The magnitude of the global problem of diarrhoeal disease: a ten-year update.
In order to update global estimates of diarrhoeal morbidity and mortality in developing countries, we carried out a review of articles published from 1980 to the present and calculated median estimates for the incidence of diarrhoea and diarrhoeal mortality among under-5-year-olds. The incidence of diarrhoea obtained (2.6 episodes per child per year) was virtually the same as that estimated by Snyder & Merson in 1982, while the global mortality estimate was lower (3.3 million deaths per year; range, 1.5-5.1 million). The mortality estimate is based on a small number of active surveillance and prospective studies, and thus associated with a large degree of uncertainty, reflecting the weakness of the global database. However, many surveys reporting reductions in mortality in several locations are consistent with a decreased estimate for mortality. More accurate execution of WHO survey methods, including population-based sampling in representative locations, and repeat surveys every 5 years, are needed to monitor the progress of diarrhoeal disease control programmes and trends in diarrhoeal morbidity and mortality over time.
Bern
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Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, GA 30333.
Martines
J
J
de Zoysa
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Glass
R I
RI
D002675:Child, Preschool; D003906:Developing Countries; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D004812:Epidemiologic Methods; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D012494:Sampling Studies