Study Shows Decline in Diarrhoeal Disease Deaths Among Children Under 5 in India

New Delhi: India has achieved a remarkable reduction in mortality rates among children under five due to diarrhoeal diseases between 1990 and 2021, according to a global study published in The Lancet Infectious Diseases. The study highlights substantial progress in combating diarrhoeal mortality, showcasing India's success in reducing premature deaths and disability caused by these diseases.

The report, based on the Global Burden of Disease (GBD) analysis across 204 countries, was conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. It revealed that diarrhoeal disease-related deaths among Indian children under five fell from 147 per 100,000 population in 1990 to over 35 per 100,000 in 2021. Similarly, mortality rates among males ranged between 25 and 50 per 100,000, while for females, the range was between 50 and 100 per 100,000 in 2021.

Globally, diarrhoeal disease mortality decreased by 60% from 1990 to 2021, with the largest gains observed among children under five, who experienced a 79% decline. Despite this progress, children in this age group continue to have the highest mortality rates, followed by individuals aged 70 years and older. Sub-Saharan Africa and South Asia remain regions with the highest diarrhoeal disease burden.

The study emphasized that India, Nigeria, and Pakistan made the most significant strides in reducing disability-adjusted life-years (DALYs) due to diarrhoeal diseases, largely due to their population sizes. In India, DALYs dropped from 16.8 million in 1990 to 2.11 million in 2021. Comparatively, Nigeria saw a decline from 10.1 million to 164,000 DALYs, and Pakistan reported a reduction from 2.47 million to 152,000 DALYs over the same period.

The study identified multiple pathogens, including adenovirus, cholera, norovirus, rotavirus, salmonella, and shigella, as major contributors to diarrhoeal disease mortality and morbidity in India. Risk factors such as poor neonatal conditions, child growth failure, unsafe water, and inadequate sanitation were also highlighted as critical contributors to the disease burden.

Health interventions, including oral rehydration therapy, improved water, sanitation, and hygiene (WASH) infrastructure, and global immunization efforts, particularly against rotavirus, were credited for the decline in mortality and morbidity. However, the study stressed the need for a multipronged approach to address persistent challenges. This includes expanding access to WHO-recommended rotavirus vaccines and developing vaccines targeting specific diarrhoeal pathogens.

"In spite of the encouraging progress made in combating diarrhoeal mortality, a multipronged approach is required to simultaneously implement life-saving solutions while also prioritizing preventive interventions to alleviate burdens on health systems," Dr. Hmwe Hmwe Kyu, associate professor at IHME and study author told IANS.

In 2021, diarrhoeal diseases caused approximately 1.2 million deaths globally, a significant decline from 2.9 million in 1990. While children under five experienced the most substantial reductions, South Asia reported the highest mortality among older adults, with 476 deaths per 100,000 in those aged 70 and above.

The findings underscore the critical role of continued investments in preventive healthcare measures, including vaccination, improved sanitation, and enhanced public health infrastructure, in reducing diarrhoeal disease burdens worldwide.