The magnitude of the global problem of diarrhoeal disease: a ten-year update.

TLDR

The study aims to update global estimates of diarrhoeal morbidity and mortality among under‑5 children in developing countries by reviewing literature from 1980 onward and calculating median incidence and mortality estimates. They reviewed articles from 1980 onward, calculated median incidence and mortality estimates, and suggested improved WHO survey methods with population‑based sampling and five‑year repeat surveys. Incidence remained at 2.6 episodes per child per year, while global mortality was estimated at 3.3 million deaths per year (range 1.5–5.1 million), a lower figure than earlier estimates but with large uncertainty, though several surveys indicate declining mortality.

Abstract

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.