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Simple measures could reduce diarrhea deaths in children

For most of us living in the developed world, diarrhea is an uncomfortable nuisance -- not a life-threatening event. But each year for more than a million children under the age of 5, it is a killer.

It’s known that a few simple precautions and treatments can make a difference and save a child. What’s been unknown, say researchers led by Christa Fischer Walker of the Johns Hopkins School of Public Health, is whether providing those interventions makes a difference on a large scale, cutting disease and death rates around the globe. Broad reductions in diarrhea deaths could help nations meet the United Nations’ fourth Millennium Development Goal: reducing child mortality to two-thirds of 1990 rates by 2015.

To project the interventions’ impact, Walker and colleagues used a computer program to model what happened when children in 68 target countries identified by the U.N. had access to 10 preventive measures and treatments known to reduce the number of diarrhea deaths: breastfeeding; vitamin A supplements; hand-washing with soap; improved sanitation; improved drinking water; better water treatment at home; rotavirus vaccination; and treatments with antibiotics, oral rehydration salts, and zinc. The team looked at two scenarios, one representing a relatively modest, “realizable” approach and a second representing a more aggressive “universal” program designed to help as many children as possible.

The researchers generated total numbers of diarrhea deaths assuming a gradual implementation of the preventive measures in the years 2010 through 2015. In both scenarios, diarrhea deaths plummeted over the five-year period. The more modest measures would decrease annual deaths 78%, from 1.39 million in 2010 to just 334,000 in 2015, the study reported. The universal effort was projected to decrease annual deaths 92%, to less than 115,000. In both scenarios, just over half of the lives saved would be in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and Afghanistan.

While financing and policy hurdles remain, the authors wrote, the results suggest that working to implement these prevention strategies could save many lives -- simply, and for just a few dollars per child. “These analyses remind us that reaching goals in reducing under-5 mortality does not require the development of new technologies or interventions; rather, these can be reached by implementing existing low-cost and effective interventions,” they wrote.

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Click here to read the study in PLoS Medicine.

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