Cited by 471Child Nutrition and Water AccessViral gastroenteritis research and epidemiologyGlobal Maternal and Child Health

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Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review

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Fischer Walker, Christa L, Perin, Jamie, Aryee, Martin J, Boschi-Pinto, Cynthia, Black, Robert E·2012·BMC Public Health

DOI 10.1186/1471-2458-12-220PMC PMC3323412

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Abstract

BACKGROUND: Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify cohort studies that sought to quantify diarrhea incidence among any age group of children 0-59 mo of age. METHODS: We used the Expectation-Maximization algorithm as a part of a two-stage regression model to handle diverse age data and overall incidence rate variation by study to generate country specific incidence rates for low- and middle-income countries for 1990 and 2010. We then calculated regional incidence rates and uncertainty ranges using the bootstrap method, and estimated the total number of episodes for children 0-59 mo of age in 1990 and 2010. RESULTS: We estimate that incidence has declined from 3.4 episodes/child year in 1990 to 2.9 episodes/child year in 2010. As was the case previously, incidence rates are highest among infants 6-11 mo of age; 4.5 episodes/child year in 2010. Among these 139 countries there were nearly 1.9 billion episodes of childhood diarrhea in 1990 and nearly 1.7 billion episodes in 2010. CONCLUSIONS: Although our results indicate that diarrhea incidence rates may be declining slightly, the total burden on the health of each child due to multiple episodes per year is tremendous and additional funds are needed to improve both prevention and treatment practices in low- and middle-income countries.

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Figure 1 Flow chart diagram of the systematic review process.CC BY · PubMed Central

Figure 2 Location of studies reporting Diarrhea incidence outcomes for children and adults.CC BY · PubMed Central

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Authors: Fischer Walker, C. L., Perin, J., Aryee, M. J., Boschi-Pinto, C., & Black, R. E.
Affiliations: Johns Hopkins University (US)
World Health Organization (CH)
ORCID: Perin, Jamie
Aryee, Martin J
Black, Robert E
Venue: BMC Public Health
Publisher: Springer Science and Business Media LLC
Published: 2012-03-21
Volume: 12
Issue: 1
Pages: 220-220
ISSN: 1471-2458 (ISSN-L)
DOI: 10.1186/1471-2458-12-220
PMC: PMC3323412
OpenAlex: W2096394008
Cited by: 471
References: 17
Citations by year: 2026: 8 · 2025: 14 · 2024: 14 · 2023: 21 · 2022: 34 · 2021: 27 · 2020: 30 · 2019: 48 · 2018: 37 · 2017: 50 · 2016: 51 · 2015: 55 · 2014: 33 · 2013: 40 · 2012: 9
FWCI: 5.34
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
www.springer.com/tdm (unspecified)
Locations: BMC Public Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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: childhood diarrhea, diarrhea incidence, low- and middle-income countries, children under five, infant diarrhea, global burden of disease, age-specific incidence, cohort studies
MeSH terms: Adolescent, Adult, Child, Child, Preschool, Developing Countries, Diarrhea, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Global Health, Cohort Studies, Incidence, Cost of Illness

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Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review

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