As the 2016 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides an up-to-date analysis of the burden of diarrhea in 195 countries, researchers appraised cases, deaths, and etiologies from 1990–2016 and determined the changes in the burden of diarrhea in people of all ages. Outcomes revealed that globally, a substantial progress in reducing the burden of diarrheal diseases has been made. Decreases in several primary risk factors seemed to be the driving factor for this progress. However, this reduction varies across locations, and burden among adults older than 70 years of age demands attention.

Methods

• Researchers modelled diarrhea mortality using a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types based on vital registration and verbal autopsy data.
• They used a compartmental meta-regression tool to model diarrhea incidence.
• Using a counterfactual population attributable fraction approach, they attributed diarrhea deaths and episodes to 13 pathogens.
• Diarrhea risk factors were also assessed in relation to counterfactual estimates of risk exposure and the association of risk with diarrhea.
• Uncertainty was accounted in each modelled estimate.

Results

• Among all ages, diarrhea was identified to be the eighth leading cause of death in 2016, and the fifth leading cause of death among children younger than 5 years of age.
• Among children younger than 5 years of age and among all ages, rotavirus was identified to be the leading etiology for diarrhea mortality.
• In children younger than 5 years of age, the leading risk factors for diarrhea included childhood wasting, unsafe water, and unsafe sanitation, which were responsible for 80.4%, 72.1%, and 56.4% of diarrhea deaths, respectively.