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Published 25 September 2009, doi:10.1136/bmj.b3482
Cite this as: BMJ 2009;339:b3482
Getting it to communities at highest risk of mortality from diarrhoeal disease is the greatest challenge
| The first 150 words of the full text of this article appear below. |
Diarrhoeal disease causes around 17% of deaths in children under 5 years worldwide.1 Hence, effective interventions are crucial to reaching the fourth millennium development goal of reducing mortality by two thirds in children under 5 between 1990 and 2015.2 Oral rehydration therapy is a highly cost effective intervention and has been described as one of the most important public health advances of the 20th century. A packet of oral rehydration salts costs only a few cents. However, because of a breakdown of health services in some of the worlds poorest communities, its use is not expanding and is actually falling in some countries. As a result, children are still dying from this curable disease.
Rotavirus causes about a third of diarrhoea related mortality worldwide.3 The linked study by Rose and colleagues (doi:10.1136/bmj.b3653) shows that although a newly licensed oral rotavirus vaccine is considered to be cost effective in
U K Griffiths, lecturer in health economics , A D Clark, research fellow in mathematical modelling, K M Mulholland, professor of child health and epidemiology
1 London School of Hygiene and Tropical Medicine, London WC1E 7HT
ulla.griffiths@lshtm.ac.uk