Reducing mortality from childhood pneumonia and diarrhoea: The leading priority is also the greatest opportunity

Abstract

Pneumonia and diarrhoea have been the leading causes of global child mortality for many decades. The work of Child Health Epidemiology Reference Group (CHERG) has been pivotal in raising awareness that the UN's Millennium Development Goal 4 cannot be achieved without increased focus on preventing and treating the two diseases in low– and middle–income countries. Global Action Plan for Pneumonia (GAPP) and Diarrhoea Global Action Plan (DGAP) groups recently concluded that addressing childhood pneumonia and diarrhoea is not only the leading priority but also the greatest opportunity in global health today: scaling up of existing highly cost–effective interventions could prevent 95% of diarrhoea deaths and 67% of pneumonia deaths in children younger than 5 years by the year 2025. The cost of such effort was estimated at about US$ 6.7 billion.

Deconstructing the differences: a comparison of GBD 2010 and CHERG’s approach to estimating the mortality burden of diarrhea, pneumonia, and their etiologies

“…To estimate the number of pneumonia deaths due to pneumococcus and Haemophilus influenzae type B (Hib), CHERG relied on meta-analyses of vaccine efficacy trials conducted by O’Brien et al [15] and Watt et al [9,16]. O’Brien et al used four vaccine trials to estimate mortality due to pneumococcus [18-21].…”

“…For Hib, Watt et al [16] included four studies, one each from the Gambia (individually randomized) [23], Indonesia (cluster randomized) [24], Bangladesh (case control) [25], and Chile (open cluster randomized) [26]. Rudan et al [9] estimated the fraction of deaths due to pneumococcus and Hib based upon the assumption that the fraction of all cases due to each etiologic agent was equal to the fraction of deaths due to that etiologic agent. Through the systematic review they estimated that 33.0% and 21.3% of pneumonia deaths were due to pneumococcus and Hib, respectively [9].…”

“…Rudan et al [9] estimated the fraction of deaths due to pneumococcus and Hib based upon the assumption that the fraction of all cases due to each etiologic agent was equal to the fraction of deaths due to that etiologic agent. Through the systematic review they estimated that 33.0% and 21.3% of pneumonia deaths were due to pneumococcus and Hib, respectively [9]. …”

“…CHERG noted that the estimates from two reviews of disease caused by RSV and influenza virus, based on work conducted by Nair et al [34,35], could not provide point estimates or confidence intervals, and consequently global and country-level etiologic estimates could not be made. Therefore, CHERG did not make country-level mortality estimates for RSV and influenza based on this study [9]. …”

Development of the Quality of Nursing Care Scale for Hospitalized Acute Respiratory Infection Children in Indonesia

“…The global incidence of ARIs in children is estimated to be 156 million new cases per year of which 151 million episodes occur in developing countries (Rudan, Nair, Marusic & Campbell 2013).…”