ArticleThe Lancet. Infectious diseases2018
Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016.
Article in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 787 papers, 8 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness-Implementation Research to Assess the Effect of Prompting the Supply of Zinc/LO-ORS Co-packs Through the Private Sector Coupled With Behavior Change Intervention on the Treatment of Uncomplicated Childhood Diarrhoea in Kenya
Double-blind, Placebo-Controlled Trial Assessing the Efficacy and Safety of CampETEC Hyperimmune Bovine Colostrum (HBC) for the Prevention of Campylobacter-Mediated Diarrheal Diseases
The Efficacy and Safety of CMTS4520 for Chronic Diarrhoea in Adults： A Randomized, Double-Blind, Placebo-Controlled Trial.
The Efficacy and Safety of CMTS4520-Assisted Washed Microbiota Transplantation for Chronic Diarrhoea in Adults： a Randomized, Double-Blind, Placebo-Controlled Trial.
A Randomised, Controlled, Double-blind Exploratory Study of ND-12 Combined With H-6 in the Treatment of Adult Chronic Inflammatory Diarrhea
Who cites it
787 citing papers in PubMed, 8 syntheses or guidelines pooled it, 1,489 citations in OpenAlex.
- Burden ofBMJ global health · 2026Pooled it
- Acute kidney injury due to diarrhoeal diseases in children: a systematic review.BMJ paediatrics open · 2026Pooled it
- Parasitic colitis misdiagnosis as inflammatory bowel disease in high-income settings and association with poor clinical outcomes when exposed to corticosteroids: a systematic review of case reports.BMJ open gastroenterology · 2025Pooled it
- Effectiveness of infrastructural interventions to improve access to safe drinking water in Latin America and the Caribbean on the burden of diarrhoea in children <5 years: a systematic literature review and narrative synthesis.Global health action · 2025Pooled it
- Rotavirus vaccine coverage, completion, and compliance: A systematic literature review.Human vaccines & immunotherapeutics · 2025Pooled it
- Global childhood diarrhoea prevalence and its determinants: a systematic meta-analytic assessment, 1985-2024.EBioMedicine · 2025Pooled it
- A systematic review and meta-analysis of the global prevalence of human enteric adenovirus infections.Journal of infection and public health · 2025Pooled it
- Disease burden of rotavirus related diarrhea in children under 5 years in China: a meta-analysis.Scientific reports · 2025Pooled it
- A community-level complementary-food safety and hygiene intervention improves family-food preparation behaviours in rural Gambia: a follow-up of a cluster randomised controlled trial.BMJ global health · 2026Trial
- Effects of a Water, Sanitation, and Hygiene Program on Diarrhea, Cholera, and Child Growth in the Democratic Republic of the Congo: A Cluster-Randomized Controlled Trial of the Preventative Intervention for Cholera for 7 Days (PICHA7 WASHmobile) Mobile Health Program.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Trial
- Personalized azithromycin treatment rules for children with watery diarrhea using machine learning.Nature communications · 2025Trial
- Identifying risk factors for vomiting during diarrhea: A secondary analysis of a randomized trial of zinc supplementation.Journal of pediatric gastroenterology and nutrition · 2025Trial
- Associations Between Histo-blood Group Antigen Status in Mother-Infant Dyads and Infant Oral Rotavirus Vaccine Immunogenicity in Rural Zimbabwe.The Journal of infectious diseases · 2025Trial
- Effect of Group Antenatal Care on Breastfeeding Knowledge and Practices Among Pregnant Women in Ghana: Findings from a Cluster-Randomized Controlled Trial.International journal of environmental research and public health · 2024Trial
- Attenuating ETEC virulence using a heat-labile enterotoxin-blocking binding protein.Gut microbes · 2026Article
- Article
- Review
- Enteropathogen-specific pathways linking moderate-to-severe diarrhea to linear growth faltering in sub-Saharan African children: a decomposition analysis of the GEMS study.Tropical medicine and health · 2026Article
- Article
- Draft genome sequences of 22Microbiology resource announcements · 2026Article
727 more citing papers are in PubMed but not listed here.
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Funding
Abstract
backgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990-2016 and assesses how the burden of diarrhoea has changed in people of all ages.
methodsWe modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types on the basis of vital registration and verbal autopsy data. We modelled diarrhoea incidence with a compartmental meta-regression tool that enforces an association between incidence and prevalence, and relies on scientific literature, population representative surveys, and health-care data. Diarrhoea deaths and episodes were attributed to 13 pathogens by use of a counterfactual population attributable fraction approach. Diarrhoea risk factors are also based on counterfactual estimates of risk exposure and the association between the risk and diarrhoea. Each modelled estimate accounted for uncertainty.
findingsIn 2016, diarrhoea was the eighth leading cause of death among all ages (1 655 944 deaths, 95% uncertainty interval [UI] 1 244 073-2 366 552) and the fifth leading cause of death among children younger than 5 years (446 000 deaths, 390 894-504 613). Rotavirus was the leading aetiology for diarrhoea mortality among children younger than 5 years (128 515 deaths, 105 138-155 133) and among all ages (228 047 deaths, 183 526-292 737). Childhood wasting (low weight-for-height score), unsafe water, and unsafe sanitation were the leading risk factors for diarrhoea, responsible for 80·4% (95% UI 68·2-85·0), 72·1% (34·0-91·4), and 56·4% (49·3-62·7) of diarrhoea deaths in children younger than 5 years, respectively. Prevention of wasting in 1762 children (95% UI 1521-2170) could avert one death from diarrhoea.
interpretationSubstantial progress has been made globally in reducing the burden of diarrhoeal diseases, driven by decreases in several primary risk factors. However, this reduction has not been equal across locations, and burden among adults older than 70 years requires attention.
fundingBill & Melinda Gates Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.