Multiple studies show that
- Diarrhea and pneumonia impair children’s growth and that underlying malnutrition is a major risk factor for these conditions.
- “Episodes of diarrhea may predispose to pneumonia in undernourished children” and
- Immunization against influenza (in mothers) and Streptococcus pneumoniae may improve infant growth. In addition, new studies from Bangladesh, Colombia, Ghana, and Israel further support the paradigm that malnutrition is a key risk factor for diarrhea and pneumonia.
In a recent review of data from developing countries, researchers found that episodes of diarrhea may predispose undernourished children to pneumonia.
A study looking at the long term cognitive deficits faced by children in an urban Brazilian shantytown with high incidence of diarrhea in the first two years of life showed that this cohort scored significantly lower on 3/5 types of test measuring cognitive function at ages 6-10 compared to children who did not suffer recurrent bouts of early childhood diarrhea. In particular, the children who suffered from persistent early childhood diarrhea scored lower on tests assessing nonverbal intelligence (TONI) and IQ through assessing ability to match symbols to numbers (WISC-III Coding task) and short-term memory (WISC-III digit scan).
Two years after rotavirus vaccine introduction in Rwanda, the country saw nearly 400 fewer hospital admissions for diarrhea among young children at 24 district hospitals.
In Rwanda, the number of hospital admissions for diarrhea and rotavirus fell substantially after rotavirus vaccine (RVV) introduction, including among older children age-ineligible for vaccination. This suggests indirect protection through reduced transmission of rotavirus. Two years after RVV introduction, the country had nearly 400 fewer hospital admissions for diarrhea among young children.
In a study of children in a Brazilian shantytown, researchers found that the greater the number of episodes of persistent diarrhea before age two, the more delayed a child was in terms of school readiness. Overall, each episode of diarrhea delayed a child’s starting school by 0.7 months. Likewise, 6-10 years later, increasing episodes of diarrhea before age two predicted delays in age-appropriate educational attainment.
A prospective case-control study conducted in several developing countries found that children with moderate-to-severe diarrhea grew significantly less in length in the two months following their episode compared to age- and gender-matched controls.
A study of the economic burden of cholera in Africa found that 110,837 cases of cholera reported in 2007 resulted in an economic loss of $43.3 million, $60 million and $72.7 million US dollars, assuming life expediencies of 40, 53 and 73 years respectively.
This paper presents the first cost-benefit comparison of improved water supply investments and cholera vaccination programs. The modeling results showed that improved water supply interventions combined with targeted cholera vaccination programs are much more likely to yield attractive cost-benefit ratio outcomes than a community-based vaccination program alone.
In Malawi, in 17% of cases where children were admitted to the hospital, and in 9% of cases where children were treated as outpatients for diarrhea, household costs associated with treating that episode, exceeded monthly income in a significant number of cases. The costs were significant enough to push families from each income level below the national poverty line for the month in which the illness occurred.
