Abstract
Diarrhea is a leading cause of death and illness globally among children younger than 5 years. We used the Global Burden of Diseases, Injuries, and Risk Factors Study framework and leveraged existing estimates of diarrhoea incidence, childhood under nutrition, and infectious disease burden to estimate the effect of malnutrition on physical growth, including weight and height, and subsequent disease among children younger than 5 year. The burden of diarrhea was steady in disability-adjusted life-years (DALYs), a composite metric of morbidity and mortality We hypothesized that diarrhoea is negatively associated with three common markers of growth: weight-for-age, weight-for-height, and height-for-age Z-scores. Result showed that Diarrhoea episodes are significantly associated with childhood growth faltering. We found that each day of malnutrition was associated with height-for-age Z-score (-0·0033 [95% CI -0·0024 to -0·0041]; p=4·43 × 10-14), weight-for-age Z-score (-0·0077 [-0·0058 to -0·0097]; p=3·19 × 10-15), and weight-for-height Z-score (-0·0096 [-0·0067 to -0·0125]; p=7·78 × 10-11). was responsible for 55 778 000 DALYs (95% UI 49 125 400-62 396 200) among After addition of the DALYs due to the long-term sequelae as a consequence of undernutrition, the burden of malnutrition diseases increased by 39·0% (95% uncertainty interval [UI] 33·0-46·6) and was responsible for 55 778 000 DALYs (95% UI 49 125 400-62 396 200) among children younger than 5 years in 2016 Among the 15 652 300 DALYs (95% UI 12 951 300-18 806 100) associated with under nutrition due to malnutrition episodes, more than 84·7% are due to increased risk of infectious disease, whereas the remaining 15·3% of long-term DALYs are due to enhanced prevalence of protein energy malnutrition. The burden of malnutrition has decreased substantially since 1990, but progress has been greater in long-term (78·7% reduction [95% UI 69·3-85·5]) than in acute (70·4% reduction [95% UI 61·7-76·5]) DALYs.
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