Article

Global burden of childhood pneumonia and diarrhoea.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
The Lancet (Impact Factor: 39.21). 04/2013; DOI: 10.1016/S0140-6736(13)60222-6
Source: PubMed

ABSTRACT Diarrhoea and pneumonia are the leading infectious causes of childhood morbidity and mortality. We comprehensively reviewed the epidemiology of childhood diarrhoea and pneumonia in 2010-11 to inform the planning of integrated control programmes for both illnesses. We estimated that, in 2010, there were 1·731 billion episodes of diarrhoea (36 million of which progressed to severe episodes) and 120 million episodes of pneumonia (14 million of which progressed to severe episodes) in children younger than 5 years. We estimated that, in 2011, 700 000 episodes of diarrhoea and 1·3 million of pneumonia led to death. A high proportion of deaths occurs in the first 2 years of life in both diseases-72% for diarrhoea and 81% for pneumonia. The epidemiology of childhood diarrhoea and that of pneumonia overlap, which might be partly because of shared risk factors, such as undernutrition, suboptimum breastfeeding, and zinc deficiency. Rotavirus is the most common cause of vaccine-preventable severe diarrhoea (associated with 28% of cases), and Streptococcus pneumoniae (18·3%) of vaccine-preventable severe pneumonia. Morbidity and mortality from childhood pneumonia and diarrhoea are falling, but action is needed globally and at country level to accelerate the reduction.

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    ABSTRACT: Oxygen is an essential medicine for the treatment of pneumonia, the leading cause of death in children under five worldwide. Yet, providing a sufficient and reliable supply of oxygen is a major challenge for many health facilities in the developing world, particularly in paediatric care units. The cost-effectiveness of oxygen concentrators versus compressed gas cylinders as a source of oxygen in low-resource health facilities has been demonstrated, but evidence of their long- term functionality is scarce. The Biomedical Engineering De- partment at the Medical Research Council Unit in The Gam- bia manages and maintains 27 oxygen concentrators at several sites across the country, and has kept electronic records of all preventive maintenance checks and repairs on these devices since 2006. Through a retrospective analysis of these mainte- nance records, the objective of this study was to assess the long-term reliability and maintenance needs of oxygen con- centrators in a low-income setting with biomedical engineer- ing technologist support. We found that the majority of B. D. Bradley : S. Chow : Y.<L. Cheng Centre for Global Engineering, University of Toronto, Toronto, Canada B. D. Bradley (*) : Y.<L. Cheng Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada e-mail: bev.bradley@mail.utoronto.ca E. Nyassi Biomedical Engineering Department, Medical Research Council Unit The Gambia, Fajara, The Gambia D. Peel Ashdown Consultants, East Sussex, UK S. R. C. Howie Child Survival Theme, Medical Research Council Unit The Gambia, Fajara, The Gambia concentrator repairs are low-cost and require a low experience level to complete. We estimate that the useful lifespan of ox- ygen concentrators in low-resource settings could reasonably exceed 7 years provided a system is in place for routine pre- ventive maintenance. We conclude the paper with additional insights on the broader support ecosystem required to manage and maintain oxygen concentrators in low-resource settings.
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