Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved
Tool Analysis
Background:
Diarrhea remains a leading cause of mortality among young children in low- and
middle-income countries. Although the evidence for individual diarrhea prevention
and treatment interventions is solid, the effect a comprehensive scale-up effort
would have on diarrhea mortality has not been estimated.
Methods and Findings:
We use the Lives Saved Tool (LiST) to estimate the potential
lives saved if two scale-up scenarios for key diarrhea interventions (oral
rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus
vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and
breastfeeding) were implemented in the 68 high child mortality countries. We also
conduct a simple costing exercise to estimate cost per capita and total costs for
each scale-up scenario. Under the ambitious (feasible improvement in coverage of
all interventions) and universal (assumes near 100% coverage of all
interventions) scale-up scenarios, we demonstrate that diarrhea mortality can be
reduced by 78% and 92%, respectively. With universal coverage nearly
5 million diarrheal deaths could be averted during the 5-year scale-up period for
an additional cost of US$12.5 billion invested across 68 priority countries
for individual-level prevention and treatment interventions, and an additional
US$84.8 billion would be required for the addition of all water and
sanitation interventions.
Conclusion:
Using currently available interventions, we demonstrate that with improved
coverage, diarrheal deaths can be drastically reduced. If delivery strategy
bottlenecks can be overcome and the international community can collectively
deliver on the key strategies outlined in these scenarios, we will be one step
closer to achieving success for the United Nations' Millennium Development
Goal 4 (MDG4) by 2015.
:
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved
Tool Analysis. PLoS Med 8(3): e32767. doi:10.1371/journal.pmed.1000428
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1000428
Souhrn
Background:
Diarrhea remains a leading cause of mortality among young children in low- and
middle-income countries. Although the evidence for individual diarrhea prevention
and treatment interventions is solid, the effect a comprehensive scale-up effort
would have on diarrhea mortality has not been estimated.
Methods and Findings:
We use the Lives Saved Tool (LiST) to estimate the potential
lives saved if two scale-up scenarios for key diarrhea interventions (oral
rehydration salts [ORS], zinc, antibiotics for dysentery, rotavirus
vaccine, vitamin A supplementation, basic water, sanitation, hygiene, and
breastfeeding) were implemented in the 68 high child mortality countries. We also
conduct a simple costing exercise to estimate cost per capita and total costs for
each scale-up scenario. Under the ambitious (feasible improvement in coverage of
all interventions) and universal (assumes near 100% coverage of all
interventions) scale-up scenarios, we demonstrate that diarrhea mortality can be
reduced by 78% and 92%, respectively. With universal coverage nearly
5 million diarrheal deaths could be averted during the 5-year scale-up period for
an additional cost of US$12.5 billion invested across 68 priority countries
for individual-level prevention and treatment interventions, and an additional
US$84.8 billion would be required for the addition of all water and
sanitation interventions.
Conclusion:
Using currently available interventions, we demonstrate that with improved
coverage, diarrheal deaths can be drastically reduced. If delivery strategy
bottlenecks can be overcome and the international community can collectively
deliver on the key strategies outlined in these scenarios, we will be one step
closer to achieving success for the United Nations' Millennium Development
Goal 4 (MDG4) by 2015.
:
Please see later in the article for the Editors' Summary
Zdroje
1. Black
RE
Cousens
S
Johnson
HL
Lawn
JE
Rudan
I
2010
Global, regional, and national causes of child mortality in 2008: a
systematic analysis.
Lancet
375
1969
1987
2. Snyder
JD
Merson
MH
1982
The magnitude of the global problem of acute diarrhoeal disease: a
review of active surveillance data.
Bull World Health Organ
60
605
613
3. UNICEFWHO
2009
Diarrhoea: why children are still dying and what can be
done.
Geneva
WHO
4. Stover
J
McKinnon
R
Winfrey
B
2010
Spectrum: a model platform for linking of maternal and child survival
interventions with AIDS, family planning and demographic
projections.
Int J Epi
39
i7
i10
5. UNICEF
2008
Tracking progress in maternal, newborn and child
survival.
New York
UNICEF
6. Walker
N
Fischer Walker
CL
Bryce
JL
Bahl
R
Cousens
S
2010
Standards for CHERG Reviews of Intervention Effects on Child
Survival.
Int J Epi
39
i21
i31
7. Cairncross
S
Hunt
C
Boisson
S
Bostoen
K
Curtis
V
2010
Water, sanitation, and hygiene for the prevention of
diarrhoea.
Int J Epi
39
i193
i205
8. Fischer Walker
CL
Black
RE
2010
Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity,
mortality and incidence of future episodes.
Int J Epi
39
i63
i69
9. Munos
MK
Fischer Walker
CL
Black
RE
2010
The effect of oral rehydration solution and recommended home fluids on
diarrhoea mortality.
Int J Epi
39
i75
i87
10. Munos
MK
Fischer Walker
CL
Black
RE
2010
The effect of rotavirus vaccine on diarrhoea
mortality.
Int J Epi
39
i56
i62
11. Traa
BS
Fischer Walker
CL
Munos
M
Black
RE
2010
Antibiotics for the treatment of dysentery in
children.
Int J Epi
39
i70
i74
12. Bhutta
ZA
Ahmed
T
Black
RE
Cousens
S
Dewey
K
2008
What works? Interventions for maternal and child undernutrition
and survival.
Lancet
371
417
440
13. Black
RE
Allen
LH
Bhutta
ZA
Caulfield
LE
de Onis
M
2008
Maternal and child undernutrition: global and regional exposures and
health consequences.
Lancet
371
243
460
14. Friberg
IK
Bhutta
ZA
Darmstadt
GL
Bang
A
Cousens
S
2010
Neonatal: comparing modelled predictions of neonatal mortality impacts
using LiST with observed results of community-based intervention trials in South
Asia.
Int J Epi
39
i11
i20
15. Hazel
E
Gilroy
K
Friberg
I
Black
RE
Bryce
J
2010
ACSD: Comparing the modeled to the measured mortality reduction:
applying the Lives Saved Tool to evaluate data from the Accelerated Child Survival
Project in West Africa.
Int J Epi
30
i32
i39
16. Bryce
J
Boschi‐Pinto
C
Shibuya
K
2005
WHO estimates of the causes of death in children.
Lancet
365
1147
1152
17. Interagency Group for Child Mortality Estimation
2009
Child mortality estimation.
Available: http://www.childmortality.org/cmeMain.html. Accessed 31 December
2009
18. World Health Organization
2010
Progress on sanitation and drinking water: 2010
update.
Geneva
WHO
19. WHO
2010
WHO/UNICEF estimates of national immunization
coverage.
Available: http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html.
Accessed 19 March 2010
20. Waddington
H
Snilstveit
B
White
H
Fewtrell
L
2009
Water, sanitation, and hygiene interventions to combat childhood
diarrhoea in developing countries in International Initiative for Impact
Evaluation. 3rd edition.
London
Intiative for Impact Evaluation
21. UNICEF
2010
Supply catalogue.
Available: http://www.supply.unicef.dk/catalogue/. Accessed 1 September
2010
22. WHO
2010
Tables of costs and prices used in WHO-CHOICE
analysis.
Available: http://www.who.int/choice/costs/en/. Accessed 1 September
2010
23. Boerma
JT
Bryce
J
Kinfu
Y
Axelson
H
Victora
CG
2008
Mind the gap: equity and trends in coverage of maternal, newborn, and
child health services in 54 Countdown countries.
Lancet
371
1259
1267
24. Johns
B
Baltussen
R
2004
Accounting for the cost of scaling-up health
interventions.
Health Econ
13
1117
1124
25. Johns
B
Torres
TT
2005
Costs of scaling up health interventions: a systematic
review.
Health Policy Plan
20
1
13
26. Guinness
L
Kumaranayake
L
Hanson
K
2007
A cost function for HIV prevention services: is there a
‘u’ - shape?
Cost Eff Resour Alloc
5
13
27. Santosham
M
Chandran
A
Fitzwater
S
Fischer-Walker
C
Baqui
AH
Black
R
2010
Progress and barriers for the control of diarrhoeal
disease.
Lancet
376
63
67
28. Victora
CG
Bryce
J
Fontaine
O
Monasch
R
2000
Reducing deaths from diarrhoea through oral rehydration
therapy.
Bull World Health Organ
78
1246
1255
29. Baqui
AH
Black
RE
Arifeen
SE
Yunus
M
Chakraborty
J
2002
Effect of zinc supplementation started during diarrhoea on morbidity
and mortality in Bangladeshi children: community randomised trial.
BMJ
325
1059
30. Bhandari
N
Mazumder
S
Taneja
S
Dube
B
Agarwal
RC
2008
Effectiveness of zinc supplementation plus oral rehydration salts
compared with oral rehydration salts alone as a treatment for acute diarrhea in a
primary care setting: a cluster randomized trial.
Pediatrics
121
1279
1285
31. Curtis
VA
Danquah
LO
Aunger
RV
2009
Planned, motivated and habitual hygiene behaviour: an eleven country
review.
Health Education Review
24
655
673
32. WHO
WHO/UNICEF estimates of national immunization
coverage.
Available: http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html.
Accessed 19 March 2010
Štítky
Interné lekárstvoČlánok vyšiel v časopise
PLOS Medicine
2011 Číslo 3
- Statiny indukovaná myopatie: Jak na diferenciální diagnostiku?
- MUDr. Dana Vondráčková: Hepatopatie sú pri liečbe metamizolom väčším strašiakom ako agranulocytóza
- Vztah mezi statiny a rizikem vzniku nádorových onemocnění − metaanalýza
- Nech brouka žít… Ať žije astma!
- Parazitičtí červi v terapii Crohnovy choroby a dalších zánětlivých autoimunitních onemocnění
Najčítanejšie v tomto čísle
- The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices
- How Can Institutional Review Boards Best Interpret Preclinical Data?
- The Challenge of Discharging Research Ethics Duties in Resource-Constrained Settings
- HIV-1 Drug Resistance Emergence among Breastfeeding Infants Born to HIV-Infected Mothers during a Single-Arm Trial of Triple-Antiretroviral Prophylaxis for Prevention of Mother-To-Child Transmission: A Secondary Analysis