Chronic Health Consequences of Acute Enteric Infections in the Developing World

摘要

The long-term health burden of acute enteric infections has not been well quantified. We assessed the 2013 global burden of diarrheal disease (DD) among children under 5 and explored current limitations in estimating diarrhea-associated morbidity. We modeled diarrheal morbidity using incidence and prevalence data from systematic reviews and representative surveys and diarrheal mortality using vital registration data and representative verbal autopsy surveys. We also modeled the DD burden due to specific enteric pathogens. For both sexes, diarrhea-associated years lived with disability (YLD) per 100,000 were 51 (95% uncertainty interval (Ul): 35-72) and 685 (95% Ul: 467-946) in developed and developing regions, respectively. The highest male YLD rates were in Togo (1,251, 95% Ul: 813-1,771) and the highest female YLD rates were in Niger (1,156, 95% Ul: 723-1,690). The diarrhea death rate per 100,000 was 1 (95% Ul: 1-1) in developed countries and 89 (95% Ul: 75-101) in developing countries. Among assessed etiologies, rotavirus contributed the largest proportion of YLDs (15.15%, 95% Ul: 13,44-16.49%). The global burden of DD remains sizeable, with renewed efforts needed to address both diarrhea mortality and morbidity. Additional studies of diarrhea sequelae are needed to comprehensively quantify the YLDs attributable to diarrhea.