August 30, 2020 Journal article Open Access

Local Burden of Disease Diarrhoea Collaborators*

DCAT Export

<?xml version='1.0' encoding='utf-8'?>
<rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" xmlns:adms="http://www.w3.org/ns/adms#" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dct="http://purl.org/dc/terms/" xmlns:dctype="http://purl.org/dc/dcmitype/" xmlns:dcat="http://www.w3.org/ns/dcat#" xmlns:duv="http://www.w3.org/ns/duv#" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:frapo="http://purl.org/cerif/frapo/" xmlns:geo="http://www.w3.org/2003/01/geo/wgs84_pos#" xmlns:gsp="http://www.opengis.net/ont/geosparql#" xmlns:locn="http://www.w3.org/ns/locn#" xmlns:org="http://www.w3.org/ns/org#" xmlns:owl="http://www.w3.org/2002/07/owl#" xmlns:prov="http://www.w3.org/ns/prov#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:schema="http://schema.org/" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:vcard="http://www.w3.org/2006/vcard/ns#" xmlns:wdrs="http://www.w3.org/2007/05/powder-s#">
  <rdf:Description rdf:about="https://nadre.ethernet.edu.et/record/8661">
    <dct:identifier rdf:datatype="http://www.w3.org/2001/XMLSchema#anyURI">https://nadre.ethernet.edu.et/record/8661</dct:identifier>
    <foaf:page rdf:resource="https://nadre.ethernet.edu.et/record/8661"/>
    <dct:creator>
      <rdf:Description>
        <rdf:type rdf:resource="http://xmlns.com/foaf/0.1/Agent"/>
        <foaf:name>Local Burden of Disease Diarrhoea Collaborators*</foaf:name>
      </rdf:Description>
    </dct:creator>
    <dct:title>Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17</dct:title>
    <dct:publisher>
      <foaf:Agent>
        <foaf:name>Zenodo</foaf:name>
      </foaf:Agent>
    </dct:publisher>
    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#gYear">2020</dct:issued>
    <dct:issued rdf:datatype="http://www.w3.org/2001/XMLSchema#date">2020-08-30</dct:issued>
    <owl:sameAs rdf:resource="https://nadre.ethernet.edu.et/record/8661"/>
    <adms:identifier>
      <adms:Identifier>
        <skos:notation rdf:datatype="http://www.w3.org/2001/XMLSchema#anyURI">https://nadre.ethernet.edu.et/record/8661</skos:notation>
        <adms:schemeAgency>url</adms:schemeAgency>
      </adms:Identifier>
    </adms:identifier>
    <owl:sameAs rdf:resource="https://doi.org/10.1016/S2214-109X(20)30230-8"/>
    <dct:description>&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the&lt;br&gt; potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger&lt;br&gt; than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of&lt;br&gt; recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent&lt;br&gt; child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but&lt;br&gt; subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and&lt;br&gt; absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs.&lt;br&gt; &lt;strong&gt;Methods &lt;/strong&gt;&lt;/p&gt; &lt;p&gt;We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys&lt;br&gt; across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received&lt;br&gt; ORS or RHF (or both) on continuous continent-wide surfaces in 2000&amp;ndash;17, and aggregated results to policy-relevant&lt;br&gt; administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and&lt;br&gt; estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the&lt;br&gt; mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and&lt;br&gt; creating uncertainty intervals (UIs) with the 2&amp;middot;5th and 97&amp;middot;5th percentiles of those 250 draws.&lt;br&gt; &lt;strong&gt;Findings&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage&lt;br&gt; remained below 50% in the majority (62&amp;middot;6%; 12 417 of 19 823) of second administrative-level units and an estimated&lt;br&gt; 6 519 000 children (95% UI 5 254 000&amp;ndash;7 733 000) with diarrhoea were not treated with any form of ORT in 2017.&lt;br&gt; Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall&lt;br&gt; ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, withincountry&lt;br&gt; geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units&lt;br&gt; compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in&lt;br&gt; diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910&amp;ndash;68 860) were averted by&lt;br&gt; scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria,&lt;br&gt; and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains&lt;br&gt; lower than average.&lt;br&gt; &lt;strong&gt;Interpretation&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and&lt;br&gt; ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress&lt;br&gt; over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can&lt;br&gt; support subnational needs assessments aimed at furthering policy makers&amp;rsquo; understanding of within-country&lt;br&gt; disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in&lt;br&gt; reducing mortality could still be made by reducing geographical inequalities in ORS coverage.&lt;/p&gt;</dct:description>
    <dct:accessRights rdf:resource="http://publications.europa.eu/resource/authority/access-right/PUBLIC"/>
    <dct:accessRights>
      <dct:RightsStatement rdf:about="info:eu-repo/semantics/openAccess">
        <rdfs:label>Open Access</rdfs:label>
      </dct:RightsStatement>
    </dct:accessRights>
    <dct:license rdf:resource="https://creativecommons.org/licenses/by-nc/4.0/"/>
    <dcat:distribution>
      <dcat:Distribution>
        <dcat:accessURL rdf:resource="https://doi.org/10.1016/S2214-109X(20)30230-8"/>
        <dcat:byteSize>6088098</dcat:byteSize>
        <dcat:downloadURL rdf:resource="https://nadre.ethernet.edu.et/record/8661/files/PIIS2214109X20302308.pdf"/>
        <dcat:mediaType>application/pdf</dcat:mediaType>
      </dcat:Distribution>
    </dcat:distribution>
  </rdf:Description>
</rdf:RDF>