Khalil Ibrahim, Colombara Danny V, Forouzanfar Mohammad Hossein, Troeger Christopher, Daoud Farah, Moradi-Lakeh Maziar, Bcheraoui Charbel El, Rao Puja C, Afshin Ashkan, Charara Raghid, Abate Kalkidan Hassen, Razek Mohammed Magdy Abd El, Abd-Allah Foad, Abu-Elyazeed Remon, Kiadaliri Aliasghar Ahmad, Akanda Ali Shafqat, Akseer Nadia, Alam Khurshid, Alasfoor Deena, Ali Raghib, AlMazroa Mohammad A, Alomari Mahmoud A, Al-Raddadi Rajaa Mohammad Salem, Alsharif Ubai, Alsowaidi Shirina, Altirkawi Khalid A, Alvis-Guzman Nelson, Ammar Walid, Antonio Carl Abelardo T, Asayesh Hamid, Asghar Rana Jawad, Atique Suleman, Awasthi Ashish, Bacha Umar, Badawi Alaa, Barac Aleksandra, Bedi Neeraj, Bekele Tolesa, Bensenor Isabela M, Betsu Balem Demtsu, Bhutta Zulfiqar, Abdulhak Aref A Bin, Butt Zahid A, Danawi Hadi, Dubey Manisha, Endries Aman Yesuf, Faghmous Imad D A, Farid Talha, Farvid Maryam S, Farzadfar Farshad, Fereshtehnejad Seyed-Mohammad, Fischer Florian, Fitchett Joseph Robert Anderson, Gibney Katherine B, Ginawi Ibrahim Abdelmageem Mohamed, Gishu Melkamu Dedefo, Gugnani Harish Chander, Gupta Rahul, Hailu Gessessew Bugssa, Hamadeh Randah Ribhi, Hamidi Samer, Harb Hilda L, Hedayati Mohammad T, Hsairi Mohamed, Husseini Abdullatif, Jahanmehr Nader, Javanbakht Mehdi, Jibat Tariku, Jonas Jost B, Kasaeian Amir, Khader Yousef Saleh, Khan Abdur Rahman, Khan Ejaz Ahmad, Khan Gulfaraz, Khoja Tawfik Ahmed Muthafer, Kinfu Yohannes, Kissoon Niranjan, Koyanagi Ai, Lal Aparna, Latif Asma Abdul Abdul, Lunevicius Raimundas, Razek Hassan Magdy Abd El, Majeed Azeem, Malekzadeh Reza, Mehari Alem, Mekonnen Alemayehu B, Melaku Yohannes Adama, Memish Ziad A, Mendoza Walter, Misganaw Awoke, Mohamed Layla Abdalla Ibrahim, Nachega Jean B, Nguyen Quyen Le, Nisar Muhammad Imran, Peprah Emmanuel Kwame, Platts-Mills James A, Pourmalek Farshad, Qorbani Mostafa, Rafay Anwar, Rahimi-Movaghar Vafa, Rahman Sajjad Ur, Rai Rajesh Kumar, Rana Saleem M, Ranabhat Chhabi L, Rao Sowmya R, Refaat Amany H, Riddle Mark, Roshandel Gholamreza, Ruhago George Mugambage, Saleh Muhammad Muhammad, Sanabria Juan R, Sawhney Monika, Sepanlou Sadaf G, Setegn Tesfaye, Sliwa Karen, Sreeramareddy Chandrashekhar T, Sykes Bryan L, Tavakkoli Mohammad, Tedla Bemnet Amare, Terkawi Abdullah S, Ukwaja Kingsley, Uthman Olalekan A, Westerman Ronny, Wubshet Mamo, Yenesew Muluken A, Yonemoto Naohiro, Younis Mustafa Z, Zaidi Zoubida, Zaki Maysaa El Sayed, Rabeeah Abdullah A Al, Wang Haidong, Naghavi Mohsen, Vos Theo, Lopez Alan D, Murray Christopher J L, Mokdad Ali H
Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.
Department of Community Medicine, Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.
Am J Trop Med Hyg. 2016 Dec 7;95(6):1319-1329. doi: 10.4269/ajtmh.16-0339. Epub 2016 Oct 10.
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.
腹泻病是造成疾病负担、死亡和残疾的主要原因，在低收入环境中的儿童中尤为如此。腹泻病还会通过身体发育迟缓、认知障碍和其他后遗症影响儿童未来的生计。作为全球疾病负担研究的一部分，我们估算了1990年至2013年期间东地中海区域腹泻病的负担，以及特定风险因素和具体病因所致的负担。对于所有性别和年龄段，我们计算了伤残调整生命年（DALYs），即生命损失年数与残疾生存年数之和。我们估计，2013年东地中海区域超过12.5万人死亡（占总死亡人数的3.6%）是由腹泻病所致，低收入和中等收入国家的腹泻病负担更重。每10万名5岁以下儿童的腹泻病死亡人数在巴林和阿曼为1例（95%不确定区间[UI]=0-1），在索马里为471例（95% UI=245-763）。5岁以下儿童腹泻病伤残调整生命年的模式与腹泻病死亡模式密切相关。每10万人的伤残调整生命年数在叙利亚为739（95% UI=520-989），在索马里为40869（95% UI=21540-65823）。我们的结果凸显了东地中海区域腹泻病负担极不均衡，主要原因是缺乏诸如水和卫生设施等适当资源。我们的研究结果将为基于证据并遵循减轻腹泻病负担这一最终目标的预防和治疗干预措施提供指导。
