Deaths from diarrhea--a major killer of young children in poor countries--could be almost halved if already available interventions such as breastfeeding, hand washing with soap, and improved household water treatment were widely implemented.
In a study published in this week's PLoS Medicine, Christa Fischer Walker from the Johns Hopkins University Bloomberg School of Public Health, USA, and colleagues found that a complete package of interventions, including access to clean water and improved sanitation, would reduce child diarrhea deaths by up to 92% and would only cost just over US$3.24 per person--helping to meet the Millennium Development Goal (MDG) 4 target of reducing deaths in children aged under 5 years by two thirds by 2015.
The authors used the LiST (Lives Saved Tool) statistical model to estimate the number of child lives that could potentially be saved by widely implementing seven prevention interventions (breastfeeding, vitamin A supplementation, hand washing with soap, improved sanitation, improved water source, better household water treatment, and rotavirus vaccination) and three treatment interventions (oral rehydration solution, zinc supplementation, and antibiotics for dysentery) in 68 countries that together account for 95% of child deaths.
They found that a do-able increase in the coverage of all interventions would reduce child deaths due to diarrhea by 78% by 2015 at a cost of US$0.80 per capita. However, if these countries were able to provide all of their citizens with the package of interventions, by 2015, diarrhea deaths could be reduced by 92% at a cost of $3.24 per capita--averting nearly 5 million deaths.
The authors say: "Using currently available interventions, we demonstrate that with improved coverage, diarrheal deaths can be drastically reduced." They add: "To reach MDG4 by 2015, the number of child deaths needs to be reduced by an additional 4.6 million annually from the 2008 estimate of 8.8 million. Reducing diarrheal deaths by more than 1.4 million per year would be a major contribution toward this goal. "
Funding: This work was supported in part by a grant to the US Fund for UNICEF from the Bill & Melinda Gates Foundation (grant 43386) for the Child Health Epidemiology Reference Group to "Promote evidence-based decision making in designing maternal, neonatal and child health interventions in low- and middle income countries." The funders had no role in the study design, data collection, analysis, decision to publish or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Fischer Walker CL, Friberg IK, Binkin N, Young M, Walker N, et al. (2011) Scaling Up Diarrhea Prevention and Treatment Interventions: A Lives Saved Tool Analysis. PLoS Med 8(3): e1000428. doi:10.1371/journal.pmed.1000428
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Christa Fischer Walker
Johns Hopkins School of Public Health
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