More than 1,300,000 deaths were attributable to diarrhea in 2015, with more than 400,000 of these deaths from children under 5 years of age. The Global Burden of Disease Study 2016 (GBD2016), an ongoing effort to measure global epidemiological trends, estimates diarrhea disease burden and the burden attributable to rotavirus and other enteric pathogens.
Diarrhea deaths are estimated using a suite of prediction models for all ages, both sexes, and for all countries and some subnational geographic areas from 1980 to 2016 using an ensemble modeling tool called CODEm. To estimate the burden of rotavirus, we calculated a population attributable fraction using a counter-factual approach by modeling the proportion of diarrheal cases that are positive for rotavirus and applying odds ratios describing the odds of diarrhea given rotavirus detection.
Results: In 2016, rotavirus was the leading cause of diarrhea mortality in children under 5 years old, responsible for 29.5% of diarrhea deaths in this age group (149,200 deaths, 95% Uncertainty Interval (UI): 119,200-189,400), and responsible for 15.3% of diarrhea deaths among all ages (202,300 deaths, 95% UI: 165,800-246,400). The population attributable fraction of diarrhea mortality due to rotavirus is generally stable across geographic regions. The global attributable fraction of rotavirus decreased by 24.2% (95% UI: 16.7-31.6%) between 2005 and 2016
The global deaths attributable to rotavirus in children under 5 is substantial and the burden in older children and adults may be unrecognized. GBD 2016 estimates describe epidemiological trends for rotavirus diarrhea and will inform evidence-based Public Health policy, to reduce the global burden of rotavirus. Our findings call for acceleration of delivery existing rotavirus vaccines and development of more affordable options for Low and Middle Income countries.
I. Abdel-Messih Khalil, None