Death rate due to diarrhoeal diseases declines in children under 5 in India: Study

New Delhi: India has seen a significant drop in mortality rates among children under five from diarrhoeal diseases between 1990 and 2021, according to a global report published in The Lancet Infectious Diseases journal on Thursday.

The country also has fewer children with lives lost due to premature mortality and disability due to diarrhoea during the same period, revealed the study based on the Global Burden of Disease (GBD) of 204 countries.

The findings, conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, showed that in India, about 147 deaths per 100,000 population were reported in children under five in 1990. These dropped to more than 38 deaths per 100,000 population in 2019 and over 35 deaths per 100,000 population in 2021.

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Further the death rate due to diarrhoeal diseases was between 25 and 50 per 100,000 population in males in India, while in females, it was between 50 and 100 per 100,000 population in 2021.

India, Nigeria, and Pakistan experienced the most gains due to their population sizes, with a decrease in disability-adjusted life-years (DALYs) for diarrhoeal diseases.

While India saw a drop from 16·8 million (12·0-24·2) to 2·11 million (0·644-4·56), Nigeria reported a decline from 10·1 million (6·93-13·9) to 164,000 (0-452,000), and Pakistan saw a reduction from 2·47 million (1·83-3·39) to 152,000 (35,600-363.000) in DALYs, the report said.

The report showed that adenovirus, aeromonas, campylobacter, cholera, clostridium difficile, cryptosporidium, norovirus, rotavirus, salmonella, and shigella were the bacteria and viruses responsible for diarrhoea-related mortality and disability in India.

Globally, the report observed a 60 per cent drop in mortality from diarrheal diseases, the study said. However, it reported the highest death rates in children and the elderly, particularly in sub-Saharan Africa and South Asia.

“In spite of the encouraging progress made combating diarrhoeal mortality, a multipronged approach is required to simultaneously tackle live-saving solutions while also prioritising preventive interventions to alleviate burdens on health systems,” said Dr. Hmwe Hmwe Kyu, study author, and associate professor at IHME.

In 2021, diarrhoeal diseases caused 1.2 million deaths worldwide, which is a substantial drop from 2.9 million deaths recorded in 1990. The largest decrease was among children under 5 years with a 79 per cent decline, but that age group still had the highest mortality rate among all ages, followed by those 70 years and older, making it a leading cause of death across all ages.

South Asia had the highest mortality rates among those aged 70 years and older with 476 deaths per 100,000.

Major risk factors for diarrhoeal DALYs include poor neonatal conditions such as low birthweight and preterm birth, child growth failure, unsafe water, and poor sanitation, the team said.

The decline in diarrheal mortality and morbidity suggests health interventions such as oral rehydration therapy, enhanced water, sanitation, and hygiene infrastructure, and global immunisation efforts against rotavirus are working.

The study also called for increasing adoption of WHO-recommended rotavirus vaccines; and the need to expand vaccine development to target specific pathogens that cause diarrhoeal diseases.