Incidence of acute diarrheal illness in Chinese communities: a meta-analysis

Pengwei Cui,Zhao-Jun Duan,Jingxin Li,Na Liu

doi:10.1186/s12876-018-0839-2

Pengwei Cui, Zhao-Jun Duan + Show 2 more

Open Access

https://doi.org/10.1186/s12876-018-0839-2

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Abstract

BackgroundAcute diarrheal illness (ADI) is an important public health problem worldwide. We estimated the morbidity, distribution, and burden of self-reported ADI in China over the last three decades.MethodsWe used the keywords “diarrhea and morbidity” to identify studies published in Chinese by searching CNKI, WANFANG, Chongqing VIP, and SinoMed. Studies published in English were identified using the keywords “diarrhea, morbidity, and China” to search Pubmed/Medline, Embase, and Cochrane Library Data. All articles published before Dec 31, 2014 were included in the search. Data were extracted and the pooled 2-week incidence rate of ADI was calculated using the fixed-effects or random-effects model according to statistical testing for homogeneity. The incidences of each subgroup (organized by age, location, study period) were also calculated. Publication bias was examined using Begg’s test. Data manipulation and statistical analyses were undertaken using R-2.15.1 software.ResultsWe estimated that the pooled 2-week prevalence of ADI in China was 2.04% (95% CI: 1.48–2.79) and that the corresponding incidence rate was 0.53 (95% CI: 0.38–0.73) episodes per person-year. The ADI rate was highest among children aged < 5 years (1.43 episodes per person-year), and it was slightly higher in males than in females (0.58 vs 0.52 episodes per person-year). From 1980 to 2012, there was a significant decrease in the incidence of ADI, from 0.82 to 0.48 episodes per person-year, but the ADI incidence was consistent over the last two decades. Additionally, the incidence of ADI was higher in rural areas and in west China and peaked in the summer months.ConclusionsThe current study indicates that ADI caused a substantial disease burden in China in the last 30 years, especially in rural areas and west China, where sanitation conditions were relatively poor. These findings highlight the importance of further investigation of the specific causes of and effective preventive measures for ADI.

Highlights

Acute diarrheal illness (ADI) is an important public health problem worldwide
Given the prevalence of ADI in the community, China has established several national diarrhea surveillance systems based in healthcare facilities or laboratories [9, 10], including the National Notifiable Disease Reporting System, the National Foodborne Diseases Surveillance
We excluded studies from the National Notifiable Disease Reported System of China because there is a high proportion of missing reports in the passive surveillance system, which leads to an underestimation of the ADI incidence [11]

Summary

Introduction

Acute diarrheal illness (ADI) is an important public health problem worldwide. Acute diarrheal illness (ADI) is a common and important public health problem worldwide [1, 2]. It is one of the leading causes of morbidity and mortality in children younger than 5 years of age (YOA) and is responsible for the deaths of about 577,508 children worldwide every year, predominantly in developing countries [3]. Given the prevalence of ADI in the community, China has established several national diarrhea surveillance systems based in healthcare facilities or laboratories [9, 10], including the National Notifiable Disease Reporting System, the National Foodborne Diseases Surveillance. Cross-sectional surveys in the community are a better way to estimate the burden of ADI [8, 13, 14]

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