The overlapping burden of the three leading causes of disability and death in sub-Saharan African children · SciRah

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The overlapping burden of the three leading causes of disability and death in sub-Saharan African children

Robert C. Reiner^{a b c d}✉, LBD Triple Burden Collaborators^d, Catherine A. Welgan^d, Christopher Troeger^d, Mathew M Baumann^{d e}, Daniel J. Weiss^{d e}, Aniruddha Deshpande^d, Brigette F. Blacker^d, Molly Katherine Miller-Petrie^d, Lucas Earl^{d f}, Samir Bhatt^{f g},

Nature Communications Nature Portfolio2022-12-06 31 citations37 references

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Abstract

Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseases, while others had one or two dominant sources of unit-level burden, with no consistent pattern geographically across the entire subcontinent. Using a subnational counterfactual analysis, we show that nearly 300 million DALYs could have been averted since 2000 by raising all units to their national average. Our findings are directly relevant for decision-makers in determining which and targeting where the most appropriate interventions are for increasing child survival.

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^aDepartment of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA. bcreiner@uw.edu
^bInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. bcreiner@uw.edu
^cDepartment of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
^dInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
^eMalaria Atlas Project, University of Oxford, Oxford, UK
^fImperial College London, London, UK
^gDepartment of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
^hResearch Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
ⁱDepartment of Public Health, Debre Berhan University, Debre Berhan, Ethiopia
^jDepartment of Clinical Sciences, University of Sharjah, Sharjah, United Arab Emirates
^kPopulation Health Sciences, King's College London, London, England
^lPopulation Health Sciences, King’s College London, London, England
^mCentre of Excellence for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa
ⁿDepartment of Global Health, Stellenbosch University, Cape Town, South Africa
^oDepartment of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
^pFaculty of Medicine and Public Health, Jenderal Soedirman University, Purwokerto, Indonesia
^qMayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
^rClinical Epidemiology Center, Department of Veterans Affairs, St Louis, MO, USA
^sJohn T. Milliken Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA
^tInstitute of Health Research, University of Health and Allied Sciences, Ho, Ghana
^uDepartment of Information Systems, College of Economics and Political Science, Sultan Qaboos University, Muscat, Oman
^vInfectious and Tropical Disease Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
^wDepartment of Health Policy and Management, Kuwait University, Safat, Kuwait
^xInternational Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
^yDepartment of Epidemiology, Arak University of Medical Sciences, Arak, Iran
^zDepartment of Parasitology, Sana'a University, Sana'a, Yemen
^aaMedical Research Center, Jazan University, Jazan, Saudi Arabia
^abDepartment of Parasitology, Sana’a University, Sana’a, Yemen
^acPediatric Intensive Care Unit, King Saud University, Riyadh, Saudi Arabia
^adResearch Group in Health Economics, University of Cartagena, Cartagena, Colombia
^aeResearch Group in Hospital Management and Health Policies, ALZAK Foundation, Cartagena, Colombia
^afCollege of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
^agSchool of Medicine, University of Adelaide, Adelaide, SA, Australia
^ahHealth Services Management Department, Arak University of Medical Sciences, Arak, Iran
^aiMaternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya
✉Corresponding author