Burden of enterotoxigenic Escherichia coli and shigella non-fatal diarrhoeal infections in 79 low-income and lower middle-income countries: a modelling analysis

Publication date: March 2019Source: The Lancet Global Health, Volume 7, Issue 3Author(s): John D Anderson, Karoun H Bagamian, Farzana Muhib, Mirna P Amaya, Lindsey A Laytner, Thomas Wierzba, Richard RheingansSummaryBackgroundEnterotoxigenic Escherichia coli (ETEC) and shigella are two major pathogens that cause moderate-to-severe diarrhoea in children younger than 5 years. Diarrhoea is associated with an increased risk of stunting, which puts children at risk of death due to other infectious diseases.MethodsWe modelled ETEC-related and shigella-related mortality and the effect of moderate-to-severe diarrhoea episodes to determine the number of children with stunting due to these infections in 79 low-income and lower middle-income countries. We applied population attributable risk for increased number of deaths due to other infectious diseases in children who are stunted. We calculated 95% uncertainty intervals (UIs) for the point estimates.FindingsIn children younger than 5 years, we estimate 196 million (95% UI 135–269) episodes of ETEC and shigella diarrhoea occur annually, resulting in 3·5 million (0·8–5·4) cases of moderate-to-severe stunting and 44 400 (29 400–59 800) total ETEC deaths and 63 100 (44 000–81 900) total shigella deaths in 2015. Additional infectious disease mortality due to stunting resulted in increases of 24% (8–34; for ETEC) and 28% (10–39; for shigella) over direct deaths due to diarrhoeal episodes. The distribution of mortal...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research