Diarrhoea deaths and disability-adjusted life years attributable to suboptimal breastfeeding practices in Nigeria: findings from the global burden of disease study 2016

Felix Akpojene Ogbo,Anselm Okoro,Bolajoko O Olusanya,Akorede O Awosemo,Pascal Ogeleka,Ifegwu K Ifegwu,Andrew Page,Jacob Olusanya

doi:10.1186/s13006-019-0198-9

Abstract

BackgroundIn Nigeria, diarrhoea contributes significantly to childhood morbidity and mortality, with suboptimal breastfeeding practices playing a key role. The present study aimed to report on diarrhoea deaths and disability-adjusted life years (DALYs) among children aged under five years attributable to suboptimal breastfeeding practices in Nigeria.MethodsThis study used data from the Global Burden of Disease study 2016, which estimated mortality from diarrhoea in the Cause of Death Ensemble model. Suboptimal breastfeeding was assessed as a combination of non-exclusive breastfeeding and discontinued breastfeeding. The comparative risk assessment approach was used to estimate the attributable burden of diarrhoea deaths and DALYs due to suboptimal breastfeeding practices in the spatial-temporal Gaussian Process Regression tool.ResultsIn 2016, suboptimal breastfeeding practices accounted for an estimated 56.5% (95% uncertainty intervals [UI]: 47.5, 68.3) of diarrhoea deaths in the late neonatal period, 39.0% (31.0, 46.3) in post-neonatal period, 39.0% (31.3, 46.20) in infancy period and 22.8% (16.9, 29.9) in children aged under five years in Nigeria. In the same year, 22,371 (14,259, 32,746) total diarrhoea deaths in children under five years could be attributed to suboptimal breastfeeding practices. DALYs from diarrhoea attributable to suboptimal breastfeeding practices was 1.9 million (1.2, 2.8 million) among children under five years in 2016. Between 1990 and 2016, the proportion of children who died from diarrhoea due to suboptimal breastfeeding did not change substantially across all age groups in Nigeria.ConclusionsSuboptimal breastfeeding practices remain a significant contributor to diarrhoea mortality and disability among children under five years in Nigeria. The study builds on previously published works on breastfeeding practices in Nigeria and provides evidence to support calls for the scale-up of efforts to improve infant feeding outcomes and reduce diarrhoea burden in Nigeria.

Highlights

In Nigeria, diarrhoea contributes significantly to childhood morbidity and mortality, with suboptimal breastfeeding practices playing a key role
Using the comparative risk assessment (CRA) approach as described by Murray and Lopez [17], the burden of diarrhoea morbidity and mortality attributable to suboptimal breastfeeding can be estimated to provide an in-depth understanding on the impact of suboptimal breastfeeding on diarrhoea among children aged under five years at the population level in Nigeria to inform policy decision-making processes
Diarrhoea deaths due to suboptimal breastfeeding practices In 2016, suboptimal breastfeeding practices accounted for 56.5% (95% uncertainty intervals [Uncertainty intervals (UI)]: 47.5, 68.3) of diarrhoea deaths in the late neonatal period, 39.0% (31.0, 46.3) in the post-neonatal period, 39.0% (31.3, 46.20) in infancy and 22.8% (16.9, 29.9) in children younger than five years in Nigeria (Fig. 1)

Summary

Introduction

In Nigeria, diarrhoea contributes significantly to childhood morbidity and mortality, with suboptimal breastfeeding practices playing a key role. The present study aimed to report on diarrhoea deaths and disability-adjusted life years (DALYs) among children aged under five years attributable to suboptimal breastfeeding practices in Nigeria. There is strong evidence for the protective effect of exclusive breastfeeding (EBF) on childhood diseases such as diarrhoea, a significant contributor to under-5 mortality in many developing countries, including Nigeria [1, 2]. Recent studies from Nigeria have suggested that optimal breastfeeding is protective against diarrhoeal diseases among children younger than five years of age [2, 12]. Since the 1970s, diarrhoea has remained a leading cause of deaths among children under five years in Nigeria [13,14,15], and the country has the second highest number of under-five mortality from diarrhoea worldwide, after India [14]

Methods

Results

Discussion

Conclusion