The magnitude of the global problem of acute diarrhoeal disease: A review of active surveillance data

Data from 24 published studies were analysed in order to estimate the annual morbidity and mortality from acute diarrhoeal disease in the developing world. Twenty-two of the studies involved frequent surveillance through home visits to families in communities; the other two were multi-country studies in which diarrhoea mortality was calculated on the basis of death certificate information. Morbidity rates were found to be highest in the 6-11 month age group, while the mortality rates were greatest in infants under 1 year of age and children 1 year old. For children under 5 years old, the median incidence of diarrhoea was 2.2 episodes per child per year for all studies and 3.0 episodes per child per year for the studies that had the smallest populations and most frequent surveillance. Using 1980 population estimates, the estimated total yearly morbidity and mortality from diarrhoeal disease for children under 5 years of age in Africa, Asia (excluding China), and Latin America were 744-1000 million episodes and 4.6 million deaths.