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March 23, 2011

Most Diarrhea Deaths Preventable, Study Finds

by Art Chimes

Existing tools could save a million children a year

More than a million young children die each year from diarrhea, even though there's no secret about how to prevent or treat it. Now, public health experts report that the vast majority of those deaths could be prevented using currently available strategies.

The microbes that cause diarrheal disease spread through contaminated food and water, or through poor hygiene and sanitation.

Interventions from water and sewage systems to antibiotics and oral rehydration therapy have brought the death toll down from 4.5 million children a year in the early 1980s to about 1.3 million now. But further reductions have proved challenging, says Ingrid Friberg of the Johns Hopkins School of Public Health.

"The reason that this is a problem is not because we don't know what we can do; there are lots of things that we can do," she says. "It's more a matter of the cost and trying to figure out how to actually implement and make it happen in different countries."

Friberg is a co-author of a new report based on computer software that projects the impact of increased use of various interventions.

"With a conservative level of scale-up of 10 different interventions, we would be able to reduce the number of deaths by about 78 percent, to less than 400,000 [per year], compared to the 1.6 million that we're predicting in about the year 2015 if nothing else changes."

The software, called the Lives Saved Tool (LiST) projects the impact of each anti-diarrhea intervention on a country-by-country basis. Some of the simplest and cheapest ones can be extremely effective. Oral rehydration therapy costs just pennies, while others, like rotavirus vaccine, or building clean water systems, do cost more.

Friberg says she and her co-authors hope the new report will be used in a variety of ways. For example, it might help persuade donors to ramp up funding for anti-diarrhea programs.

"The other thing it's trying to do is to remind people who are solely focused on new interventions that there's a lot that we can do that's already available. We don't need to develop new things; we can use what we know," she says.