| Title: |
Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17 |
| Authors: |
Wiens, KE; Lindstedt, PA; Blacker, BF; Johnson, KB; Baumann, MM; Schaeffer, LE; Abbastabar, H; Abd-Allah, F; Abdelalim, A; Abdollahpour, I; Abegaz, KH; Abejie, AN; Abreu, LG; Abrigo, MRM; Abualhasan, A; Accrombessi, MMK; Acharya, D; Adabi, M; Adamu, AA; Adebayo, OM; Adedoyin, RA; Adekanmbi, V; Adetokunboh, OO; Adhena, BM; Afarideh, M; Ahmad, S; Ahmadi, K; Ahmed, AE; Ahmed, MB; Ahmed, R; Akalu, TY; Alahdab, F; Al-Aly, Z; Alam, N; Alam, S; Alamene, GM; Alanzi, TM; Alcalde-Rabanal, JE; Ali, BA; Alijanzadeh, M; Alipour, V; Aljunid, SM; Almasi, A; Almasi-Hashiani, A; Al-Mekhlafi, HM; Altirkawi, KA; Alvis-Guzman, N; Alvis-Zakzuk, NJ; Amini, S; Amit, AML; Andrei, CL; Anjomshoa, M; Anoushiravani, A; Ansari, F; Antonio, CAT; Antony, B; Antriyandarti, E; Arabloo, J; Aref, HMA; Aremu, O; Armoon, B; Arora, A; Aryal, KK; Arzani, A; Asadi-Aliabadi, M; Atalay, HT; Athari, SS; Athari, SM; Atre, SR; Ausloos, M; Awoke, N; Ayala Quintanilla, BP; Ayano, G; Ayanore, MA; Aynalem, YA; Azari, S; Azzopardi, PS; Babaee, E; Babalola, TK; Badawi, A; Bairwa, M; Bakkannavar, SM; Balakrishnan, S; Bali, AG; Banach, M; Banoub, JAM; Barac, A; Bärnighausen, TW; Basaleem, H; Basu, S; Bay, VD; Bayati, M; Baye, E; Bedi, N; Beheshti, M; Behzadifar, M; Bekele, BB; Belayneh, YM; Bell, ML; Boufous, Soufiane; Jha, Vivekanand; Karki, Surendra; Biswas, Raaj Kishore; Naidoo, Kovin; Bhaumik, Soumyadeep; Resnikoff, Serge; Iqbal, Usman; Manohar, Narendar |
| Source: |
urn:ISSN:2572-116X ; urn:ISSN:2214-109X ; Lancet Global Health, 8, 8, e1038-e1060 |
| Publisher Information: |
Elsevier |
| Publication Year: |
2020 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
4206 Public Health; 42 Health Sciences; Clinical Research; Pediatric Research Initiative; 3 Good Health and Well Being; Bayes Theorem; Child; Preschool; Developing Countries; Diarrhea; Fluid Therapy; Geography; Health Care Surveys; Healthcare Disparities; Humans; Infant; Newborn; Models; Statistical; Local Burden of Disease Diarrhoea Collaborators; anzsrc-for: 4206 Public Health; anzsrc-for: 42 Health Sciences; anzsrc-for: 0605 Microbiology; anzsrc-for: 1117 Public Health and Health Services; anzsrc-for: 4202 Epidemiology; anzsrc-for: 4203 Health services and systems |
| Description: |
Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/unsworks_71708 |
| DOI: |
10.1016/S2214-109X(20)30230-8 |
| Availability: |
https://hdl.handle.net/1959.4/unsworks_71708; https://unsworks.unsw.edu.au/bitstreams/b3e8f17d-22b8-46bd-8740-e1e4db88240c/download; https://doi.org/10.1016/S2214-109X(20)30230-8 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read |
| Accession Number: |
edsbas.C7804ADE |
| Database: |
BASE |