Variation in Childhood Diarrhea in Africa
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Variation in Childhood Diarrhea in Africa

September 9, 2019


Diarrheal diseases are the third leading cause
of morbidity and mortality in children under 5-years-old in Africa, and most deaths are
preventable. However, developing a targeted intervention
approach is hampered by the lack of comprehensive estimates of disease burden. The Childhood Diarrhoeal Morbidity and Mortality
in Africa study is a systematic assessment of the local variation in diarrheal morbidity
and mortality in children under 5 across Africa from 2000-2015. The study used information from surveys conducted
in 51,355 small geographic areas throughout Africa. Bayesian geostatistical methods were used
to estimate diarrheal prevalence, incidence and mortality. The mortality rate per thousand from diarrheal
disease varied from 1.6 to 9.5 across the small geographic areas, with the largest within-country
variation observed in Nigeria. Over 50% of the estimated mortality occurred in
just 7% of the small geographic areas. The highest case-fatality rates occurred in
Lesotho, Mali, Sierra Leone, Benin, and Nigeria. The authors conclude that there is marked
local variability in childhood diarrheal mortality and morbidity across Africa, and that these
findings may be used to more precisely target preventative interventions. Full study results are available at NEJM.org

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