Global disability-adjusted life-year estimates of long-term health burden and undernutrition attributable to diarrhoeal diseases in children younger than 5 years
Open accessAbstract
BACKGROUND: Diarrhoea is a leading cause of death and illness globally among children younger than 5 years. Mortality and short-term morbidity cause substantial burden of disease but probably underestimate the true effect of diarrhoea on population health. This underestimation is because diarrhoeal diseases can negatively affect early childhood growth, probably through enteric dysfunction and impaired uptake of macronutrients and micronutrients. We attempt to quantify the long-term sequelae associated with childhood growth impairment due to diarrhoea. METHODS: We used the Global Burden of Diseases, Injuries, and Risk Factors Study framework and leveraged existing estimates of diarrhoea incidence, childhood undernutrition, and infectious disease burden to estimate the effect of diarrhoeal diseases on physical growth, including weight and height, and subsequent disease among children younger than 5 years. The burden of diarrhoea was measured in disability-adjusted life-years (DALYs), a composite metric of mortality and morbidity. We hypothesised that diarrhoea is negatively associated with three common markers of growth: weight-for-age, weight-for-height, and height-for-age Z-scores. On the basis of these undernutrition exposures, we applied a counterfactual approach to quantify the relative risk of infectious disease (subsequent diarrhoea, lower respiratory infection, and measles) and protein energy malnutrition morbidity and mortality per day of diarrhoea and quantified the burden of diarrhoeal disease due to these outcomes caused by undernutrition. FINDINGS: ). After addition of the DALYs due to the long-term sequelae as a consequence of undernutrition, the burden of diarrhoeal diseases increased by 39·0% (95% uncertainty interval [UI] 33·0-46·6) and was responsible for 55 778 000 DALYs (95% UI 49 125 400-62 396 200) among children younger than 5 years in 2016. Among the 15 652 300 DALYs (95% UI 12 951 300-18 806 100) associated with undernutrition due to diarrhoeal episodes, more than 84·7% are due to increased risk of infectious disease, whereas the remaining 15·3% of long-term DALYs are due to increased prevalence of protein energy malnutrition. The burden of diarrhoea has decreased substantially since 1990, but progress has been greater in long-term (78·7% reduction [95% UI 69·3-85·5]) than in acute (70·4% reduction [95% UI 61·7-76·5]) DALYs. INTERPRETATION: Diarrhoea represents an even larger burden of disease than was estimated in the Global Burden of Disease Study. In order to adequately address the burden of its long-term sequelae, a renewed emphasis on controlling the risk of diarrhoea incidence may be required. This renewed effort can help further prevent the potential lifelong cost on child health, growth, and overall potential. FUNDING: Bill & Melinda Gates Foundation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Vos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32154-2 · Cited by 13,220 · see citing works
Forouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., Brauer, M., Burnett, R., Cercy, K., Charlson, F. J., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31679-8 · Cited by 7,698 · see citing works
Self-citationVos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31678-6 · Cited by 7,253 · see citing works
Self-citationWang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coates, M. M., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31012-1 · Cited by 6,596 · see citing works
Self-citationNaghavi, M., Abajobir, A. A., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abera, S. F., Aboyans, V., Adetokunboh, O., Afshin, A., Agrawal, A., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32152-9 · Cited by 4,821 · see citing works
Kyu, H. H., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32335-3 · Cited by 4,112 · see citing works
Maternal and child undernutrition: consequences for adult health and human capital
Victora, C. G., Adair, L. S., Fall, C. H. D., Hallal, P. C., Martorell, R., Richter, L., & Sachdev, H. S. (2008) · The Lancet · doi:10.1016/s0140-6736(07)61692-4 · Cited by 4,052 · see citing works
Liu, L., Oza, S., Hogan, D., Chu, Y., Perin, J., Zhu, J., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31593-8 · Cited by 3,453 · see citing works
Interpretation of random effects meta-analyses
Riley, R. D., Higgins, J. P. T., & Deeks, J. J. (2011) · BMJ · doi:10.1136/bmj.d549 · Cited by 2,884 · see citing works
Gakidou, E., Afshin, A., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulle, A. M., Abera, S. F., Aboyans, V., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32366-8 · Cited by 2,406 · see citing works
Kassebaum, N. J., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, J., Carter, A., Casey, D. C., Charlson, F. J., Coates, M. M., Coggeshall, M., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31460-x · Cited by 2,163 · see citing works
Self-citationHay, S. I., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32130-x · Cited by 2,083 · see citing works
Self-citationTroeger, C., Forouzanfar, M. H., Rao, P. C., Khalil, I., Brown, A., Reiner, R. C., Fullman, N., Thompson, R. L., Abajobir, A. A., Ahmed, M. B., et al. (2017) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(17)30276-1 · Cited by 1,421 · see citing works
Self-citationThe impoverished gut—a triple burden of diarrhoea, stunting and chronic disease
Guerrant, R. L., DeBoer, M. D., Moore, S. R., Scharf, R. J., & Lima, A. A. M. (2013) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2012.239 · Cited by 604 · see citing works
Self-citationModeling causes of death: an integrated approach using CODEm
Foreman, K. J., Lozano, R., Lopez, A. D., & Murray, C. J. (2012) · Population Health Metrics · doi:10.1186/1478-7954-10-1 · Cited by 564 · see citing works
Malnutrition as an enteric infectious disease with long-term effects on child development
Guerrant, R. L., Oriá, R. B., Moore, S. R., Oriá, M. O. B., & Lima, A. Â. M. (2008) · Nutrition Reviews · doi:10.1111/j.1753-4887.2008.00082.x · Cited by 544 · see citing works
Self-citationMechanisms of nutrient modulation of the immune response
Cunningham–Rundles, S., McNeeley, D. F., & Moon, A. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.04.036 · Cited by 535 · see citing works
Olofin, I. O., McDonald, C. M., Ezzati, M., Flaxman, S. R., Black, R. E., Fawzi, W. W., Caulfield, L. E., Danaei, G., & pooling), F. T. N. I. M. S. (. C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0064636 · Cited by 531 · see citing works
Reversibility of stunting: epidemiological findings in children from developing countries.
Martorell, R., Khan, L. K., & Schroeder, D. G. (1994) · PubMed · Cited by 527 · see citing works
Guerrant, D. I., Moore, S. R., Lima, A. Â. M., Patrick, P. D., Schorling, J. B., & Guerrant, R. L. (1999) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.1999.61.707 · Cited by 470 · see citing works
Self-citationA review of adjusted estimators of attributable risk
Bénichou, J. (2001) · Statistical Methods in Medical Research · doi:10.1177/096228020101000303 · Cited by 440 · see citing works
Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis
Sudfeld, C. R., McCoy, D. C., Danaei, G., Fink, G., Ezzati, M., Andrews, K. G., & Fawzi, W. W. (2015) · PEDIATRICS · doi:10.1542/peds.2014-3111 · Cited by 429 · see citing works
Checkley, W., Epstein, L., Gilman, R. H., Black, R. E., Cabrera, L. Z., & Sterling, C. R. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009675 · Cited by 329 · see citing works
Hutton, G., & Chase, C. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13060536 · Cited by 329 · see citing works
The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality
Munos, M. K., Walker, C. L. F., & Black, R. E. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq025 · Cited by 308 · see citing works
Mølbak, K., Andersen, M., Aaby, P., Højlyng, N., Jakobsen, M., Sodemann, M., & da Silva, A. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.1.149 · Cited by 160 · see citing works
Chronic Sequelae of Foodborne Disease
Lindsay, J. A. (1997) · Emerging infectious diseases · doi:10.3201/eid0304.970405 · Cited by 126 · see citing works
Interactions of diarrhea, pneumonia, and malnutrition in childhood
Schlaudecker, E. P., Steinhoff, M. C., & Moore, S. R. (2011) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0b013e328349287d · Cited by 126 · see citing works
Schmidt, W., Cairncross, S., Barreto, M. L., Clasen, T., & Genser, B. (2009) · International Journal of Epidemiology · doi:10.1093/ije/dyp159 · Cited by 113 · see citing works
Global burden of childhood diarrhea and interventions
Das, J. K., Salam, R. A., & Bhutta, Z. A. (2014) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000000096 · Cited by 112 · see citing works
Immune responses and protection in children in developing countries induced by oral vaccines
Qadri, F., Bhuiyan, T. R., Sack, D. A., & Svennerholm, A. (2012) · Vaccine · doi:10.1016/j.vaccine.2012.11.012 · Cited by 104 · see citing works
Early Childhood Diarrhea Predicts Cognitive Delays in Later Childhood Independently of Malnutrition
Pinkerton, R., Oriá, R. B., Lima, A. Â. M., McQuade, E. T. R., Oriá, M. O. B., Patrick, P. D., Moore, S. R., Wiseman, B. L., Niehaus, M. D., & Guerrant, R. L. (2016) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.16-0150 · Cited by 99 · see citing works
Self-citationDoes Childhood Diarrhea Influence Cognition Beyond the Diarrhea-Stunting Pathway?
Walker, C. L. F., Lamberti, L. M., Adair, L. S., Guerrant, R. L., Lescano, A. G., Martorell, R., Pinkerton, R., & Black, R. E. (2012) · PLoS ONE · doi:10.1371/journal.pone.0047908 · Cited by 90 · see citing works
Self-citationSchorling, J. B., McAuliffe, J. F., SOUZA, M. A. D., & Guerrant, R. L. (1990) · International Journal of Epidemiology · doi:10.1093/ije/19.3.728 · Cited by 79 · see citing works
Self-citationFever and malnutrition: endogenous pyrogen/interleukin-1 in malnourished patients
Kauffman, C., Jones, P., & Kluger, M. (1986) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/44.4.449 · Cited by 73 · see citing works
The Impact of Rotavirus Vaccination on Discounted Net Tax Revenue in Egypt
Connolly, M. P., Topachevskyi, O., Standaert, B. A., Ortega, O., & Postma, M. J. (2012) · PharmacoEconomics · doi:10.2165/11597750-000000000-00000 · Cited by 36 · see citing works
Management of children with acute malnutrition in resource-poor settings
Brown, K. H., Nyirandutiye, D. H., & Jungjohann, S. M. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.194 · Cited by 32 · see citing works
Chronic Health Consequences of Acute Enteric Infections in the Developed World
Porter, C. K., Kowalcyk, B. B., & Riddle, M. S. (2016) · The American Journal of Gastroenterology Supplements · doi:10.1038/ajgsup.2016.10 · Cited by 28 · see citing works
Self-citationChronic Health Consequences of Acute Enteric Infections in the Developing World
Colombara, D. V., Khalil, I. A.-M., Rao, P. C., Troeger, C., Forouzanfar, M. H., Riddle, M. S., & Mokdad, A. H. (2016) · The American Journal of Gastroenterology Supplements · doi:10.1038/ajgsup.2016.9 · Cited by 28 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Troeger, C., Blacker, B. F., Khalil, I. A., Rao, P. C., Cao, S., Zimsen, S. R. M., Albertson, S. B., Stanaway, J. D., Deshpande, A., Zegeye, A., et al. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30362-1 · Cited by 1,512 · see citing works
Self-citationKhalil, I. A., Troeger, C., Blacker, B. F., Rao, P. C., Brown, A., Atherly, D., Brewer, T. G., Engmann, C., Houpt, E. R., Kang, G., et al. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30475-4 · Cited by 691 · see citing works
Self-citationRogawski, E. T., Liu, J., Platts-Mills, J. A., Kabir, F., Lertsethtakarn, P., Siguas, M., Khan, S. S., Praharaj, I., Murei, A., Nshama, R., et al. (2018) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30351-6 · Cited by 387 · see citing works
Self-citationWolf, J., Johnston, R. B., Ambelu, A., Arnold, B. F., Bain, R., Brauer, M., Brown, J., Caruso, B. A., Clasen, T., Colford, J. M., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00458-0 · Cited by 343 · see citing works
Self-citationClimate Change Impacts on Waterborne Diseases: Moving Toward Designing Interventions
Lévy, K., Smith, S. M., & Carlton, E. J. (2018) · Current Environmental Health Reports · doi:10.1007/s40572-018-0199-7 · Cited by 273 · see citing works
Kyu, H. H., Vongpradith, A., Dominguez, R.-M. V., Ma, J., Albertson, S. B., Novotney, A., Khalil, I. A., Troeger, C., Doxey, M. C., Ledesma, J. R., et al. (2024) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(24)00691-1 · Cited by 251 · see citing works
Self-citationTroeger, C. E., Khalil, I. A., Blacker, B. F., Biehl, M. H., Albertson, S. B., Zimsen, S. R. M., Rao, P. C., Abate, D., Ahmadi, A., Ahmed, M. L. C. B., et al. (2020) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(19)30401-3 · Cited by 210 · see citing works
Self-citationZhang, Y., Tan, P., Zhao, Y., & Ma, X. (2022) · Gut Microbes · doi:10.1080/19490976.2022.2055943 · Cited by 189 · see citing works
Anderson, J. D., Bagamian, K. H., Muhib, F., Amaya, M. P., Laytner, L. A., Wierzba, T. F., & Rheingans, R. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30483-2 · Cited by 168 · see citing works
Variation in Childhood Diarrheal Morbidity and Mortality in Africa, 2000–2015
Reiner, R. C., Graetz, N., Casey, D., Troeger, C., Garcia, G. M., Mosser, J. F., Deshpande, A., Swartz, S. J., Ray, S. E., Blacker, B. F., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1716766 · Cited by 158 · see citing works
Self-citationGlobal disease burden of pathogens in animal source foods, 2010
Li, M., Havelaar, A. H., Hoffmann, S., Hald, T., Kirk, M., Torgerson, P. R., & Devleesschauwer, B. (2019) · PLoS ONE · doi:10.1371/journal.pone.0216545 · Cited by 127 · see citing works
Khalil, I., Walker, R. I., Porter, C. K., Muhib, F., Chilengi, R., Cravioto, A., Guerrant, R. L., Svennerholm, A., Qadri, F., Baqar, S., et al. (2021) · Vaccine · doi:10.1016/j.vaccine.2021.04.018 · Cited by 117 · see citing works
Self-citationThe seasonality of diarrheal pathogens: A retrospective study of seven sites over three years
Chao, D. L., Roose, A. W., Roh, M. K., Kotloff, K. L., & Proctor, J. L. (2019) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0007211 · Cited by 104 · see citing works
Self-citationBangladesh: a success case in combating childhood diarrhoea
Billah, S. M., Raihana, S., Ali, N. B., Iqbal, A., Rahman, M. M., Khan, A. N. S., Karim, F., Karim, M. A., Hassan, A., Jackson, B. D., et al. (2019) · Journal of Global Health · doi:10.7189/jogh.09.020803 · Cited by 77 · see citing works
Breastfeeding and the Risk of Infant Illness in Asia: A Review
Lee, M. K., & Binns, C. W. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010186 · Cited by 70 · see citing works
Disentangling Microbial Mediators of Malnutrition: Modeling Environmental Enteric Dysfunction
Bartelt, L. A., Bolick, D. T., & Guerrant, R. L. (2019) · Cellular and Molecular Gastroenterology and Hepatology · doi:10.1016/j.jcmgh.2018.12.006 · Cited by 55 · see citing works
Self-citationFoster, T., Falletta, J., Amin, N., Rahman, M. M., Liu, P., Raj, S., Mills, F., Petterson, S., Norman, G., Moe, C. L., et al. (2021) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2020.113669 · Cited by 54 · see citing works
Mebrahtom, S., Worku, A., & Gage, D. J. (2022) · BMC Public Health · doi:10.1186/s12889-022-12735-7 · Cited by 53 · see citing works
Infections and Acute Kidney Injury: A Global Perspective
Batte, A., Shahrin, L., Granado, R. C., Luyckx, V. A., & Conroy, A. L. (2023) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2023.151466 · Cited by 51 · see citing works
Bagamian, K. H., Anderson, J. D., Muhib, F., Cumming, O., Laytner, L. A., Wierzba, T. F., & Rheingans, R. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30456-5 · Cited by 50 · see citing works
Li, Z., Zhu, G., Li, C., Lai, H., Liu, X., & Zhang, L. (2021) · Nutrients · doi:10.3390/nu13124319 · Cited by 52 · see citing works
The First-in-Human Synthetic Glycan-Based Conjugate Vaccine Candidate against Shigella
van der Put, R. M. F., Smitsman, C., de Haan, A., Hamzink, M., Timmermans, H., Uittenbogaard, J. P., Westdijk, J., Stork, M., Ophorst, O. J. A. E., Thouron, F., et al. (2022) · ACS Central Science · doi:10.1021/acscentsci.1c01479 · Cited by 47 · see citing works
Karambizi, N. U., McMahan, C. S., Blue, C. N., & Temesvari, L. A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0259077 · Cited by 46 · see citing works
Controlled Human Infection Models To Accelerate Vaccine Development
Choy, R. K. M., Bourgeois, A. L., Ockenhouse, C. F., Walker, R. I., Sheets, R., & Flores, J. (2022) · Clinical Microbiology Reviews · doi:10.1128/cmr.00008-21 · Cited by 44 · see citing works
Budge, S., Barnett, M. J., Hutchings, P., Parker, A., Tyrrel, S., Hassard, F., Garbutt, C., Moges, M., Woldemedhin, F., & Jemal, M. Y. (2020) · PLoS ONE · doi:10.1371/journal.pone.0232541 · Cited by 40 · see citing works
Abbasi, E., Mondanizadeh, M., van Belkum, A., & Ghaznavi‐Rad, E. (2020) · Infection and Drug Resistance · doi:10.2147/idr.s247732 · Cited by 42 · see citing works
Tang, X., Hu, Y., Zhong, X., & Xu, H. (2022) · Frontiers in Pediatrics · doi:10.3389/fped.2022.826600 · Cited by 42 · see citing works
Pienaar, J. A., Singh, A., & Barnard, T. G. (2019) · Microbial Pathogenesis · doi:10.1016/j.micpath.2019.01.022 · Cited by 41 · see citing works
Anwar, M. Y., Warren, J. L., & Pitzer, V. E. (2019) · The American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.18-0735 · Cited by 40 · see citing works
Rouhani, S., Griffin, N. W., Yori, P. P., Olórtegui, M. P., Salas, M. S., Trigoso, D. R., Moulton, L. H., Houpt, E. R., Barratt, M. J., Kosek, M. N., et al. (2019) · Clinical Infectious Diseases · doi:10.1093/cid/ciz906 · Cited by 40 · see citing works
Self-citationThe effect of extreme weather events on child nutrition and health
Amondo, E. I., Nshakira‐Rukundo, E., & Mirzabaev, A. (2023) · Food Security · doi:10.1007/s12571-023-01354-8 · Cited by 37 · see citing works
Sada, T. S., & Tessema, T. S. (2024) · BMC Infectious Diseases · doi:10.1186/s12879-024-09152-z · Cited by 41 · see citing works
Mańko, A., Allain, T., Motta, J., Cotton, J. A., Feener, T. D., Oyeyemi, A., Bindra, S., Vallance, B. A., Wallace, J. L., Beck, P. L., et al. (2020) · International Journal for Parasitology · doi:10.1016/j.ijpara.2019.12.011 · Cited by 34 · see citing works
Remote monitoring of rural water systems: A pathway to improved performance and sustainability?
Thomson, P. (2020) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1502 · Cited by 35 · see citing works
Chronic diarrhoea in children: A practical algorithm‐based approach
Shankar, S., & Rosenbaum, J. (2020) · Journal of Paediatrics and Child Health · doi:10.1111/jpc.14986 · Cited by 33 · see citing works
Factors associated with child malnutrition in mountainous ethnic minority communities in Lao PDR
Boulom, S., Essink, D. R., Kang, M., Kounnavong, S., & Broerse, J. E. W. (2020) · Global Health Action · doi:10.1080/16549716.2020.1785736 · Cited by 30 · see citing works
Functional antibodies as immunological endpoints to evaluate protective immunity againstShigella
Ndungo, E., & Pasetti, M. F. (2019) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2019.1640427 · Cited by 29 · see citing works
Onozuka, D., Gasparrini, A., Sera, F., Hashizume, M., Honda, Y., Nishimura, K., & Hagihara, A. (2019) · Environmental Health Perspectives · doi:10.1289/ehp4731 · Cited by 29 · see citing works
Hasso-Agopsowicz, M., Lopman, B. A., Lanata, C. F., McQuade, E. T. R., Kang, G., Prudden, H. J., Khalil, I., Platts-Mills, J. A., Kotloff, K. L., Jit, M., et al. (2021) · Vaccine · doi:10.1016/j.vaccine.2021.11.033 · Cited by 29 · see citing works
Self-citationEarly life gut microbiota: Consequences for health and opportunities for prevention
Wang, S., Cui, J., Jiang, S., Zheng, C., Zhao, J., Zhang, H., & Zhai, Q. (2022) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2022.2158451 · Cited by 29 · see citing works
Exploring the broader consequences of diarrhoeal diseases on child health
Wierzba, T. F., & Muhib, F. (2018) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30047-0 · Cited by 28 · see citing works
Ghosh, K., Chakraborty, A. S., & Sengupta, S. (2023) · BMC Pediatrics · doi:10.1186/s12887-023-04073-3 · Cited by 26 · see citing works
Hu, Y., Arora, J., Joshi, S. B., Esfandiary, R., Middaugh, C. R., Weis, D. D., & Volkin, D. B. (2019) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2019.06.005 · Cited by 26 · see citing works
Noreen, Z., Siddiqui, F., Javed, S., Wren, B. W., & Bokhari, H. (2019) · Journal of Global Antimicrobial Resistance · doi:10.1016/j.jgar.2019.07.018 · Cited by 25 · see citing works
Parasitic infections of the gut in children
Chifunda, K., & Kelly, P. M. (2018) · Paediatrics and International Child Health · doi:10.1080/20469047.2018.1479055 · Cited by 24 · see citing works
Overbey, K. N., Schwab, K. J., & Exum, N. G. (2019) · International Journal of Epidemiology · doi:10.1093/ije/dyz043 · Cited by 25 · see citing works
Hu, Y., Kumru, O. S., Xiong, J., Antúnez, L. R., Hickey, J. M., Wang, Y., Cavacini, L. A., Klempner, M. S., Joshi, S. B., & Volkin, D. B. (2019) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2019.07.018 · Cited by 22 · see citing works
Anderson, J. D., Bagamian, K. H., Pecenka, C. J., Muhib, F., Puett, C., Hausdorff, W. P., & Scheele, S. K. (2023) · The Lancet Global Health · doi:10.1016/s2214-109x(23)00192-4 · Cited by 22 · see citing works
Efunshile, A. M., Ezeanosike, O. B., Onyekachi, O. N. I., Ugwu, M. I., König, B., & Robertson, L. J. (2018) · Epidemiology and Infection · doi:10.1017/s0950268818003151 · Cited by 21 · see citing works
Alemayehu, B., Ayele, B. T., Kloos, H., & Ambelu, A. B. (2020) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2019.113447 · Cited by 21 · see citing works
Deichsel, E. L., Keita, A. M., Verani, J. R., Powell, H., Jamka, L. P., Hossain, M. J., Jones, J. C. M., Omore, R., Awuor, A. O., Sow, S. O., et al. (2023) · Clinical Infectious Diseases · doi:10.1093/cid/ciac926 · Cited by 20 · see citing works
Self-citationAddo, I. Y., Boadu, E. F., Bonsu, E. O., Boadi, C., & Dadzie, F. A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0289933 · Cited by 20 · see citing works
Effectiveness of monovalent rotavirus vaccine in the Philippines
Lopez, A. L., Daag, J. V., Esparagoza, J., Bonifacio, J., Fox, K., Nyambat, B., Parashar, U. D., Ducusin, M. J., & Tate, J. E. (2018) · Scientific Reports · doi:10.1038/s41598-018-32595-9 · Cited by 20 · see citing works
Dynamics of the Gut Microbiome in Shigella -Infected Children during the First Two Years of Life
Ndungo, E., Holm, J. B., Gama, S., Buchwald, A. G., Tennant, S. M., Laufer, M. K., Pasetti, M. F., & Rasko, D. A. (2022) · mSystems · doi:10.1128/msystems.00442-22 · Cited by 20 · see citing works
El Niño Southern Oscillation, monsoon anomaly, and childhood diarrheal disease morbidity in Nepal
Adams, N., Dhimal, M., Mathews, S., Iyer, V. J., Murtugudde, R. G., Liang, X., Haider, M., Cruz‐Cano, R., Thu, D. T. A., Hashim, J. H., et al. (2022) · PNAS Nexus · doi:10.1093/pnasnexus/pgac032 · Cited by 19 · see citing works
Song, M., Zhou, W., Fan, J., Jia, C., Xiong, W., Wei, H., & Tao, S. (2025) · Gut Microbes · doi:10.1080/19490976.2025.2541036 · Cited by 17 · see citing works
Meron-Sudai, S., Asato, V., Adler, A., Bialik, A., Goren, S., Ariel-Cohen, O., Reizis, A., Mulard, L. A., Phalipon, A., & Cohen, D. (2023) · npj Vaccines · doi:10.1038/s41541-023-00624-y · Cited by 18 · see citing works
Old and new challenges related to global burden of diarrhoea
Keddy, K. H. (2018) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(18)30424-9 · Cited by 16 · see citing works
The global burden of childhood diarrhea and its epidemiological characteristics from 1990 to 2021
Zhu, H.-Y., Xu, F., Zhao, W., Wang, H., & Wang, H. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1656234 · Cited by 20 · see citing works
Duah, H. O., Amankwa, C. E., Adomako, I., Owusu, B., & Agbadi, P. (2020) · International Health · doi:10.1093/inthealth/ihaa099 · Cited by 15 · see citing works
Abera, S. F., Kantelhardt, E. J., Mulugeta, A., Gebru, A. A., Ejeta, G., Lauvai, J., Wienke, A., & Scherbaum, V. (2019) · Global Health Action · doi:10.1080/16549716.2018.1556572 · Cited by 15 · see citing works
Varghese, T., Mills, J., Revathi, R., Antoni, S., Soeters, H. M., Njambe, T. O. E., Houpt, E. R., Tate, J. E., Parashar, U. D., & Kang, G. (2024) · Gut Pathogens · doi:10.1186/s13099-024-00599-8 · Cited by 14 · see citing works
Self-citationAbbasi, E., & Ghaznavi‐Rad, E. (2021) · BMC Gastroenterology · doi:10.1186/s12876-021-01719-3 · Cited by 14 · see citing works
Keddy, K. H., Saha, S., Okeke, I. N., Kalule, J. B., Qamar, F. N., & Kariuki, S. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103668 · Cited by 14 · see citing works
Can Simple Psychological Interventions Increase Preventive Health Investment?
Haushofer, J., John, A., & Orkin, K. (2019) · National Bureau of Economic Research · doi:10.3386/w25731 · Cited by 27 · see citing works
Unequal geographic distribution of water and sanitation at the household and school level in Sudan
Cha, S., Jin, Y., Elhag, M. S., Kim, Y.-J., & Ismail, H. A. H. A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0258418 · Cited by 12 · see citing works
Dharod, J. M., Nounkeu, C. D., Paynter, L., Labban, J. D., & Sastre, L. R. (2021) · Journal of Water and Health · doi:10.2166/wh.2021.123 · Cited by 12 · see citing works
Simiyu, S. N., Aseyo, E., Anderson, J., Cumming, O., Baker, K. K., Dreibelbis, R., & Mumma, J. A. O. (2022) · Maternal and Child Health Journal · doi:10.1007/s10995-022-03548-6 · Cited by 13 · see citing works
on behalf of the Child Health and Nutrition Study team, Hanieh, S., Mahanty, S., Gurruwiwi, G. G., Kearns, T. M., Dhurrkay, R. G., Gondarra, V., Shield, J., Ryan, N. J., Azzato, F., et al. (2021) · BMC Infectious Diseases · doi:10.1186/s12879-020-05685-1 · Cited by 12 · see citing works
Blyth, C. C., Britton, K. J., Nguyen, C. D., Sapura, J., Kave, J., Nivio, B., Chan, J., Satzke, C., Ford, R. L., Kirarock, W., et al. (2022) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100432 · Cited by 11 · see citing works
O’Dowd, A., Maciel, M., Poole, S., Jobling, M. G., Rollenhagen, J. E., Woods, C. M., Sincock, S. A., McVeigh, A. L., Gregory, M. J., Maves, R. C., et al. (2020) · Infection and Immunity · doi:10.1128/iai.00252-20 · Cited by 11 · see citing works
Large Pediatric Randomized Clinical Trials in ClinicalTrials.gov
Cho, S. M., Serghiou, S., Ioannidis, J., Klassen, T., & Contopoulos-Ioannidis, D. (2021) · Pediatrics · doi:10.1542/peds.2020-049771 · Cited by 10 · see citing works
Saavedra-Sanchez, L., Dickinson, M. S., Apte, S., Zhang, Y., de Jong, M. F., Skavicus, S., Heaton, N. S., Alto, N. M., & Coers, J. (2024) · eLife · doi:10.7554/elife.102714 · Cited by 11 · see citing works
Age-dependent pathogenic profiles of enterotoxigenic Escherichia coli diarrhea in Bangladesh
Akhtar, M., Begum, Y. A., Rahman, S. I. A., Afrad, M. H., Parvin, N., Akter, A., Tauheed, I., Amin, M. A., Ryan, E. T., Khan, A. I., et al. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1484162 · Cited by 10 · see citing works
Yeshaw, Y., Alem, A. Z., Ayalew, H. G., Liyew, A. M., Tessema, Z. T., Worku, M. G., Tesema, G. A., Alamneh, T. S., & Teshale, A. B. (2023) · Tropical Medicine and Health · doi:10.1186/s41182-023-00503-1 · Cited by 10 · see citing works
Three structural solutions for bacterial adhesion pilus stability and superelasticity
Doran, M. H., Baker, J. L., Dahlberg, T., Andersson, M. J., & Bullitt, E. (2023) · Structure · doi:10.1016/j.str.2023.03.005 · Cited by 10 · see citing works
Anderson, J. D., Muhib, F., Rheingans, R., & Wierzba, T. F. (2019) · Vaccine X · doi:10.1016/j.jvacx.2019.100043 · Cited by 10 · see citing works
Kelly, G. C., Rachmat, A., Hontz, R. D., Sklar, M. J., Tran, L. K., Supaprom, C., Luy, M., Lina, S., Gregory, M. J., Sopheab, H., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283871 · Cited by 11 · see citing works
Eislmayr, K. D., Nichols, C. A., Liu, F. L., Yuvaraj, S., Babirye, J., Roncaioli, J. L., Vickery, J., Barton, G. M., Lesser, C. F., & Vance, R. E. (2025) · Cell Host and Microbe · doi:10.1016/j.chom.2025.08.001 · Cited by 7 · see citing works
Ofori, S. K., Hung, Y. W., Schwind, J. S., Muniz-Rodríguez, K., Kakou, R. J., Alade, S. E., Diallo, K., Sullivan, K. L., Cowling, B. J., & Fung, I. C. (2020) · International Journal of Environmental Health Research · doi:10.1080/09603123.2020.1784398 · Cited by 9 · see citing works
Relative Risk Prediction of Norovirus Incidence under Climate Change in Korea
Kim, T., Paek, J., Kim, H.-Y., & Choi, I. (2021) · Life · doi:10.3390/life11121332 · Cited by 9 · see citing works
Lamberti, M., Terán, L. C., López, F. E., Pescaretti, M. D. L. M., & Delgado, M. A. (2022) · BMC Genomics · doi:10.1186/s12864-022-08711-5 · Cited by 9 · see citing works
Ge, T., Zhang, Q., Lü, J., Chen, G., Sun, M., & Li, X. (2019) · PeerJ · doi:10.7717/peerj.6382 · Cited by 9 · see citing works
Delahoy, M. J., Cárcamo, C., Ibargüen, L. O., Vásquez, V., Lopman, B. A., Clasen, T., Gonzales, G. F., Steenland, K., & Lévy, K. (2020) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0000000000002702 · Cited by 9 · see citing works
Kaewkod, T., Ngamsaoad, P., Mayer, K.-O., Cheepchirasuk, N., Promputtha, I., & Tragoolpua, Y. (2024) · Journal of Food Biochemistry · doi:10.1155/jfbc/1862818 · Cited by 8 · see citing works
Ganbold, G., Farnaz, N., Scutts, T., Borg, B., & Mihrshahi, S. (2025) · Maternal and Child Nutrition · doi:10.1111/mcn.70042 · Cited by 14 · see citing works
Lambrecht, N., Müller‐Hauser, A. A., Sobhan, S., Schmidt, W., Huda, T. M. N., Waid, J. L., Wendt, A. S., Kader, A., & Gabrysch, S. (2023) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.23-0152 · Cited by 7 · see citing works
Lopez, A. L., Raguindin, P. F., & Silva, M. W. T. (2018) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2018.1551673 · Cited by 8 · see citing works
Informing decisions with disparate stakeholders: cross-sector evaluation of cash transfers in Malawi
Ramponi, F., Nkhoma, D., & Griffin, S. C. (2021) · Health Policy and Planning · doi:10.1093/heapol/czab137 · Cited by 8 · see citing works
Groome, M. J., & Parashar, U. D. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30056-7 · Cited by 8 · see citing works
Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India
Sharma, A., Mathur, A., Lundborg, C. S., & Pathak, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17020616 · Cited by 7 · see citing works
Fangfang, Q., Wu, H., Li, X.-M., & Han, J. (2020) · Journal of International Medical Research · doi:10.1177/0300060519896154 · Cited by 8 · see citing works
RetractedStrategies for resilience: Mitigating the effects of climate change on hunger and mental health
Mezieobi, K. C., Alum, E. U., Egwu, C. K., Uti, D. E., Alum, B. N., Ainebyoona, C., & Omuna, D. (2025) · Journal of Agriculture and Food Research · doi:10.1016/j.jafr.2025.102023 · Cited by 7 · see citing works
Cumulative effects of environmental factors on household childhood diarrhoea in Ghana
Afitiri, A., Armah, F. A., Ekumah, B., Nyieku, F. E., Yawson, D. O., & Odoi, J. O. (2020) · Water Practice & Technology · doi:10.2166/wpt.2020.083 · Cited by 8 · see citing works
Rao, G., Blackstock, A. J., Derado, G., Cuéllar, V. M., Juliao, P., Alvarez, M., López, B., Muñoz, F., Thornton, A., Patel, J. C., et al. (2021) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2021.160 · Cited by 7 · see citing works
Trang, N. V., Tate, J. E., Phượng, L. T., Thiểm, V. Đ., Quyet, N. T., Le, L. K. T., Chu, M. T. N., Tran, M. P. N., Pham, T. P. T., Nguyen, H. T., et al. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2023.100789 · Cited by 7 · see citing works
Naz, L., & Ghimire, U. (2020) · doi:10.21203/rs.3.rs-36037/v1 · Cited by 6 · see citing works
Jasuja, J. K., Bub, F., Veit, J., Fofana, H. K. M., Sacko, M., Saye, R., Chatigre, J. K., N'Goran, E. K., Yao, J. A., Khanal, B., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-60491-y · Cited by 6 · see citing works
Yu, W., Guo, M., Li, G., Wen, L., Cao, Y., Hu, K., Wang, H., Ma, W., Zhao, Q., Li, L., et al. (2025) · Environment International · doi:10.1016/j.envint.2025.109792 · Cited by 6 · see citing works
- Authors
- Troeger, C., Colombara, D. V., Rao, P. C., Khalil, I. A., Brown, A., Brewer, T. G., Guerrant, R. L., Houpt, E. R., Kotloff, K. L., Misra, K., Petri, W. A., Platts-Mills, J., Riddle, M. S., Swartz, S. J., Forouzanfar, M. H., Reiner, R. C., Hay, S. I., & Mokdad, A. H.
- Affiliations
- University of Washington (US)
- University of Virginia (US)
- University of Maryland, Baltimore (US)
- New York City Department of Health and Mental Hygiene (US)
- Uniformed Services University of the Health Sciences (US)
- Corresponding author
- Mokdad, Ali H
- ORCID
- Venue
- The Lancet Global Health
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 6
- Issue
- 3
- Pages
- e255-e269
- ISSN
- 2214-109X (ISSN-L)
- PMC
- PMC5861379
- OpenAlex
- W2785669008
- Cited by
- 200
- References
- 39
- Citations by year
- 2026: 22 · 2025: 25 · 2024: 28 · 2023: 24 · 2022: 19 · 2021: 19 · 2020: 22 · 2019: 29 · 2018: 12
- FWCI
- 16.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Allergy and Infectious Diseases (R01AI043596)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- child undernutrition, disability-adjusted life years, protein-energy malnutrition, lower respiratory tract infection, measles, weight-for-age, height-for-age, weight-for-height, children under five, global burden of disease, micronutrient uptake, infectious disease risk
- MeSH terms
- Child, Preschool, Diarrhea, Female, Growth Disorders, Disabled Persons, Persons with Disabilities, Humans, Infant, Male, Time Factors, Global Health, Cost of Illness, Quality-Adjusted Life Years, Malnutrition
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review