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Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2015: Findings From the Global Burden of Disease 2015 Study Publisher Pubmed



Mokdad AH1 ; Khalil I1 ; El Bcheraoui C1 ; Charara R2 ; Moradilakeh M3 ; Afshin A1 ; Kassebaum NJ1, 4 ; Collison M1 ; Chew A1 ; Krohn KJ1 ; Daoud F1 ; Colombara D1 ; Foreman KJ1, 5 ; Godwin WW1 Show All Authors
Authors
  1. Mokdad AH1
  2. Khalil I1
  3. El Bcheraoui C1
  4. Charara R2
  5. Moradilakeh M3
  6. Afshin A1
  7. Kassebaum NJ1, 4
  8. Collison M1
  9. Chew A1
  10. Krohn KJ1
  11. Daoud F1
  12. Colombara D1
  13. Foreman KJ1, 5
  14. Godwin WW1
  15. Kutz M1
  16. Mirarefin M1, 6
  17. Rao PC1
  18. Troeger C1
  19. Wang H1
  20. Niguse Abraha H7
  21. Abuelyazeed R8
  22. Aburaddad LJ9
  23. Ahmad Kiadaliri A10
  24. Ahmadi A11
  25. Beshir Ahmed M12
  26. Alam K13, 14, 15
  27. Alizadehnavaei R16
  28. Alraddadi R17
  29. Altirkawi KA18
  30. Alvisguzman N19
  31. Anber N20
  32. Anwari P21
  33. Mehari Atey T7
  34. Arthur Avokpaho EFG22, 23
  35. Bacha U24
  36. Bazarganhejazi S25, 26
  37. Bedi N27
  38. Bensenor IM28
  39. Berhane A29
  40. Obong Bessong P30
  41. Shunu Beyene A31
  42. Bhutta ZA32, 33
  43. Colin Buckle G34
  44. Butt ZA35
  45. Danawi H36
  46. Deribew A37, 38
  47. Djalalinia S39
  48. Dubey M40
  49. Yesuf Endries A41
  50. Eshrati B42, 43
  51. Fereshtehnejad SM44
  52. Fischer F45
  53. Tewelde Gebrehiwot T46
  54. Chander Gugnani H47
  55. Ribhi Hamadeh R48
  56. Hamidi S49
  57. Husseini A50
  58. James SL51
  59. Jonas JB52
  60. Kasaeian A53, 54
  61. Saleh Khader Y55
  62. Ahmad Khan E56
  63. Khan G57
  64. Khubchandani J58
  65. Kissoon N59, 81
  66. Kopec JA59, 81
  67. Koyanagi A60
  68. Kuate Defo B61, 62
  69. Larson HJ1, 63
  70. Abdul Latif A64
  71. Lunevicius R65, 66
  72. Abd El Razek HM67
  73. Abd El Razek MM68
  74. Majdzadeh R69
  75. Majeed A70
  76. Malekzadeh R71
  77. Memiah P72
  78. Memish ZA73, 74
  79. Mendoza W75
  80. Tadese Mengistu D76
  81. Mohammed S77, 78
  82. Murthy S59, 81
  83. Wanjiku Ngunjiri J79
  84. Akpojene Ogbo F80
  85. Pourmalek F59, 81
  86. Qorbani M82
  87. Radfar A83
  88. Rafay A84, 85
  89. Rahimimovaghar V86
  90. Kumar Rai R87
  91. Ram U40
  92. Laith Rawaf D88, 89, 90
  93. Rawaf S5
  94. Renzaho AMN91
  95. Rezaei S92
  96. Roshandel G71, 93
  97. Safdarian M94
  98. Ali Sahraian M95
  99. Salamati P86
  100. Samy AM96
  101. Ramon Sanabria J97, 98
  102. Sartorius B99, 100
  103. Sepanlou SG71
  104. Ali Shaikh M101
  105. Shigematsu M102, 103
  106. Sobaih BHA18
  107. Sreeramareddy CT104
  108. Sykes BL105
  109. Tehranibanihashemi A106
  110. Temsah MH18
  111. Sulieman Terkawi A107, 108, 109
  112. Yimer Tiruye T110
  113. Topormadry R111, 112
  114. Nnanna Ukwaja K113
  115. Emil Vollset S1, 114, 115
  116. Wakayo T46
  117. Werdecker A116
  118. Shey Wiysonge C117, 118
  119. Workicho A46, 119
  120. Yaghoubi M120
  121. Yaseri M121, 122
  122. Yenesew M123
  123. Yonemoto N124
  124. Younis MZ125
  125. El Sayed Zaki M126
  126. Zodpey S127
  127. Zein B128
  128. Jumaan AO129
  129. Vos T1
  130. Hay SI1, 130
  131. Naghavi M1
  132. Murray CJL1
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  2. 2. American University of Beirut, Beirut, Lebanon
  3. 3. Department of Community Medicine, Preventive Medicine and Public Health Research Center, Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Anesthesiology & Pain Medicine, Seattle Children’s Hospital, Seattle, WA, United States
  5. 5. Imperial College London, London, United Kingdom
  6. 6. Hunger Action Los Angeles, Los Angeles, CA, United States
  7. 7. Mekelle University, Mekelle, Ethiopia
  8. 8. GlaxoSmithKline-Vaccines, Philadelphia, PA, United States
  9. 9. Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Doha, Qatar
  10. 10. Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
  11. 11. Kermanshah University of Medical Sciences, Kermanshah, Iran
  12. 12. College of Health Sciences, Department of Epidemiology, ICT and e-Learning Coordinator, Jimma University, Jimma, Ethiopia
  13. 13. Murdoch Childrens Research Institute, The University of Melbourne, Parkville, VIC, Australia
  14. 14. The University of Melbourne, Melbourne, VIC, Australia
  15. 15. The University of Sydney, Sydney, NSW, Australia
  16. 16. Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  17. 17. Joint Program of Family and Community Medicine, Jeddah, Makkah, Saudi Arabia
  18. 18. King Saud University, Riyadh, Saudi Arabia
  19. 19. Universidad de Cartagena, Cartagena de Indias, Colombia
  20. 20. Mansoura University, Mansoura, Egypt
  21. 21. Kabul, Afghanistan
  22. 22. Institut de Recherche Clinique du Benin (IRCB), Cotonou, Benin
  23. 23. Laboratoire d’Etudes et de Recherche-Action en Sante (LERAS Afrique), Parakou, Benin
  24. 24. School of Health Sciences, University of Management and Technology, Lahore, Pakistan
  25. 25. College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
  26. 26. David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
  27. 27. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
  28. 28. University of SaËœo Paulo, SaËœo Paulo, Brazil
  29. 29. College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
  30. 30. University of Venda, Thohoyandou, South Africa
  31. 31. College of Health and Medical Science, Haramaya University, Harar, Ethiopia
  32. 32. Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  33. 33. Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
  34. 34. University of California, San Francisco, San Francisco, CA, United States
  35. 35. Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  36. 36. Walden University, Minneapolis, MN, United States
  37. 37. Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
  38. 38. KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
  39. 39. Undersecretary for Research & Technology, Ministry of Health & Medical Education, Tehran, Iran
  40. 40. International Institute for Population Sciences, Mumbai, India
  41. 41. Arba Minch University, Arba Minch, Ethiopia
  42. 42. Ministry of Health and Medical Education, Tehran, Iran
  43. 43. Arak University of Medical Sciences, Arak, Iran
  44. 44. Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
  45. 45. School of Public Health, Bielefeld University, Bielefeld, Germany
  46. 46. Jimma University, Jimma, Ethiopia
  47. 47. Departments of Microbiology and Epidemiology & Biostatistics, Saint James School of Medicine, The Quarter, Anguilla
  48. 48. Arabian Gulf University, Manama, Bahrain
  49. 49. Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  50. 50. Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
  51. 51. Denver Health/University of Colorado, Denver, CO, United States
  52. 52. Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls- University Heidelberg, Mannheim, Germany
  53. 53. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  54. 54. Endocrinology and Metabolism Population Sciences Institute, Tehran, Iran
  55. 55. Department of Community Medicine, Public Health and Family Medicine, Jordan University of Science and Technology, Irbid, Jordan
  56. 56. Health Services Academy, Islamabad, Pakistan
  57. 57. Department of Microbiology and Immunology, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
  58. 58. Department of Nutrition and Health Science, Ball State University, Muncie, IN, United States
  59. 59. University of British Columbia, Vancouver, BC, Canada
  60. 60. Research and Development Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain
  61. 61. Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
  62. 62. Department of Demography and Public Health Research Institute, University of Montreal, Montreal, Canada
  63. 63. Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
  64. 64. Department of Zoology, Lahore College for Women University, Lahore, Pakistan
  65. 65. Aintree University Hospital National Health Service Foundation Trust, Liverpool, United Kingdom
  66. 66. School of Medicine, University of Liverpool, Liverpool, United Kingdom
  67. 67. Mansoura Faculty of Medicine, Mansoura, Egypt
  68. 68. Aswan University Hospital, Aswan Faculty of Medicine, Aswan, Egypt
  69. 69. Knowledge Utilization Research Center and Community Based Participatory Research Center, Tehran University of Medical Sciences, Tehran, Iran
  70. 70. Department of Primary Care & Public Health, Imperial College London, London, United Kingdom
  71. 71. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  72. 72. University of West Florida, Pensacola, FL, United States
  73. 73. Saudi Ministry of Health, Riyadh, Saudi Arabia
  74. 74. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  75. 75. United Nations Population Fund, Lima, Peru
  76. 76. College of Health Sciences, Mekelle University, Mekelle, Ethiopia
  77. 77. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  78. 78. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  79. 79. University of Nairobi, Nairobi, Kenya
  80. 80. Centre for Health Research, Western Sydney University, Sydney, NSW, Australia
  81. 81. University of British Columbia, Vancouver, BC, Canada
  82. 82. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  83. 83. A T Still University, Kirksville, MO, United States
  84. 84. Contech International Health Consultants, Lahore, Pakistan
  85. 85. Contech School of Public Health, Lahore, Pakistan
  86. 86. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  87. 87. Society for Health and Demographic Surveillance, Suri, India
  88. 88. WHO Collaborating Centre, Imperial College London, London, United Kingdom
  89. 89. North Hampshire Hospitals, Basingstroke, United Kingdom
  90. 90. University College London Hospitals, London, United Kingdom
  91. 91. Western Sydney University, Penrith, NSW, Australia
  92. 92. School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  93. 93. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  94. 94. Sina Trauma & Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  95. 95. MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  96. 96. Ain Shams University, Cairo, Egypt
  97. 97. J Edwards School of Medicine, Marshall Univeristy, Huntington, WV, United States
  98. 98. Case Western Reserve University, Cleveland, OH, United States
  99. 99. Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
  100. 100. UKZN Gastrointestinal Cancer Research Centre, South African Medical Research Council (SAMRC), Durban, South Africa
  101. 101. Independent Consultant, Karachi, Pakistan
  102. 102. National Institute of Infectious Diseases, Tokyo, Japan
  103. 103. Sandia National Laboratories, Albuquerque, NM, United States
  104. 104. Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
  105. 105. Departments of Criminology, Law & Society, Sociology, and Public Health, University of California, Irvine, Irvine, CA, United States
  106. 106. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  107. 107. Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States
  108. 108. Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
  109. 109. Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, United States
  110. 110. Debre Markos University, Debre Markos, Ethiopia
  111. 111. Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  112. 112. Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
  113. 113. Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
  114. 114. Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
  115. 115. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  116. 116. Competence Center Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
  117. 117. South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa
  118. 118. Stellenbosch University, Cape Town, South Africa
  119. 119. Ghent University, Ghent, Belgium
  120. 120. School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
  121. 121. Tehran University of Medical Sciences, Terhan, Iran
  122. 122. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  123. 123. Bahir Dar University, Bahir Dar, Ethiopia
  124. 124. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  125. 125. Jackson State University, Jackson, MS, United States
  126. 126. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  127. 127. Public Health Foundation of India, Gurgaon, India
  128. 128. Neuroscience Department, Georgetown University, Washington, DC, United States
  129. 129. Independent Consultant, Seattle, WA, United States
  130. 130. Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom

Source: International Journal of Public Health Published:2018


Abstract

Objectives: Diarrheal diseases (DD) are an important cause of disease burden, especially in children in low-income settings. DD can also impact children’s potential livelihood through growth faltering, cognitive impairment, and other sequelae. Methods: As part of the Global Burden of Disease study, we estimated DD burden, and the burden attributable to specific risk factors and etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2015. We calculated disability-adjusted life-years (DALYs)—the sum of years of life lost and years lived with disability—for both sexes and all ages. Results: We estimate that over 103,692 diarrhea deaths occurred in the EMR in 2015 (95% uncertainty interval: 87,018–124,692), and the mortality rate was 16.0 deaths per 100,000 persons (95% UI: 13.4–19.2). The majority of these deaths occurred in children under 5 (63.3%) (65,670 deaths, 95% UI: 53,640–79,486). DALYs per 100,000 ranged from 304 (95% UI 228–400) in Kuwait to 38,900 (95% UI 25,900–54,300) in Somalia. Conclusions: Our findings will guide evidence-based health policy decisions for interventions to achieve the ultimate goal of reducing the DD burden. © 2017, The Author(s).