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Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Malnutrition | Research

The burden of diarrhoeal diseases in the Democratic Republic of Congo: a time-series analysis of the global burden of disease study estimates (1990–2019)

Authors: Gloire O. Mbaka, Rute Vieira

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

Diarrhoeal diseases are important causes of disability and mortality being one of the main causes of mortality in the Democratic Republic of Congo (DRC). One of the largest and wealthiest African countries, DRC has been for long subjected to continuous political and economic instability, conflicts and disease outbreaks. This study aimed to address the knowledge gap in understanding how prevalence, mortality and burden of diseases in DRC changed over time and examine the influence of specific factors in these disease-related outcomes.

Methods

A time-series analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 estimates was performed to describe prevalence, years lived with disabilities (YLDs) and mortality due to diarrhoeal diseases, by age-group and sex, between 1990–2019 in DRC. The contribution of water, sanitation and hygiene (WASH) and child malnutrition risk factors to these outcomes was also analysed. Piecewise regression analysis was used to assess trends over time.

Results

The overall age-standardised prevalence of diarrhoeal diseases for both sexes in DRC was 1350.84 (UI:1240.16—1461.62) cases per 100,000 people in 1990. The prevalence increased until 2019, also fuelled by the movement of Rwandan refugees to DRC and First/Second Congo wars between 1996–2003. Age-standardised prevalence and mortality were consistently higher in males, compared to females, decreasing by 42% and 54%, respectively, between 1990 and 2019. Overall prevalence was also usually higher in over 70 years old, except between 1998–2003 when mortality in under five years old was the highest. Unsafe water sources and child wasting among under five years old were the main contributors to YLDs and deaths associated to diarrhoeal diseases in DRC.

Conclusion

Diarrhoeal diseases are important and preventable causes of disability and mortality in DRC. National measures of surveillance and cost-effective interventions targeting the identified risk groups could be effective in reducing its prevalence and associated burden.
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Literature
2.
go back to reference Kotloff KL, Blackwelder WC, Nasrin D, et al. The Global Enteric Multicenter Study (GEMS) of diarrhoeal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case/control study. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2012;55(Suppl 4):S232–45.CrossRef Kotloff KL, Blackwelder WC, Nasrin D, et al. The Global Enteric Multicenter Study (GEMS) of diarrhoeal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case/control study. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2012;55(Suppl 4):S232–45.CrossRef
3.
go back to reference World Health Organization. UNICEF/WHO, Diarrhoea: Why children are still dying and what can be done. Geneva, Switzerland: WHO; 2009. 978-92-806-4462-3, ISBN:978-92-4-159841-5. World Health Organization. UNICEF/WHO, Diarrhoea: Why children are still dying and what can be done. Geneva, Switzerland: WHO; 2009. 978-92-806-4462-3, ISBN:978-92-4-159841-5.
4.
go back to reference Kotloff KL, Platts-Mills JA, Nasrin D, Roose A, Blackwelder WC, Levine MM. Global burden of diarrhoeal diseases among children in developing countries: Incidence, etiology, and insights from new molecular diagnostic techniques. Vaccine. 2019;35(49 Pt A):6783–9. Kotloff KL, Platts-Mills JA, Nasrin D, Roose A, Blackwelder WC, Levine MM. Global burden of diarrhoeal diseases among children in developing countries: Incidence, etiology, and insights from new molecular diagnostic techniques. Vaccine. 2019;35(49 Pt A):6783–9.
6.
go back to reference Cha S, Lee J, Seo D, et al. Effects of improved sanitation on diarrhoeal reduction for children under five in Idiofa, DR Congo: a cluster randomized trial. Infect Dis Poverty. 2019;6:137.CrossRef Cha S, Lee J, Seo D, et al. Effects of improved sanitation on diarrhoeal reduction for children under five in Idiofa, DR Congo: a cluster randomized trial. Infect Dis Poverty. 2019;6:137.CrossRef
8.
go back to reference United Nations Economic Commission for Africa. Conflicts in the Democratic Republic of Congo: Causes, Impact and Implications for Great Lakes region. Ethiopia: Addis Ababa; 2015. ISBN:978–99944–61–75–2. United Nations Economic Commission for Africa. Conflicts in the Democratic Republic of Congo: Causes, Impact and Implications for Great Lakes region. Ethiopia: Addis Ababa; 2015. ISBN:978–99944–61–75–2.
9.
go back to reference World health Organization. Geneva, Switzerland. The Democratic Republic of Congo: quantifying the crisis. Past issues. Bull World Health Organ. 2009;87(1):1–80.CrossRef World health Organization. Geneva, Switzerland. The Democratic Republic of Congo: quantifying the crisis. Past issues. Bull World Health Organ. 2009;87(1):1–80.CrossRef
11.
go back to reference Kotloff KL, Blackwelder WC, Nasrin D, et al. The Global Enteric Multicenter Study (GEMS) of Diarrhoeal Disease in Infants and Young Children in Developing Countries: Epidemiologic and Clinical Methods of the Case/Control Study. Clin Infect Dis. 2012;55(4):S232–45.CrossRef Kotloff KL, Blackwelder WC, Nasrin D, et al. The Global Enteric Multicenter Study (GEMS) of Diarrhoeal Disease in Infants and Young Children in Developing Countries: Epidemiologic and Clinical Methods of the Case/Control Study. Clin Infect Dis. 2012;55(4):S232–45.CrossRef
12.
go back to reference Progress on household drinking water, sanitation and hygiene 2000–2017. Special focus on inequalities. New York: United Nations Children’s Fund (UNICEF) and World Health Organization, 2019. Progress on household drinking water, sanitation and hygiene 2000–2017. Special focus on inequalities. New York: United Nations Children’s Fund (UNICEF) and World Health Organization, 2019.
14.
go back to reference Public health impact of Rwandan refugee crisis. what happened in Goma, Zaire, in July 1994? Goma Epidemiology Group. Lancet (London, England). 1995;345(8946):339–44.CrossRef Public health impact of Rwandan refugee crisis. what happened in Goma, Zaire, in July 1994? Goma Epidemiology Group. Lancet (London, England). 1995;345(8946):339–44.CrossRef
16.
go back to reference Zivich P, Lapika B, Behets F, Yotebieng M. Implementation of Steps 1–9 to Successful Breastfeeding Reduces the Frequency of Mild and Severe Episodes of Diarrhoea and Respiratory Tract Infection Among 0–6 Month Infants in Democratic Republic of Congo. Matern Child Health J. 2018;22:762–71.CrossRef Zivich P, Lapika B, Behets F, Yotebieng M. Implementation of Steps 1–9 to Successful Breastfeeding Reduces the Frequency of Mild and Severe Episodes of Diarrhoea and Respiratory Tract Infection Among 0–6 Month Infants in Democratic Republic of Congo. Matern Child Health J. 2018;22:762–71.CrossRef
17.
go back to reference Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP) and ICF International. 2014. Democratic Republic of Congo Demographic and Health Survey 2013–14: Key Findings. Rockville, Maryland, USA: MPSMRM, MSP et ICF International. Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP) and ICF International. 2014. Democratic Republic of Congo Demographic and Health Survey 2013–14: Key Findings. Rockville, Maryland, USA: MPSMRM, MSP et ICF International.
18.
go back to reference Kabuya MS, Mukuku O, Van Geertruyden JP, et al. Maternal determinants of diarrhoea in children under five in Lubumbashi, Democratic Republic of the Congo. Déterminants maternels de la diarrhée chez les enfants de moins de cinq ans à Lubumbashi, République Démocratique du Congo. Med Sante Trop. 2019;29(3):273–8.PubMed Kabuya MS, Mukuku O, Van Geertruyden JP, et al. Maternal determinants of diarrhoea in children under five in Lubumbashi, Democratic Republic of the Congo. Déterminants maternels de la diarrhée chez les enfants de moins de cinq ans à Lubumbashi, République Démocratique du Congo. Med Sante Trop. 2019;29(3):273–8.PubMed
19.
go back to reference Pukuta ES, Esona MD, Nkongolo A, et al. Molecular surveillance of rotavirus infection in the Democratic Republic of the Congo August 2009 to June 2012. Pediatr Infect Dis J. 2014;33(4):355–9.CrossRef Pukuta ES, Esona MD, Nkongolo A, et al. Molecular surveillance of rotavirus infection in the Democratic Republic of the Congo August 2009 to June 2012. Pediatr Infect Dis J. 2014;33(4):355–9.CrossRef
20.
go back to reference Dikassa L, Mock N, Magnani R, et al. Maternal Behavioural Risk Factors for Severe Childhood Diarrhoeal Disease in Kinshasa. Zaire, International Journal of Epidemiology. 1993;22(2):P327-333.CrossRef Dikassa L, Mock N, Magnani R, et al. Maternal Behavioural Risk Factors for Severe Childhood Diarrhoeal Disease in Kinshasa. Zaire, International Journal of Epidemiology. 1993;22(2):P327-333.CrossRef
22.
go back to reference GBD 2019 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2018;392(10159):P1789-1858.CrossRef GBD 2019 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2018;392(10159):P1789-1858.CrossRef
23.
go back to reference GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease study 2016. Lancet. 2019;390:1151–210. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease study 2016. Lancet. 2019;390:1151–210.
26.
go back to reference Boyle P, Parkin D. Statisical Methods for Registries. Cancer Registration: Principles and Methods. 95th ed. Lyon: IARC Sci Publ; 2020. p. 126–58. Boyle P, Parkin D. Statisical Methods for Registries. Cancer Registration: Principles and Methods. 95th ed. Lyon: IARC Sci Publ; 2020. p. 126–58.
28.
go back to reference Murison J. The African Stakes of the Congo War. In: Clark JF, editor. The Politics of Refugees and Internally Displaced Persons in the Congo War. New York: Palgrave Macmillan; 2002. p. 225–37. Murison J. The African Stakes of the Congo War. In: Clark JF, editor. The Politics of Refugees and Internally Displaced Persons in the Congo War. New York: Palgrave Macmillan; 2002. p. 225–37.
30.
go back to reference Abuzerr S, Nasseri S, Yunesian M, et al. Prevalence of diarrhoeal illness and healthcare-seeking behavior by age-group and sex among the population of Gaza strip: a community-based cross-sectional study. BMC Public Health. 2019;19:704.CrossRef Abuzerr S, Nasseri S, Yunesian M, et al. Prevalence of diarrhoeal illness and healthcare-seeking behavior by age-group and sex among the population of Gaza strip: a community-based cross-sectional study. BMC Public Health. 2019;19:704.CrossRef
31.
go back to reference Boschi-Pinto C, Lanata CF, Mendoza W, Habte D. Diarrhoeal Diseases. In: Jamison DT, Feachem RG, Makgoba MW, et al., editors. Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2006. Chapter 9. Boschi-Pinto C, Lanata CF, Mendoza W, Habte D. Diarrhoeal Diseases. In: Jamison DT, Feachem RG, Makgoba MW, et al., editors. Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2006. Chapter 9.
32.
go back to reference Lawrence R, Schiller MD. Diarrhoea and Malabsorption in the elderly. Gastroenterol Clin N Am. 2009;38:481–502.CrossRef Lawrence R, Schiller MD. Diarrhoea and Malabsorption in the elderly. Gastroenterol Clin N Am. 2009;38:481–502.CrossRef
Metadata
Title
The burden of diarrhoeal diseases in the Democratic Republic of Congo: a time-series analysis of the global burden of disease study estimates (1990–2019)
Authors
Gloire O. Mbaka
Rute Vieira
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Malnutrition
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13385-5

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