Diarrhea continues to be 'leading killer' among children under 5 and elderly, study finds

Children and individuals above the age of 70 account for the highest death rates due to diarrheal infections

Diarrhea and related infections continue to be a leading cause of death among children under five years and the elderly, particularly in sub-Saharan Africa and South Asia, even though deaths from these conditions have dropped globally by 60 per cent between 1990 to 2021, a study says.

Published in The Lancet Infectious Diseases journal, the study found that in 2021, diarrheal diseases infections were responsible for 12 lakh deaths worldwide, a significant decrease from 29 lakh deaths in 1990.

These estimates are the latest and most comprehensive from the Global Burden of Disease (GBD), coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, US.

The findings suggest that health interventions, including oral rehydration therapy, improved sanitation, and global immunisation efforts against rotavirus (which causes diarrheal infections), are proving effective, researchers said.

They also found that the largest decline in deaths occurred among children under five, although mortality rates remain highest in this age group.

Individuals aged 70 years or older were the second most affected age group in terms of death rates, making diarrhea and related infections a leading cause of death across all age groups, the researchers noted.

Regionally, children under five in sub-Saharan Africa had the highest mortality rates, with over 150 deaths per 100,000 population, compared to other global regions. In South Asia, the highest mortality rates were found among those aged 70 and older, with 476 deaths per 100,000 population.

The authors stated that preventive measures targeting key risk factors and infection-causing microbes could further reduce the global burden of diarrheal diseases.

"The new granular-level analysis in our study can help decision-makers better target and prioritise evidence-based strategies to fight diarrheal diseases," said Dr. Hmwe Hmwe Kyu, a study author and associate professor at IHME.

"Despite the encouraging progress made in combating diarrheal mortality, a multipronged approach is needed to simultaneously implement life-saving solutions while also prioritising preventive interventions to alleviate the burden on health systems," Dr. Kyu added.

The authors also suggested that as more vaccines are added to the World Health Organisation's Expanded Programme on Immunisation, combining them could reduce manufacturing costs and make scheduling easier.

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