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, 7 (1), e29151

Estimating Diarrhea Mortality Among Young Children in Low and Middle Income Countries


Estimating Diarrhea Mortality Among Young Children in Low and Middle Income Countries

Christa L Fischer Walker et al. PLoS One.


Background: Diarrhea remains one of the leading causes of morbidity and mortality among children under 5 years of age, but in many low and middle-income countries where vital registration data are lacking, updated estimates with regard to the proportion of deaths attributable to diarrhea are needed.

Methods: We conducted a systematic literature review to identify studies reporting diarrhea proportionate mortality for children 1-59 mo of age published between 1980 and 2009. Using the published proportionate mortality estimates and country level covariates we constructed a logistic regression model to estimate country and regional level proportionate mortality and estimated uncertainty bounds using Monte-Carlo simulations.

Findings: We identified more than 90 verbal autopsy studies from around the world to contribute data to a single-cause model. We estimated diarrhea proportionate mortality for 84 countries in 6 regions and found diarrhea to account for between 10.0% of deaths in the Americas to 31.3% of deaths in the South-east Asian region.

Discussion: Diarrhea remains a leading cause of death for children 1-59 mo of age. Published literature can be used to create a single-cause mortality disease model to estimate mortality for countries lacking vital registration data.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Systematic review and data abstraction flow chart.
Figure 2
Figure 2. Geographic distribution of model input data and countries for which the model predicts proportionate mortality.
Figure 3
Figure 3. Distribution of study level diarrhea proportionate mortality by WHO region.
Figure 4
Figure 4. Comparison of country specific diarrhea-proportionate mortality estimates by country for the single cause-model vs. Lancet estimates .

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