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 Ali; Mohammad 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

doi:10.4269/ajtmh.16-0339

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

Research output: Contribution to journal › Article › peer-review

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 language	English (US)
Pages (from-to)	1319-1329
Number of pages	11
Journal	American Journal of Tropical Medicine and Hygiene
Volume	95
Issue number	6
DOIs	https://doi.org/10.4269/ajtmh.16-0339
State	Published - Dec 2016

ASJC Scopus subject areas

Parasitology
Infectious Diseases
Virology

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10.4269/ajtmh.16-0339

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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

Khalil, I, Colombara, DV, Forouzanfar, MH, Troeger, C, Daoud, F, Moradi-Lakeh, M, El Bcheraoui, C, Rao, PC, Afshin, A, Charara, R, Abate, KH, Abd El Razek, MM, Abd-Allah, F, Abu-Elyazeed, R, Kiadaliri, AA, Akanda, AS, Akseer, N, Alam, K, Alasfoor, D, Ali, R, AlMazroa, MA, Alomari, MA, Salem Al-Raddadi, RM, Alsharif, U, Alsowaidi, S, Altirkawi, KA, Alvis-Guzman, N, Ammar, W, Antonio, CAT, Asayesh, H, Asghar, RJ, Atique, S, Awasthi, A, Bacha, U, Badawi, A, Barac, A, Bedi, N, Bekele, T, Bensenor, IM, Betsu, BD, Bhutta, Z, Abdulhak, AAB, Butt, ZA, Danawi, H, Dubey, M, Endries, AY, Faghmous, IMDA, Farid, T, Farvid, MS, Farzadfar, F, Fereshtehnejad, SM, Fischer, F, Anderson Fitchett, JR, Gibney, KB, Mohamed Ginawi, IA, Gishu, MD, Gugnani, HC, Gupta, R, Hailu, GB, Hamadeh, RR, Hamidi, S, Harb, HL, Hedayati, MT, Hsairi, M, Husseini, A, Jahanmehr, N, Javanbakht, M, Jibat, T, Jonas, JB, Kasaeian, A, Khader, YS, Khan, AR, Khan, EA, Khan, G, Khoja, TAM, Kinfu, Y, Kissoon, N, Koyanagi, A, Lal, A, Abdul Latif, AA, Lunevicius, R, Abd El Razek, HM, Majeed, A, Malekzadeh, R, Mehari, A, Mekonnen, AB, Melaku, YA, Memish, ZA, Mendoza, W, Misganaw, A, Ibrahim Mohamed, LA, Nachega, JB, Nguyen, QL, Nisar, MI, Peprah, EK, Platts-Mills, JA, Pourmalek, F, Qorbani, M, Rafay, A, Rahimi-Movaghar, V, Ur Rahman, S, Rai, RK, Rana, SM, Ranabhat, CL, Rao, SR, Refaat, AH, Riddle, M, Roshandel, G, Ruhago, GM, Saleh, MM, Sanabria, JR, Sawhney, M, Sepanlou, SG, Setegn, T, Sliwa, K, Sreeramareddy, CT, Sykes, BL, Tavakkoli, M, Tedla, BA, Terkawi, AS, Ukwaja, K, Uthman, OA, Westerman, R, Wubshet, M, Yenesew, MA, Yonemoto, N, Younis, MZ, Zaidi, Z, El Sayed Zaki, M, Al Rabeeah, AA, Wang, H, Naghavi, M, Vos, T, Lopez, AD, Murray, CJL & Mokdad, AH 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, vol. 95, no. 6, pp. 1319-1329. https://doi.org/10.4269/ajtmh.16-0339

@article{07846435033645c3b33b23147e48f7af,

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

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.",

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

note = "Publisher Copyright: Copyright {\textcopyright} 2016 by The American Society of Tropical Medicine and Hygiene.",

year = "2016",

month = dec,

doi = "10.4269/ajtmh.16-0339",

language = "English (US)",

volume = "95",

pages = "1319--1329",

journal = "American Journal of Tropical Medicine and Hygiene",

issn = "0002-9637",

publisher = "American Society of Tropical Medicine and Hygiene",

number = "6",

}

TY - JOUR

T1 - Burden of diarrhea in the eastern mediterranean region, 1990-2013

T2 - Findings from the global burden of disease study 2013

AU - Khalil, Ibrahim

AU - Colombara, Danny V.

AU - Forouzanfar, Mohammad Hossein

AU - Troeger, Christopher

AU - Daoud, Farah

AU - Moradi-Lakeh, Maziar

AU - El Bcheraoui, Charbel

AU - Rao, Puja C.

AU - Afshin, Ashkan

AU - Charara, Raghid

AU - Abate, Kalkidan Hassen

AU - Abd El Razek, Mohammed Magdy

AU - Abd-Allah, Foad

AU - Abu-Elyazeed, Remon

AU - Kiadaliri, Aliasghar Ahmad

AU - Akanda, Ali Shafqat

AU - Akseer, Nadia

AU - Alam, Khurshid

AU - Alasfoor, Deena

AU - Ali, Raghib

AU - AlMazroa, Mohammad A.

AU - Alomari, Mahmoud A.

AU - Salem Al-Raddadi, Rajaa Mohammad

AU - Alsharif, Ubai

AU - Alsowaidi, Shirina

AU - Altirkawi, Khalid A.

AU - Alvis-Guzman, Nelson

AU - Ammar, Walid

AU - Antonio, Carl Abelardo T.

AU - Asayesh, Hamid

AU - Asghar, Rana Jawad

AU - Atique, Suleman

AU - Awasthi, Ashish

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Barac, Aleksandra

AU - Bedi, Neeraj

AU - Bekele, Tolesa

AU - Bensenor, Isabela M.

AU - Betsu, Balem Demtsu

AU - Bhutta, Zulfiqar

AU - Abdulhak, Aref A.Bin

AU - Butt, Zahid A.

AU - Danawi, Hadi

AU - Dubey, Manisha

AU - Endries, Aman Yesuf

AU - Faghmous, Imad M.D.A.

AU - Farid, Talha

AU - Farvid, Maryam S.

AU - Farzadfar, Farshad

AU - Fereshtehnejad, Seyed Mohammad

AU - Fischer, Florian

AU - Anderson Fitchett, Joseph Robert

AU - Gibney, Katherine B.

AU - Mohamed Ginawi, Ibrahim Abdelmageem

AU - Gishu, Melkamu Dedefo

AU - Gugnani, Harish Chander

AU - Gupta, Rahul

AU - Hailu, Gessessew Bugssa

AU - Hamadeh, Randah Ribhi

AU - Hamidi, Samer

AU - Harb, Hilda L.

AU - Hedayati, Mohammad T.

AU - Hsairi, Mohamed

AU - Husseini, Abdullatif

AU - Jahanmehr, Nader

AU - Javanbakht, Mehdi

AU - Jibat, Tariku

AU - Jonas, Jost B.

AU - Kasaeian, Amir

AU - Khader, Yousef Saleh

AU - Khan, Abdur Rahman

AU - Khan, Ejaz Ahmad

AU - Khan, Gulfaraz

AU - Khoja, Tawfik Ahmed Muthafer

AU - Kinfu, Yohannes

AU - Kissoon, Niranjan

AU - Koyanagi, Ai

AU - Lal, Aparna

AU - Abdul Latif, Asma Abdul

AU - Lunevicius, Raimundas

AU - Abd El Razek, Hassan Magdy

AU - Majeed, Azeem

AU - Malekzadeh, Reza

AU - Mehari, Alem

AU - Mekonnen, Alemayehu B.

AU - Melaku, Yohannes Adama

AU - Memish, Ziad A.

AU - Mendoza, Walter

AU - Misganaw, Awoke

AU - Ibrahim Mohamed, Layla Abdalla

AU - Nachega, Jean B.

AU - Nguyen, Quyen Le

AU - Nisar, Muhammad Imran

AU - Peprah, Emmanuel Kwame

AU - Platts-Mills, James A.

AU - Pourmalek, Farshad

AU - Qorbani, Mostafa

AU - Rafay, Anwar

AU - Rahimi-Movaghar, Vafa

AU - Ur Rahman, Sajjad

AU - Rai, Rajesh Kumar

AU - Rana, Saleem M.

AU - Ranabhat, Chhabi L.

AU - Rao, Sowmya R.

AU - Refaat, Amany H.

AU - Riddle, Mark

AU - Roshandel, Gholamreza

AU - Ruhago, George Mugambage

AU - Saleh, Muhammad Muhammad

AU - Sanabria, Juan R.

AU - Sawhney, Monika

AU - Sepanlou, Sadaf G.

AU - Setegn, Tesfaye

AU - Sliwa, Karen

AU - Sreeramareddy, Chandrashekhar T.

AU - Sykes, Bryan L.

AU - Tavakkoli, Mohammad

AU - Tedla, Bemnet Amare

AU - Terkawi, Abdullah S.

AU - Ukwaja, Kingsley

AU - Uthman, Olalekan A.

AU - Westerman, Ronny

AU - Wubshet, Mamo

AU - Yenesew, Muluken A.

AU - Yonemoto, Naohiro

AU - Younis, Mustafa Z.

AU - Zaidi, Zoubida

AU - El Sayed Zaki, Maysaa

AU - Al Rabeeah, Abdullah A.

AU - Wang, Haidong

AU - Naghavi, Mohsen

AU - Vos, Theo

AU - Lopez, Alan D.

AU - Murray, Christopher J.L.

AU - Mokdad, Ali H.

PY - 2016/12

Y1 - 2016/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85005950002&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85005950002&partnerID=8YFLogxK

U2 - 10.4269/ajtmh.16-0339

DO - 10.4269/ajtmh.16-0339

M3 - Article

C2 - 27928080

AN - SCOPUS:85005950002

VL - 95

SP - 1319

EP - 1329

JO - American Journal of Tropical Medicine and Hygiene

JF - American Journal of Tropical Medicine and Hygiene

SN - 0002-9637

IS - 6

ER -

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

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