Clinical Review

Burden of infectious diseases in South Asia

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7443.811 (Published 01 April 2004) Cite this as: BMJ 2004;328:811
  1. Anita K M Zaidi ([email protected]), associate professor of paediatrics and microbiology1,
  2. Shally Awasthi, professor2,
  3. H Janaka deSilva, professor3
  1. 1 Department of Paediatrics, Aga Khan University, Karachi 74800, Pakistan
  2. 2 Department of Paediatrics, King George Medical University, Lucknow, India
  3. 3 Department of Medicine, Faculty of Medicine, University of Kelaniya, Sri Lanka
  1. Correspondence to: A K M Zaidi

    Infectious diseases are a major cause of death in South Asia, with children incurring a disproportionate share of the burden. This review discusses the underlying causes of some of the more common diseases and strategies to improve their detection and control

    Introduction

    Preventable infections are a major cause of deaths and disabilities in South Asia. Over two thirds of the estimated 3.7 million deaths in children in South Asia in the year 2000 were attributable to infections such as pneumonia, diarrhoea, and measles.1 2 India now has the second largest population with AIDS and HIV infection in the world, and tuberculosis and chronic hepatitis continue to threaten the lives of millions. Of the overall burden of deaths related to infectious disease in the region, around 63% are in children aged under 5 years.3 Serious effort should be devoted to the control of infectious disease if South Asian countries are to meet their millennium development goal of two thirds reduction in child mortality by 2015.

    Sri Lanka alone among South Asian countries has made remarkable progress in reducing the burden of infectious disease, despite civil war and meagre resources.

    This review describes the burden of infectious diseases of public health importance in South Asia, the underlying risk factors, and strategies to improve detection and control.

    Sources and selection criteria

    We searched PubMed and the databases of the World Health Organization and Unicef for information on infectious diseases of public health importance in South Asia. We also reviewed the bibliographies of key references and reviews for relevant information.

    Risk factors for disease and death

    People in South Asia are at a higher risk of developing infectious diseases and dying from their illness than people in industrialised countries.3 The root causes are poverty and its associated problems of unhygienic living conditions, malnutrition, illiteracy, and poor access to clean water, toilet facilities, …

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