, Sachin R. Atre, Marcel Ausloos, Leticia Avila-Burgos, Ashish Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Lucas Earl, Getinet Ayano, Martin Amogre Ayanore, Asnakew Achaw Ayele, Yared A. Asmare Aynalem, Samad Azari, Ebrahim Babaee, Alaa Badawi, Shankar M. Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Sandra B. Munro, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Quique Bassat, Mohsen Bayati, Neeraj Bedi, Masoud Behzadifar, Meysam Behzadifar, Yibeltal Alemu Bekele
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1016/S0140-6736(20)30114-8; http://hdl.handle.net/1843/65941; https://orcid.org/0000-0001-9690-575X
• topic: Iniquidades em saúde; Fatores socioeconômicos; Diarreia infantil; Morbidade; Mortalidade da criança

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. Funding: Bill & Melinda Gates Foundation.