Etiology-specific incidence and mortality of diarrheal diseases in the African region : a systematic review and meta-analysis

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dc.contributor.author Thystrup, Cecilie
dc.contributor.author Majowicz, Shannon E.
dc.contributor.author Kitila, Dinaol B.
dc.contributor.author Desta, Binyam N.
dc.contributor.author Fayemi, Olanrewaju E.
dc.contributor.author Ayolabi, Christianah I.
dc.contributor.author Hugho, Ephrasia
dc.contributor.author Buys, E.M. (Elna Maria)
dc.contributor.author Akanni, Gabriel B.
dc.contributor.author Machava, Norgia E.
dc.contributor.author Monjane, Celso
dc.contributor.author Hald, Tine
dc.contributor.author Pires, Sara M.
dc.date.accessioned 2024-07-25T12:50:14Z
dc.date.available 2024-07-25T12:50:14Z
dc.date.issued 2024-07
dc.description DATA AVAILABILITY : All results and data generated is provided within the manuscript or supplementary information files. en_US
dc.description.abstract BACKGROUND : Diarrheal diseases substantially affect public health impact in low- and middle-income countries (LMIC), particularly in Africa, where previous studies have indicated a lack of comprehensive data. With a growing number of primary studies on enteric infections in Africa, this study aimed to estimate the incidence and mortality of diarrheal pathogens across all ages in Africa in the year 2020. We also explored different methodological assumptions to allow comparison with other approaches. METHODS : Through a systematic review and meta-analysis of data from African LMICs, we estimated the etiology proportions for diarrheal diseases and deaths. We combined the etiology proportions with incidence data collected from a population survey in Africa from 2020 and mortality data from the Global Health Observatory of WHO. RESULTS : We estimated 1,008 billion diarrhea cases (95% UI 447 million-1,4 billion) and 515,031 diarrhea deaths (95% UI 248,983-1,007,641) in the African region in 2020. In children under five, enteroaggregative E. coli (EAEC) (44,073 cases per 100,000 people, 95% UI 18,818 − 60,922) and G. lamblia (36,116 cases per 100,000 people, 95% UI 15,245 − 49,961) were the leading causes of illness. Enteroinvasive E. coli (EIEC) (155 deaths per 100,000 people, 95% UI 106.5-252.9) and rotavirus (61.5 deaths per 100,000 people, 95% UI 42.3-100.3) were the primary causes of deaths. For children over five and adults, Salmonella spp. caused the largest number of diarrheal cases in the population of children ≥ 5 and adults (122,090 cases per 100,000 people, 95% UI 51,833 − 168,822), while rotavirus (16.4 deaths per 100,000 people, 95% UI 4.2–36.7) and enteroaggregative E. coli (EAEC) (14.6 deaths per 100,000 people, 95% UI 3.9–32.9) causing the most deaths. Geographically, the highest incidence of diarrhea was in Eastern Africa for children under five (114,389 cases per 100,000 people, 95% UI 34,771 − 172,884) and Central Africa for children over five and adults (117,820 cases per 100,000 people, 95% UI 75,111–157,584). Diarrheal mortality was highest in Western Africa for both children below five and above (children < 5: 194.5 deaths per 100,000 people, 95% UI 120-325.4; children ≥ 5 and above: 33.5 deaths per 100,000 people, 95% UI 12.9–75.1). CONCLUSION : These findings provide new information on the incidence and mortality of sixteen pathogens and highlight the need for surveillance and control of diarrheal infectious diseases in Africa. The cause-specific estimates are crucial for prioritizing diarrheal disease prevention in the region. en_US
dc.description.department Consumer Science en_US
dc.description.department Food Science en_US
dc.description.librarian hj2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.sponsorship This study is part of the “FOCAL (Foodborne disease epidemiology, surveillance, and Control in African LMIC)” Project, a multi-partner, multi-study research grant co-funded by the Bill & Melinda Gates Foundation and the Foreign, Commonwealth & Development Office (FCDO) of the United Kingdom Government. en_US
dc.description.uri https://bmcpublichealth.biomedcentral.com en_US
dc.identifier.citation Thystrup, C., Majowicz, S.E., Kitila, D.B. et al. Etiology-specific incidence and mortality of diarrheal diseases in the African region: a systematic review and meta-analysis. BMC Public Health 24, 1864 (2024). https://doi.org/10.1186/s12889-024-19334-8. en_US
dc.identifier.issn 1471-2458 (online)
dc.identifier.other 10.1186/s12889-024-19334-8
dc.identifier.uri http://hdl.handle.net/2263/97257
dc.language.iso en en_US
dc.publisher BMC en_US
dc.rights © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License. en_US
dc.subject Diarrheal diseases en_US
dc.subject Low- and middle-income countries (LMICs) en_US
dc.subject Public health en_US
dc.subject Africa en_US
dc.subject Etiology-specific incidence en_US
dc.subject Mortality en_US
dc.subject SDG-03: Good health and well-being en_US
dc.subject Aetiology en_US
dc.subject Diarrheal incidence en_US
dc.title Etiology-specific incidence and mortality of diarrheal diseases in the African region : a systematic review and meta-analysis en_US
dc.type Article en_US


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