The overlapping burden of the three leading causes of disability and death in sub-Saharan African children
Reiner RC., Welgan CA., Troeger CE., Baumann MM., Weiss DJ., Deshpande A., Blacker BF., Miller-Petrie MK., Earl L., Bhatt S., Abolhassani H., Abosetugn AE., Abu-Gharbieh E., Adekanmbi V., Adetokunboh OO., Aghaali M., Aji B., Alahdab F., Al-Aly Z., Alhassan RK., Ali S., Alizade H., Aljunid SM., Almasi-Hashiani A., Al-Mekhlafi HM., Altirkawi KA., Alvis-Guzman N., Amare AT., Amini S., Amugsi DA., Ancuceanu R., Andrei CL., Ansari F., Anvari D., Appiah SCY., Arabloo J., Aremu O., Atout MMW., Ausloos M., Ausloos F., Ayanore MA., Aynalem YA., Azene ZN., Badawi A., Baig AA., Banach M., Bedi N., Bhagavathula AS., Bhandari D., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhutta ZA., Bijani A., Birhanu TTM., Bitew ZW., Boloor A., Brady OJ., Butt ZA., Car J., Carvalho F., Casey DC., Chattu VK., Chowdhury MAK., Chu D-T., Coelho CH., Cook AJ., Damiani G., Daoud F., Gela JD., Darwish AH., Daryani A., Das JK., Davis Weaver N., Deribe K., Desalew A., Dharmaratne SD., 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 VL., Fernandes E., Ferrara P., Fischer F., Foigt NA., Folayan MO., Foroutan M., Frostad JJ., Fukumoto T., Gaidhane AM., Gebrekrstos HGGK., Gebremeskel L., Gebreslassie AA., Gething PW., Gezae KE., Ghadiri K., Ghashghaee A., Golechha M., Gubari MIM., Hadgu FB., Hamidi S., Handiso DW., Hashi A., Hassan S., Hayat K., Herteliu C., Ho HC., Holla R., Hosseinzadeh M., Househ M., Hussain R., Hwang B-F., Ibitoye SE., Ilesanmi OS., Ilic IM., Ilic MD., Irvani SSN., Jaafari J., Javaheri T., Jha RP., Johnson KB., Jonas JB., Jozwiak JJ., Kabir A., Kalhor R., Kanchan T., Karch A., Kayode GA., Keiyoro PN., Khader YS., Khalil IA., Khan MN., Khan M., Khan G., Khatab K., Khater MM., Khatib MN., Kianipour N., Kim YJ., Kimokoti RW., Kisa S., Kisa A., Kissoon N., Kochhar S., Koolivand A., Kopec JA., Koyanagi A., Krishan K., Kumar P., Kurmi OP., Kusuma D., Lal DK., Lami FH., Landires I., Lansingh VC., Lasrado S., La Vecchia C., Lazzar-Atwood A., Lee PH., LeGrand KE., Lewycka S., Li B., Lim SS., Lindstedt PA., Liu X., Longbottom J., Lopez AD., Magdy Abd El Razek H., Mahasha PW., Maleki A., Mamun AA., Mansournia MA., Marczak LB., Martins-Melo FR., Mayala BK., Meharie BG., Melese A., Mendoza W., Menezes RG., Mengesha EW., Mensah GA., Meretoja TJ., Mestrovic T., Miller TR., Mirrakhimov EM., Moazen B., Mohammad Gholi Mezerji N., Mohammadi S., Mohammed S., Mokdad AH., Moradi M., Moradzadeh R., Moraga P., Mosser JF., Murray CJL., Naderi M., Nagarajan AJ., Nazari J., Ndejjo R., Negoi I., Ngunjiri JW., Nguyen QP., Nguyen HLT., Nnaji CA., Noubiap JJ., Nuñez-Samudio V., Olagunju AT., Olusanya JO., Olusanya BO., Omer MO., Onwujekwe OE., Otstavnov N., Otstavnov SS., Owolabi MO., P A M., Padubidri JR., Pana A., Peprah EK., Pham HQ., Pigott DM., Pirestani M., Postma MJ., Pottoo FH., Pourjafar H., Quazi Syed Z., Rahim F., Rahimi-Movaghar V., Rahman MHU., Rao SJ., Rao PC., Rathi P., Rawaf S., Rawaf DL., Rawal L., Rawassizadeh R., Regassa LD., Renzaho AMN., Rezaei N., Rezai MS., Ribeiro AI., Rickard J., Rios-González CM., Rumisha SF., Sabour S., Sajadi SM., Salomon JA., Samadi Kafil H., Samy AM., Sanabria J., Sartorius B., Saxena D., Schaeffer LE., Senthilkumaran S., Sha F., Shaheen AA., Shaikh MA., Sharma R., Sheikh A., Shibuya K., Shigematsu M., Il Shin J., Simonetti B., Singh JA., Smith DL., Soheili A., Sokhan A., Spurlock EE., Sreeramareddy CT., Sufiyan MB., Swartz SJ., Tadesse DB., Tamiru AT., Tefera YG., Temsah M-H., Tessema ZT., Titova MV., Tran BX., Truong PN., Unnikrishnan B., Upadhyay E., Vasankari TJ., Vasseghian Y., Violante FS., Vu GT., Waheed Y., Wamai RG., Wassie EG., Welay FT., Wickramasinghe ND., Wiens KE., Wijeratne T., Wiysonge CS., Wondmeneh TG., Yamada T., Yaya S., Yeshitila YG., Yip P., Yonemoto N., Yu C., Yuce D., Yusefzadeh H., Zaidi Z., Zamanian M., Zangeneh A., Zhang Z-J., Zhang Y., Ziapour A., Hay SI.
AbstractDespite 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.