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.J.; Deshpande, A.; Blacker, B.F.; Miller-Petrie, M.K.; Earl, L.; Bhatt, S.; Abolhassani, H.; Abosetugn, A.E.; 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.-.; Coelho, C.H.; 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.; H. C., H.; Holla, R.; Hosseinzadeh, M.; Househ, M.; Hussain, R.; Hwang, B.-.; 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.; 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.A.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.L.; 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.-.; Tessema, Z.T.; Titova, M.V.; Tran, B.X.; Truong, P.N.; Unnikrishnan, B.; Upadhyay, E.; Vasankari, T.J.; Vasseghian, Y.; Violante, F.S.; G. T., V.; Waheed, Y.; Wamai, R.G.; Wassie, E.G.; Welay, F.T.; Wickramasinghe, N.D.; Wiens, K.E.; Wijeratne, T.; Wiysonge, C.S.; Wondmeneh, T.G.; Yamada, T.; Yaya, S.; Yeshitila, Y.G.; Yip, P.; Yonemoto, N.; Yu, C.; Yuce, D.; Yusefzadeh, H.; Zaidi, Z.; Zamanian, M.; Zangeneh, A.; Zhang, Z.-.; Zhang, Y.; Ziapour, A.; Hay, S.I.

doi:10.1038/s41467-022-34240-6

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.

The overlapping burden of the three leading causes of disability and death in sub-Saharan African children / R.C. Reiner, C.A. Welgan, C.E. Troeger, M.M. Baumann, D.J. Weiss, A. Deshpande, B.F. Blacker, M.K. Miller-Petrie, L. Earl, S. Bhatt, H. Abolhassani, A.E. Abosetugn, E. Abu-Gharbieh, V. Adekanmbi, O.O. Adetokunboh, M. Aghaali, B. Aji, F. Alahdab, Z. Al-Aly, R.K. Alhassan, S. Ali, H. Alizade, S.M. Aljunid, A. Almasi-Hashiani, H.M. Al-Mekhlafi, K.A. Altirkawi, N. Alvis-Guzman, A.T. Amare, S. Amini, D.A. Amugsi, R. Ancuceanu, C.L. Andrei, F. Ansari, D. Anvari, S.C.Y. Appiah, J. Arabloo, O. Aremu, M.M.W. Atout, M. Ausloos, F. Ausloos, M.A. Ayanore, Y.A. Aynalem, Z.N. Azene, A. Badawi, A.A. Baig, M. Banach, N. Bedi, A.S. Bhagavathula, D. Bhandari, N. Bhardwaj, P. Bhardwaj, K. Bhattacharyya, Z.A. Bhutta, A. Bijani, T.T.M. Birhanu, Z.W. Bitew, A. Boloor, O.J. Brady, Z.A. Butt, J. Car, F. Carvalho, D.C. Casey, V.K. Chattu, M.A.K. Chowdhury, D.-. Chu, C.H. Coelho, A.J. Cook, G. Damiani, F. Daoud, J.D. Gela, A.H. Darwish, A. Daryani, J.K. Das, N. Davis Weaver, K. Deribe, A. Desalew, S.D. Dharmaratne, M. Dianatinasab, D. Diaz, S. Djalalinia, F. Dorostkar, E. Dubljanin, B. Duko, L. Dwyer-Lindgren, A. Effiong, M. El Sayed Zaki, M. El Tantawi, S. Enany, N. Fattahi, V.L. Feigin, E. Fernandes, P. Ferrara, F. Fischer, N.A. Foigt, M.O. Folayan, M. Foroutan, J.J. Frostad, T. Fukumoto, A.M. Gaidhane, H.G.G.K. Gebrekrstos, L. Gebremeskel, A.A. Gebreslassie, P.W. Gething, K.E. Gezae, K. Ghadiri, A. Ghashghaee, M. Golechha, M.I.M. Gubari, F.B. Hadgu, S. Hamidi, D.W. Handiso, A. Hashi, S. Hassan, K. Hayat, C. Herteliu, H.C. Ho, R. Holla, M. Hosseinzadeh, M. Househ, R. Hussain, B.-. Hwang, S.E. Ibitoye, O.S. Ilesanmi, I.M. Ilic, M.D. Ilic, S.S.N. Irvani, J. Jaafari, T. Javaheri, R.P. Jha, K.B. Johnson, J.B. Jonas, J.J. Jozwiak, A. Kabir, R. Kalhor, T. Kanchan, A. Karch, G.A. Kayode, P.N. Keiyoro, Y.S. Khader, I.A. Khalil, M.N. Khan, M. Khan, G. Khan, K. Khatab, M.M. Khater, M.N. Khatib, N. Kianipour, Y.J. Kim, R.W. Kimokoti, S. Kisa, A. Kisa, N. Kissoon, S. Kochhar, A. Koolivand, J.A. Kopec, A. Koyanagi, K. Krishan, P. Kumar, O.P. Kurmi, D. Kusuma, D.K. Lal, F.H. Lami, I. Landires, V.C. Lansingh, S. Lasrado, C. La Vecchia, A. Lazzar-Atwood, P.H. Lee, K.E. Legrand, S. Lewycka, B. Li, S.S. Lim, P.A. Lindstedt, X. Liu, J. Longbottom, A.D. Lopez, H. Magdy Abd El Razek, P.W. Mahasha, A. Maleki, A.A. Mamun, M.A. Mansournia, L.B. Marczak, F.R. Martins-Melo, B.K. Mayala, B.G. Meharie, A. Melese, W. Mendoza, R.G. Menezes, E.W. Mengesha, G.A. Mensah, T.J. Meretoja, T. Mestrovic, T.R. Miller, E.M. Mirrakhimov, B. Moazen, N. Mohammad Gholi Mezerji, S. Mohammadi, S. Mohammed, A.H. Mokdad, M. Moradi, R. Moradzadeh, P. Moraga, J.F. Mosser, C.J.L. Murray, M. Naderi, A.J. Nagarajan, J. Nazari, R. Ndejjo, I. Negoi, J.W. Ngunjiri, Q.A.P. Nguyen, H.L.T. Nguyen, C.A. Nnaji, J.J. Noubiap, V. Nunez-Samudio, A.T. Olagunju, J.O. Olusanya, B.O. Olusanya, M.O. Omer, O.E. Onwujekwe, N. Otstavnov, S.S. Otstavnov, M.O. Owolabi, M. P A, J.R. Padubidri, A. Pana, E.K. Peprah, H.Q. Pham, D.M. Pigott, M. Pirestani, M.J. Postma, F.H. Pottoo, H. Pourjafar, Z. Quazi Syed, F. Rahim, V. Rahimi-Movaghar, M.H.U. Rahman, S.J. Rao, P.C. Rao, P. Rathi, S. Rawaf, D.L. Rawaf, L. Rawal, R. Rawassizadeh, L.D. Regassa, A.M.N. Renzaho, N. Rezaei, M.S. Rezai, A.I. Ribeiro, J. Rickard, C.M. Rios-Gonzalez, S.F. Rumisha, S. Sabour, S.M. Sajadi, J.A. Salomon, H. Samadi Kafil, A.M. Samy, J. Sanabria, B. Sartorius, D. Saxena, L.E. Schaeffer, S. Senthilkumaran, F. Sha, A.A. Shaheen, M.A. Shaikh, R. Sharma, A. Sheikh, K. Shibuya, M. Shigematsu, J. Il Shin, B. Simonetti, J.A. Singh, D.L. Smith, A. Soheili, A. Sokhan, E.E. Spurlock, C.T. Sreeramareddy, M.B. Sufiyan, S.J. Swartz, D.B. Tadesse, A.T. Tamiru, Y.G. Tefera, M.-. Temsah, Z.T. Tessema, M.V. Titova, B.X. Tran, P.N. Truong, B. Unnikrishnan, E. Upadhyay, T.J. Vasankari, Y. Vasseghian, F.S. Violante, G.T. Vu, Y. Waheed, R.G. Wamai, E.G. Wassie, F.T. Welay, N.D. Wickramasinghe, K.E. Wiens, T. Wijeratne, C.S. Wiysonge, T.G. Wondmeneh, T. Yamada, S. Yaya, Y.G. Yeshitila, P. Yip, N. Yonemoto, C. Yu, D. Yuce, H. Yusefzadeh, Z. Zaidi, M. Zamanian, A. Zangeneh, Z.-. Zhang, Y. Zhang, A. Ziapour, S.I. Hay. - In: NATURE COMMUNICATIONS. - ISSN 2041-1723. - 13:1(2022 Dec 06), pp. 7457.1-7457.8. [10.1038/s41467-022-34240-6]

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. J.;Deshpande A.;Blacker B. F.;Miller-Petrie M. K.;Earl L.;Bhatt S.;Abolhassani H.;Abosetugn A. E.;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. H.;Cook A. J.;G. Damiani^{Membro del Collaboration Group};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.;S. Hassan^{Membro del Collaboration Group};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.;Lal D. K.;Lami F. H.;Landires I.;Lansingh V. C.;Lasrado S.;C. La Vecchia^{Membro del Collaboration Group};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. A. 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. L.;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. G.;Yamada T.;Yaya S.;Yeshitila Y. G.;Yip P.;Yonemoto N.;Yu C.;Yuce D.;Yusefzadeh H.;Zaidi Z.;Zamanian M.;Zangeneh A.;Zhang Z. -J.;Zhang Y.;Ziapour A.;Hay S. I.

2022

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.

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	Parole chiave
	
				Children mortality; Sub-Saharian Africa
			
	Settori scientifico-disciplinari dell'articolo (sola visualizzazione)
	
				Settore MED/01 - Statistica Medica
Settore MED/42 - Igiene Generale e Applicata
			
	Data di pubblicazione
	
				6-dic-2022
			
	Rivista in ANCE
	
				NATURE COMMUNICATIONS
			
	DOI
	
				https://dx.doi.org/10.1038/s41467-022-34240-6
			
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				01 - Articolo su periodico

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