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

Reiner, R. C., Welgan, C. A., Troeger, C. E. , Baumann, M. M., Weiss, D., Deshpande, A., Blacker, B. F., Miller-Petrie, M. K., Earl, L., Bhatti, S., Abolhassani, H., Abosetugn, A., Abu-Gharbieh, E., Adekanmbi, V., Adetokunboh, O. O., Aghaali, M., Aji, B., Alahdab, F., Al-Aly, Z., Alhassan, R. K., Ali, S., Alizade, H., Aljunid, S. M., Almasi-Hashiani, A., Al-Mekhlafi, H. M., Altirkawi, K. A., Alvis-Guzman, N., Amare, A. T., Amini, S., Amugsi, D. A., Ancuceanu, R., Andrei, C. L., Ansari, F., Anvari, D., Appiah, S. C. Y., Arabloo, J., Aremu, O., Atout, M. M. W., Ausloos, M., Ausloos, F., Ayanore, M. A., Aynalem, Y. A., Azene, Z. N., Badawi, A., Baig, A. A., Banach, M., Bedi, N., Bhagavathula, A. S., Bhandari, D., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bhutta, Z. A., Bijani, A., Birhanu, T. T. M., Bitew, Z. W., Boloor, A., Brady, O. J., Butt, Z. A., Car, J., Carvalho, F., Casey, D. C., Chattu, V. K., Chowdhury, M. A. K., Chu, D-T., Coelho, C., Cook, A. J., Damiani, G., Daoud, F., Gela, J. D., Darwish, A. H., Daryani, A., Das, J. K., Davis Weaver, N., Deribe, K., Desalew, A., Dharmaratne, S. D., Dianatinasab, M., Diaz, D., Djalalinia, S., Dorostkar, F., Dubljanin, E., Duko, B., Dwyer-Lindgren, L., Effiong, A., El Sayed Zaki, M., El Tantawi, M., Enany, S., Fattahi, N., Feigin, V. L., Fernandes, E., Ferrara, P., Fischer, F., Foigt, N. A., Folayan, M. O., Foroutan, M., Frostad, J. J., Fukumoto, T., Gaidhane, A. M., Gebrekrstos, H. G. G. K., Gebremeskel, L., Gebreslassie, A. A., Gething, P. W., Gezae, K. E., Ghadiri, K., Ghashghaee, A., Golechha, M., Gubari, M. I. M., Hadgu, F. B., Hamidi, S., Handiso, D. W., Hashi, A., Hassan, S., Hayat, K., Herteliu, C., Ho, H. C., Holla, R., Hosseinzadeh, M., Househ, M., Hussain, R., Hwang, B-F., Ibitoye, S. E., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Irvani, S. S. N., Jaafari, J., Javaheri, T., Jha, R. P., Johnson, K. B., Jonas, J. B., Jozwiak, J. J., Kabir, A., Kalhor, R., Kanchan, T., Karch, A., Kayode, G. A., Keiyoro, P. N., Khader, Y. S., Khalil, I. A., Khan, M. N., Khan, M., Khan, G., Khatab, K., Khater, M. M., Khatib, M. N., Kianipour, N., Kim, Y. J., Kimokoti, R. W., Kisa, S., Kisa, A., Kissoon, N., Kochhar, S., Koolivand, A., Kopec, J. A., Koyanagi, A., Krishan, K., Kumar, P., Kurmi, O. P., Kusuma, D. ORCID: 0000-0002-1909-9341, Lal, D. K., Lami, F. H., Landires, I., Lansingh, V. C., Lasrado, S., La Vecchia, C., Lazzar-Atwood, A., Lee, P. H., LeGrand, K. E., Lewycka, S., Li, B., Lim, S. S., Lindstedt, P. A., Liu, X., Longbottom, J., Lopez, A. D., Magdy Abd El Razek, H., Mahasha, P. W., Maleki, A., Mamun, A. A., Mansournia, M. A., Marczak, L. B., Martins-Melo, F. R., Mayala, B. K., Meharie, B. G., Melese, A., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mensah, G. A., Meretoja, T. J., Mestrovic, T., Miller, T. R., Mirrakhimov, E. M., Moazen, B., Mohammad Gholi Mezerji, N., Mohammadi, S., Mohammed, S., Mokdad, A. H., Moradi, M., Moradzadeh, R., Moraga, P., Mosser, J. F., Murray, C. J. L., Naderi, M., Nagarajan, A. J., Nazari, J., Ndejjo, R., Negoi, I., Ngunjiri, J. W., Nguyen, Q. P., Nguyen, H. L. T., Nnaji, C. A., Noubiap, J. J., Nunez-Samudio, V., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Omer, M. O., Onwujekwe, O. E., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., P A, M., Padubidri, J. R., Pana, A., Peprah, E. K., Pham, H. Q., Pigott, D. M., Pirestani, M., Postma, M. J., Pottoo, F. H., Pourjafar, H., Quazi Syed, Z., Rahim, F., Rahimi-Movaghar, V., Rahman, M. H. U., Rao, S. J., Rao, P. C., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Regassa, L. D., Renzaho, A. M. N., Rezaei, N., Rezai, M. S., Ribeiro, A. I., Rickard, J., Rios-Gonzalez, C. M., Rumisha, S. F., Sabour, S., Sajadi, S. M., Salomon, J. A., Samadi Kafil, H., Samy, A. M., Sanabria, J., Sartorius, B., Saxena, D., Schaeffer, L. E., Senthilkumaran, S., Sha, F., Shaheen, A. A., Shaikh, M. A., Sharma, R., Sheikh, A., Shibuya, K., Shigematsu, M., Il Shin, J., Simonetti, B., Singh, J. A., Smith, D., Soheili, A., Sokhan, A., Spurlock, E. E., Sreeramareddy, C. T., Sufiyan, M. B., Swartz, S. J., Tadesse, D. B., Tamiru, A. T., Tefera, Y. G., Temsah, M-H., Tessema, Z. T., Titova, M. V., Tran, B. X., Truong, P. N., Unnikrishnan, B., Upadhyay, E., Vasankari, T. J., Vasseghian, Y., Violante, F. S., Vu, G. T., Waheed, Y., Wamai, R. G., Wassie, E. G., Welay, F. T., Wickramasinghe, N. D., Wiens, K. E., Wijeratne, T., Wiysonge, C. S., Wondmeneh, T., Yamada, T., Yaya, S., Yeshitila, Y. G., Yip, P., Yonemoto, N., Yu, C., Yuce, D., Yusefzadeh, H., Zaidi, K., Zamanian, M., Zangeneh, A., Zhang, Z-J., Zhang, Y., Ziapour, A. & Hay, S. I. (2022). The overlapping burden of the three leading causes of disability and death in sub-Saharan African children. Nature Communications, 13(1), 7457. doi: 10.1038/s41467-022-34240-6

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.

Publication Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords: Child; Humans; Child, Preschool; Africa, Northern; Sub-Saharan African People
Subjects: D History General and Old World > DT Africa
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RC Internal medicine
R Medicine > RJ Pediatrics
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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