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Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013: Findings From the Global Burden of Disease Study 2013 Publisher Pubmed



Khalil I1 ; Colombara DV1 ; Forouzanfar MH1 ; Troeger C1 ; Daoud F1 ; Moradilakeh M1, 2 ; El Bcheraoui C1 ; Rao PC1 ; Afshin A1 ; Charara R1 ; Abate KH3 ; Abd El Razek MM4 ; Abdallah F5 ; Abuelyazeed R6 Show All Authors
Authors
  1. Khalil I1
  2. Colombara DV1
  3. Forouzanfar MH1
  4. Troeger C1
  5. Daoud F1
  6. Moradilakeh M1, 2
  7. El Bcheraoui C1
  8. Rao PC1
  9. Afshin A1
  10. Charara R1
  11. Abate KH3
  12. Abd El Razek MM4
  13. Abdallah F5
  14. Abuelyazeed R6
  15. Kiadaliri AA7, 8
  16. Akanda AS9
  17. Akseer N10, 11
  18. Alam K12, 13, 14
  19. Alasfoor D15
  20. Ali R16
  21. Almazroa MA17
  22. Alomari MA18
  23. Salem Alraddadi RM19
  24. Alsharif U20
  25. Alsowaidi S21
  26. Altirkawi KA22
  27. Alvisguzman N23
  28. Ammar W24
  29. Antonio CAT25
  30. Asayesh H26
  31. Asghar RJ27
  32. Atique S28
  33. Awasthi A29
  34. Bacha U30
  35. Badawi A31
  36. Barac A32
  37. Bedi N33
  38. Bekele T34
  39. Bensenor IM35
  40. Betsu BD36
  41. Bhutta Z10, 37
  42. Abdulhak AAB38
  43. Butt ZA39
  44. Danawi H40
  45. Dubey M41
  46. Endries AY42
  47. Faghmous IMDA43
  48. Farid T44, 45
  49. Farvid MS44, 46
  50. Farzadfar F47
  51. Fereshtehnejad SM48
  52. Fischer F49
  53. Anderson Fitchett JR50
  54. Gibney KB51, 52
  55. Mohamed Ginawi IA53
  56. Gishu MD54, 55
  57. Gugnani HC56, 57
  58. Gupta R58
  59. Hailu GB36, 59
  60. Hamadeh RR60
  61. Hamidi S61
  62. Harb HL24
  63. Hedayati MT62
  64. Hsairi M63
  65. Husseini A64
  66. Jahanmehr N65
  67. Javanbakht M66
  68. Jibat T67, 68
  69. Jonas JB69
  70. Kasaeian A47, 70
  71. Khader YS71
  72. Khan AR44
  73. Khan EA72
  74. Khan G73
  75. Khoja TAM74
  76. Kinfu Y75
  77. Kissoon N76
  78. Koyanagi A77
  79. Lal A78
  80. Abdul Latif AA79
  81. Lunevicius R80, 81
  82. Abd El Razek HM82
  83. Majeed A83
  84. Malekzadeh R84
  85. Mehari A85
  86. Mekonnen AB14, 86
  87. Melaku YA87, 88
  88. Memish ZA89, 90
  89. Mendoza W91
  90. Misganaw A1
  91. Ibrahim Mohamed LA92
  92. Nachega JB93, 94
  93. Nguyen QL95
  94. Nisar MI96
  95. Peprah EK97
  96. Plattsmills JA98
  97. Pourmalek F76
  98. Qorbani M99
  99. Rafay A100, 101
  100. Rahimimovaghar V102
  101. Ur Rahman S103
  102. Rai RK104
  103. Rana SM100, 101
  104. Ranabhat CL105, 106
  105. Rao SR107
  106. Refaat AH40, 108
  107. Riddle M109
  108. Roshandel G84, 110
  109. Ruhago GM111
  110. Saleh MM112
  111. Sanabria JR113, 114
  112. Sawhney M115
  113. Sepanlou SG84
  114. Setegn T116
  115. Sliwa K117
  116. Sreeramareddy CT118
  117. Sykes BL119
  118. Tavakkoli M120
  119. Tedla BA86, 121
  120. Terkawi AS122, 123, 124
  121. Ukwaja K125
  122. Uthman OA126
  123. Westerman R127, 128
  124. Wubshet M86, 129
  125. Yenesew MA116
  126. Yonemoto N130
  127. Younis MZ131
  128. Zaidi Z132
  129. El Sayed Zaki M133
  130. Al Rabeeah AA17
  131. Wang H1
  132. Naghavi M1
  133. Vos T1
  134. Lopez AD1, 134
  135. Murray CJL1
  136. Mokdad AH1
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Seattle, 98121, WA, United States
  2. 2. Department of Community Medicine, Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Jimma University, Jimma, Ethiopia
  4. 4. Aswan Faculty of Medicine, Aswan, Egypt
  5. 5. Department of Neurology, Cairo University, Cairo, Egypt
  6. 6. GlaxoSmithKline, Philadelphia, PA, United States
  7. 7. Clinical Epidemiology Unit Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
  8. 8. Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  9. 9. University of Rhode Island, Kingston, RI, United States
  10. 10. Hospital for Sick Children, Toronto, Canada
  11. 11. University of Toronto, Toronto, Canada
  12. 12. Murdoch Children's Research Institute, Melbourne, Australia
  13. 13. University of Melbourne, Melbourne, Australia
  14. 14. University of Sydney, Sydney, Australia
  15. 15. Ministry of Health, Al Khuwair, Oman
  16. 16. University of Oxford, Oxford, United Kingdom
  17. 17. Kingdom of Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
  18. 18. Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
  19. 19. Ministry of Health, Jeddah, Saudi Arabia
  20. 20. Charite Universitatsmedizin, Berlin, Germany
  21. 21. Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
  22. 22. King Saud University, Riyadh, Saudi Arabia
  23. 23. Universidad de Cartagena, Cartagena de Indias, Colombia
  24. 24. Ministry of Public Health, Beirut, Lebanon
  25. 25. Department of Health Policy and Administration, College of Public Health, University of the Philippines, Manila, Philippines
  26. 26. Department of Medical Emergency, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
  27. 27. South Asian Public Health Forum, Islamabad, Pakistan
  28. 28. Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
  29. 29. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  30. 30. School of Health Sciences, University of Management and Technology, Lahore, Pakistan
  31. 31. Public Health Agency of Canada, Toronto, Canada
  32. 32. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  33. 33. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
  34. 34. Madawalabu University, Bale Goba, Ethiopia
  35. 35. University of Sao Paulo, Sao Paulo, Brazil
  36. 36. Mekelle University, Mekelle, Ethiopia
  37. 37. Medical Center, Aga Khan University, Karachi, Pakistan
  38. 38. University of Iowa Hospitals and Clinics, Iowa City, IA, United States
  39. 39. Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  40. 40. Walden University, Minneapolis, MI, United States
  41. 41. International Institute for Population Sciences, Mumbai, India
  42. 42. Arba Minch University, Arba Minch, Ethiopia
  43. 43. London School of Hygiene and Tropical Medicine, London, United Kingdom
  44. 44. University of Louisville, Louisville, KT, United States
  45. 45. Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  46. 46. Institute for Health Policy, Boston, MA, United States
  47. 47. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  48. 48. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
  49. 49. Bielefeld University, Bielefeld, Germany
  50. 50. Harvard University, Boston, MA, United States
  51. 51. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  52. 52. Melbourne Health, Parkville, Australia
  53. 53. College of Medicine, University of Hail, Hail, Saudi Arabia
  54. 54. Haramaya University, Dire Dawa, Ethiopia
  55. 55. Kersa Health and Demographic Surveillance System, Harar, Ethiopia
  56. 56. Department of Microbiology, Saint James School of Medicine, Anguilla
  57. 57. Department of Epidemiology and Biostatistics, Saint James School of Medicine, Anguilla
  58. 58. West Virginia Bureau for Public Health, Charleston, WV, United States
  59. 59. Kilte Awlaelo Health and Demographic Surveillance System, Ethiopia
  60. 60. Arabian Gulf University, Manama, Bahrain
  61. 61. Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  62. 62. Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  63. 63. Department of Epidemiology, Salah Azaiz Institute, Tunis, Tunisia
  64. 64. Qatar University, Doha, Qatar
  65. 65. Department of Public Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  66. 66. University of Aberdeen, Aberdeen, United Kingdom
  67. 67. Addis Ababa University, Debre Zeit, Ethiopia
  68. 68. Wageningen University, Wageningen, Netherlands
  69. 69. Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
  70. 70. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  71. 71. Jordan University of Science and Technology, Irbid, Jordan
  72. 72. Health Services Academy, Islamabad, Pakistan
  73. 73. Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
  74. 74. Executive Board of the Health Ministers' Council for Cooperation Council States, Riyadh, Saudi Arabia
  75. 75. Centre for Research and Action in Public Health, Faculty of Health, University of Canberra, Canberra, Australia
  76. 76. University of British Columbia, Vancouver, Canada
  77. 77. Research and Development Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain
  78. 78. Australian National University, Canberra, Australia
  79. 79. Department of Zoology, Lahore College for Women University, Lahore, Pakistan
  80. 80. Aintree University Hospital, National Health Service Foundation Trust, Liverpool, United Kingdom
  81. 81. School of Medicine, University of Liverpool, Liverpool, United Kingdom
  82. 82. Mansoura Faculty of Medicine, Mansoura, Egypt
  83. 83. Imperial College London, London, United Kingdom
  84. 84. Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  85. 85. Howard University College of Medicine, Washington, DC, United States
  86. 86. University of Gondar, Gondar, Ethiopia
  87. 87. School of Public Health, Mekelle University, Mekelle, Ethiopia
  88. 88. School of Medicine, University of Adelaide, Adelaide, Australia
  89. 89. Saudi Ministry of Health, Riyadh, Saudi Arabia
  90. 90. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  91. 91. United Nations Population Fund, Lima, Peru
  92. 92. Federal Ministry of Health, Khartoum, Sudan
  93. 93. University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
  94. 94. Stellenbosch University, Cape Town, Western Cape, South Africa
  95. 95. Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
  96. 96. Aga Khan University, Karachi, Pakistan
  97. 97. National Heart, Lung, and Blood Institute, Bethesda, MD, United States
  98. 98. University of Virginia, Charlottesville, VA, United States
  99. 99. Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
  100. 100. Contech International Health Consultants, Lahore, Pakistan
  101. 101. Contech School of Public Health, Lahore, Pakistan
  102. 102. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  103. 103. Hamad Medical Corporation, Doha, Qatar
  104. 104. Society for Health and Demographic Surveillance, Suri, India
  105. 105. Wonju College of Medicine, Yonsei University, Wonju, South Korea
  106. 106. Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea
  107. 107. Department of Surgery, School of Medicine, Boston University, Boston, MA, United States
  108. 108. Suez Canal University, Ismailia, Egypt
  109. 109. Naval Medical Research Center, Silver Spring, MD, United States
  110. 110. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  111. 111. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  112. 112. Development Research and Projects Center, Abuja, Nigeria
  113. 113. Department of Surgery and Comprehensive Cancer Center, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
  114. 114. Case Western Reserve University, Cleveland, OH, United States
  115. 115. Marshall University, Huntington, WV, United States
  116. 116. Bahir Dar University, Bahir Dar, Ethiopia
  117. 117. Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa
  118. 118. Department of Community Medicine, International Medical University, Kuala Lumpur, Malaysia
  119. 119. Departments of Criminology, Law and Society, Sociology, and Public Health, University of California-Irvine, Irvine, CA, United States
  120. 120. Westchester Medical Center, Valhalla, NY, United States
  121. 121. James Cook University, Cairns, Australia
  122. 122. Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States
  123. 123. Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, United States
  124. 124. Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
  125. 125. Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
  126. 126. Warwick Medical School, University of Warwick, Coventry, United Kingdom
  127. 127. Federal Institute for Population Research, Wiesbaden, Germany
  128. 128. German National Cohort Consortium, Heidelberg, Germany
  129. 129. Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
  130. 130. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  131. 131. Jackson State University, Jackson, MI, United States
  132. 132. University Hospital, Setif, Algeria
  133. 133. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  134. 134. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

Source: American Journal of Tropical Medicine and Hygiene Published:2016


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. Copyright © 2016 by The American Society of Tropical Medicine and Hygiene.
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