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In 2021, sub-Saharan Africa had the highest mortality rates among children younger than five years diagnosed with diarrhoeal diseases, according to a new study conducted by the Institute for Health Metrics and Evaluation.
The death rates were 151.9 deaths per 100,000 boys and 132.4 deaths per 100,000 girls, according to the study published in The Lancet Infectious Diseases journal.
In South Asia, however, the elderly people aged 70 years and above had the highest mortality in diarrhoeal diseases in 2021. The rates were 404.4 deaths per 100,000 males and 541.1 deaths per 100,000 females.
Diarrhoea is a leading killer of children globally, accounting for around 9 per cent of all deaths among children under five years in 2021, according to UNICEF.
The study used results from the Global Burden of Diseases, Injuries and Risk Factors Study 2021 to assess the burden of, and trends in, diarrhoeal diseases overall and attributable to 13 pathogens. The researchers also factored in the contributions of associated risk factors, in children and adults, in 204 countries and territories from 1990-2021.
They analysed diarrhoeal disability-adjusted life-years (DALY) as the sum of years of life lost (YLL) and years lived with disability for each location, year and age–sex group.
The analysis indicated a decline in diarrhoeal diseases. In 2021, diarrhoeal diseases caused an estimated 1.17 million deaths globally, representing a 60.3 per cent decrease since 1990 (2.93 million deaths), according to the study.
Global YLL also decreased substantially, from 186 million in 1990 to 51.4 million in 2021. Children younger than five years showed the most significant drop in YLLs during this period, from 146 million in 1990 to 30.3 million in 2021. Declines were also seen in older age groups between 1990 and 2021.
In 2021, an estimated 59 million DALYs were attributable to diarrhoeal diseases globally, with 30.9 million of these affecting children younger than five years, according to the study.
Major risk factors for DALYs include poor neonatal conditions such as low birthweight and preterm birth, child growth failure, unsafe water and poor sanitation.
The study estimated that the removal of all evaluated diarrhoeal risk factors would reduce global DALYs from 59 million to 4.99 million among all ages combined.
The reduction in deaths and illnesses caused by diarrhoeal diseases indicates that health measures like oral rehydration therapy, improved water, sanitation and hygiene systems, along with worldwide vaccination campaigns against rotavirus (which leads to diarrhoeal infections) are effective.
The study also called for increasing adoption of WHO-recommended rotavirus vaccines and the need to expand vaccine development to target specific pathogens that cause diarrhoeal diseases.