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  1. Article ; Online: Brominated flame retardants and polychlorinated biphenyls in human breast milk from several locations in India

    Gnanasekaran Devanathan / Annamalai Subramanian / Agus Sudaryanto / Shin Takahashi / Tomohiko Isobe / Shinsuke Tanabe

    Environment International, Vol 39, Iss 1, Pp 87-

    Potential contaminant sources in a municipal dumping site

    2012  Volume 95

    Abstract: This study investigated the status of contamination of organohalogen compounds (OCs) such as polychlorinated biphenyls (PCBs) and brominated flame retardant (BFRs), including polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) in ... ...

    Abstract This study investigated the status of contamination of organohalogen compounds (OCs) such as polychlorinated biphenyls (PCBs) and brominated flame retardant (BFRs), including polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) in human milk samples from several locations in India. The levels of OCs were significantly higher in the milk of mothers living in and near municipal dumping site than other locations indicating that the open dumping sites for municipal wastes act as potential sources of these contaminants in India. The PCB concentrations observed in this study tended to decrease compared to those in the matched locations reported previously, probably due to the restriction of technical PCB usage in India. PBDE levels in human milk were two to three folds lower than those of PCBs in all the sampling locations investigated. Congener profiles of PCBs and PBDEs were different between samples from the dumping site mothers and general populations in other areas suggesting the presence of region-specific sources and pathways. HBCDs were detected in human milk from only two sites, with much lower concentrations and detection frequencies compared to PCBs and PBDEs. When hazard quotients (HQs) of PCBs and PBDEs were estimated for infant health risk, the HQs in some milk samples from the dumping site exceeded the threshold value (HQ>1) of PCBs, indicating the potential risk for infants in the specific site. Keywords: PCBs, PBDEs, HBCDs, Human milk, Dumping site, India
    Keywords Environmental sciences ; GE1-350
    Subject code 333
    Language English
    Publishing date 2012-02-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Contamination of indoor dust and air by polychlorinated biphenyls and brominated flame retardants and relevance of non-dietary exposure in Vietnamese informal e-waste recycling sites

    Nguyen Minh Tue / Shin Takahashi / Go Suzuki / Tomohiko Isobe / Pham Hung Viet / Yuso Kobara / Nobuyasu Seike / Gan Zhang / Agus Sudaryanto / Shinsuke Tanabe

    Environment International, Vol 51, Iss , Pp 160-

    2013  Volume 167

    Abstract: This study investigated the occurrence of polychlorinated biphenyls (PCBs), and several additive brominated flame retardants (BFRs) in indoor dust and air from two Vietnamese informal e-waste recycling sites (EWRSs) and an urban site in order to assess ... ...

    Abstract This study investigated the occurrence of polychlorinated biphenyls (PCBs), and several additive brominated flame retardants (BFRs) in indoor dust and air from two Vietnamese informal e-waste recycling sites (EWRSs) and an urban site in order to assess the relevance of these media for human exposure. The levels of polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCD), 1,2-bis-(2,4,6-tribromophenoxy)ethane (BTBPE) and decabromodiphenyl ethane (DBDPE) in settled house dust from the EWRSs (130–12,000, 5.4–400, 5.2–620 and 31–1400 ng g−1, respectively) were significantly higher than in urban house dust but the levels of PCBs (4.8–320 ng g−1) were not higher. The levels of PCBs and PBDEs in air at e-waste recycling houses (1000–1800 and 620–720 pg m−3, respectively), determined using passive sampling, were also higher compared with non-e-waste houses. The composition of BFRs in EWRS samples suggests the influence from high-temperature processes and occurrence of waste materials containing older BFR formulations. Results of daily intake estimation for e-waste recycling workers are in good agreement with the accumulation patterns previously observed in human milk and indicate that dust ingestion contributes a large portion of the PBDE intake (60%–88%), and air inhalation to the low-chlorinated PCB intake (>80% for triCBs) due to their high levels in dust and air, respectively. Further investigation of both indoor dust and air as the exposure media for other e-waste recycling-related contaminants and assessment of health risk associated with exposure to these contaminant mixtures is necessary. Keywords: Air, BFRs, e-Waste, House dust, PCBs, Vietnam
    Keywords Environmental sciences ; GE1-350
    Subject code 333
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Organophosphorus flame retardants (PFRs) in human breast milk from several Asian countries

    Kim, Joon-Woo / Tomohiko Isobe / Mamoru Muto / Nguyen Minh Tue / Kana Katsura / Govindan Malarvannan / Agus Sudaryanto / Kwang-Hyeon Chang / Maricar Prudente / Pham Hung Viet / Shin Takahashi / Shinsuke Tanabe

    Chemosphere. 2014 Dec., v. 116

    2014  

    Abstract: In this study, the concentrations of 10 organophosphorus flame retardants (PFRs) were determined in 89 human breast milk samples collected from Japan, the Philippines and Vietnam. Among the targeted PFRs, tris(2-chloroexyl) phosphate (TCEP) and triphenyl ...

    Abstract In this study, the concentrations of 10 organophosphorus flame retardants (PFRs) were determined in 89 human breast milk samples collected from Japan, the Philippines and Vietnam. Among the targeted PFRs, tris(2-chloroexyl) phosphate (TCEP) and triphenyl phosphate (TPHP) were the predominant compounds and were detected in more than 60% of samples in all three countries. The concentrations of PFRs in human breast milk were significantly higher (p<0.05) in the Philippines (median 70ngg−1lipidwt.) than those in Japan (median 22ngg−1lipidwt.) and Vietnam (median 10ngg−1lipidwt.). The present results suggest that the usage of products containing PFRs in the Philippines is higher than those of Japan and Vietnam. Comparing with a previous literature survey in Sweden, the levels of PFRs in human breast milk from the Philippines were 1.5–2 times higher, whereas levels in Japan and Vietnam were 4–20 times lower, suggesting that these differences might be due to their variation in the usage of flame-retarded products utilized in each country. When daily intake of PFRs to infants via human breast milk was estimated, some individuals accumulated tris(2-butoxyethyl) phosphate (TBOEP) and TCEP were close to reference dose (RfD). This is the first report to identify PFRs in human breast milk samples from Asian countries.
    Keywords breast milk ; flame retardants ; infants ; phosphates ; surveys ; Japan ; Philippines ; Sweden ; Vietnam
    Language English
    Dates of publication 2014-12
    Size p. 91-97.
    Publishing place Elsevier Ltd
    Document type Article
    ZDB-ID 120089-6
    ISSN 1879-1298 ; 0045-6535 ; 0366-7111
    ISSN (online) 1879-1298
    ISSN 0045-6535 ; 0366-7111
    DOI 10.1016/j.chemosphere.2014.02.033
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: Levels and distribution of organochlorines in fish from Indonesia

    Agus Sudaryanto / In Monirith / Natsuko Kajiwara / Shin Takahashi / Philippus Hartono / Muawanah / Koji Omori / Hidetaka Takeoka / Shinsuke Tanabe

    Environment International, Vol 33, Iss 6, Pp 750-

    2007  Volume 758

    Abstract: Organochlorines such as PCBs, DDTs, HCHs, CHLs and HCB were determined in pooled whole body homogenized of fish samples collected from five locations during 1998 and 2003 in order to understand their contamination status, temporal and spatial variation ... ...

    Abstract Organochlorines such as PCBs, DDTs, HCHs, CHLs and HCB were determined in pooled whole body homogenized of fish samples collected from five locations during 1998 and 2003 in order to understand their contamination status, temporal and spatial variation in Indonesian waters. PCBs and DDTs were the predominant contaminants with concentrations from 9.7 to 2700 ng/g lipid wt. and 12 to 1100 ng/g lipid wt., respectively, while HCHs (nd-24 ng/g lipid wt.), CHL compounds (nd-81 ng/g lipid wt.) and HCB (0.22–28 ng/g lipid wt.) were one to two orders of magnitude lower. Among the locations, PCBs and CHLs were higher in the samples from highly industrialized and thickly populated-locations, whereas OC pesticides such as DDTs and HCHs were particularly more prominent in suburban and rural areas. Levels of OCs observed in the waters surrounding Java Island were higher than those in Sumatra Island, implying significant use of OCs in highly populated Java Island. Concentrations of PCBs and DDTs in fish from Jakarta Bay were significantly lower in the samples collected in 2003 as compared to fish in 1998, indicating decreasing trend of these compounds in the Indonesian environment. Recent estimated average daily intakes of PCBs (0.81 μg/person/day), DDTs (1.1 μg/person/day), HCHs (0.018 μg/person/day), CHLs (0.010 μg/person/day) were much lower than the threshold values recommended by various agencies, suggesting minimal risk of this compound via fish ingestion to Indonesians. Keywords: Fish, Organochlorines, Contamination, Distribution, Daily intake, Risk assessment
    Keywords Environmental sciences ; GE1-350
    Subject code 910
    Language English
    Publishing date 2007-08-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Human exposure to PCBs, PBDEs and HBCDs in Ghana

    Kwadwo Ansong Asante / Sam Adu-Kumi / Kenta Nakahiro / Shin Takahashi / Tomohiko Isobe / Agus Sudaryanto / Gnanasekaran Devanathan / Edith Clarke / Osmund Duodu Ansa-Asare / Stephen Dapaah-Siakwan / Shinsuke Tanabe

    Environment International, Vol 37, Iss 5, Pp 921-

    Temporal variation, sources of exposure and estimation of daily intakes by infants

    2011  Volume 928

    Abstract: Human exposure to polychlorinated biphenyls (PCBs) and brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) was evaluated in Ghana using breast milk samples collected in 2004 and 2009. Mean ...

    Abstract Human exposure to polychlorinated biphenyls (PCBs) and brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) was evaluated in Ghana using breast milk samples collected in 2004 and 2009. Mean levels and ranges of PBDEs (4.5; 0.86–18 ng/g lw) and PCBs (62; 15–160 ng/g lw) observed in the present study were unexpectedly high, in spite of the fact that Ghana is a non-industrialized country when compared with many of the Asian and European countries. Significant increases were found in the concentrations of PCBs and PBDEs over the years, while no significant increase was observed for HBCDs. Estimated hazard quotient (HQ) showed that all the mothers had HQ values exceeding the threshold of 1 for PCBs, indicating potential health risk for their children. PCBs in dirty oils and obsolete equipment should be of concern as potential sources in Ghana, and e-waste recycling with little or no experience in safe handling could be a threat to this sub-region noted for unregulated disposal of e-waste. The results may point towards an increase in trends in human milk in Ghana, especially in the larger cities but further analysis would be required to confirm this upward trend in levels. This is the first study to report BFRs in human breast milk from Africa, and undoubtedly from Ghana. Keywords: BFRs, PBDEs, HBCDs, PCBs, Human breast milk, Ghana
    Keywords Environmental sciences ; GE1-350
    Subject code 333
    Language English
    Publishing date 2011-07-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

    Kirsten E Wiens / Paulina A Lindstedt / Brigette F Blacker / Kimberly B Johnson / Mathew M Baumann / Lauren E Schaeffer / Hedayat Abbastabar, Sr / Foad Abd-Allah / Ahmed Abdelalim / Ibrahim Abdollahpour / Kedir Hussein Abegaz / Ayenew Negesse Abejie / Lucas Guimarães Abreu / Michael R M Abrigo / Ahmed Abualhasan / Manfred Mario Kokou Accrombessi / Dilaram Acharya / Maryam Adabi / Abdu A Adamu /
    Oladimeji M Adebayo / Rufus Adesoji Adedoyin, Sr / Victor Adekanmbi / Olatunji O Adetokunboh, Sr / Beyene Meressa Adhena / Mohsen Afarideh / Sohail Ahmad / Keivan Ahmadi / Anwar E Ahmed / Muktar Beshir Ahmed / Rushdia Ahmed / Temesgen Yihunie Akalu / Fares Alahdab / Ziyad Al-Aly / Noore Alam, Sr / Samiah Alam / Genet Melak Alamene / Turki M Alanzi / Jacqueline Elizabeth Alcalde-Rabanal / Beriwan Abdulqadir Ali / Mehran Alijanzadeh / Vahid Alipour / Syed Mohamed Aljunid / Ali Almasi, Sr / Amir Almasi-Hashiani / Hesham M Al-Mekhlafi / Khalid A Altirkawi / Nelson Alvis-Guzman / Nelson J Alvis-Zakzuk / Saeed Amini, Sr / Arianna Maever L Amit, Sr / Catalina Liliana Andrei, Sr / Mina Anjomshoa / Amir Anoushiravani, Sr / Fereshteh Ansari / Carl Abelardo T Antonio / Benny Antony / Ernoiz Antriyandarti / Jalal Arabloo / Hany Mohamed Amin Aref, Sr / Olatunde Aremu / Bahram Armoon / Amit Arora, Sr / Krishna K Aryal / Afsaneh Arzani / Mehran Asadi-Aliabadi / Hagos Tasew Atalay / Seyyed Shamsadin Athari, Sr / Seyyede Masoume Athari / Sachin R Atre / Marcel Ausloos / Nefsu Awoke / Beatriz Paulina Ayala Quintanilla / Getinet Ayano / Martin Amogre Ayanore, Sr / Yared Asmare Aynalem IV / Samad Azari / Peter S Azzopardi / Ebrahim Babaee / Tesleem Kayode Babalola / Alaa Badawi, Sr / Mohan Bairwa / Shankar M Bakkannavar / Senthilkumar Balakrishnan / Ayele Geleto Bali / Maciej Banach, Sr / Joseph Adel Mattar Banoub, Sr / Aleksandra Barac / Till Winfried Bärnighausen / Huda Basaleem / Sanjay Basu / Vo Dinh Bay / Mohsen Bayati / Estifanos Baye / Neeraj Bedi / Mahya Mahya Beheshti Beheshti / Masoud Behzadifar / Meysam Behzadifar / Bayu Begashaw Bekele / Yaschilal Muche Belayneh / Michellr L Bell, Sr / Derrick A Bennett, Sr / Dessalegn Ajema Berbada / Robert S Bernstein / Anusha Ganapati Bhat, Sr / Krittika Bhattacharyya, Sr / Suraj Bhattarai / Soumyadeep Bhaumik / Zulfiqar A Bhutta / Ali Bijani / Boris Bikbov / Binyam Minuye Birihane IV / Raaj Kishore Biswas / Somayeh Bohlouli / Hunduma Amensisa Amensisa Bojia I / Soufiane Boufous / Oliver J Brady / Nicola Luigi Bragazzi / Andrey Nikolaevich Briko / Nikolay Ivanovich Briko / Gabrielle B Britton / Sharath Burugina Nagaraja, Sr / Reinhard Busse, Sr / Zahid A Butt / Luis LA Alberto Cámera, Sr / Ismael R Campos-Nonato, Sr / Jorge Cano / Josip Car / Rosario Cárdenas / Felix Carvalho, Sr / Carlos A Castañeda-Orjuela, Sr / Franz Castro / Wagaye Fentahun Chanie, Sr / Pranab Chatterjee / Vijay Kumar Chattu / Tesfaye Yitna Yitna Chichiabellu, Jr / Ken Lee Chin, Sr / Devasahayam J Christopher / Dinh-Toi Chu / Natalie Maria Cormier / Vera Marisa Costa / Carlos Culquichicon / Matiwos Soboka Daba / Giovanni Damiani, Sr / Lalit Dandona / Rakhi Dandona / Anh Kim Dang / Aso Mohammad Darwesh / Amira Hamed Darwish / Ahmad Daryani, Sr / Jai K Das / Rajat Das Gupta / Aditya Prasad Dash / Gail Davey / Claudio Alberto Dávila-Cervantes / Adrian C Davis, Sr / Dragos Virgil Davitoiu / Fernando Pio De la Hoz / Asmamaw Bizuneh Demis / Dereje Bayissa Demissie / Getu Debalkie Demissie / Gebre Teklemariam Demoz, Sr / Edgar Denova-Gutiérrez, Sr / Kebede Deribe, Sr / Assefa Desalew / Aniruddha Deshpande / Samath Dhamminda Dharmaratne / Preeti Dhillon / Meghnath Dhimal / Govinda Prasad Dhungana / Daniel Diaz, Sr / Isaac Oluwafemi Dipeolu / Shirin Djalalinia / Kerrie E Doyle / Eleonora Dubljanin / Bereket Duko / Andre Rodrigues Duraes / Mohammad Ebrahimi Kalan / Hisham Atan Edinur, Sr / Andem Effiong, Sr / Aziz Eftekhari / Nevine El Nahas / Iman El Sayed / Maysaa El Sayed Zaki / Maha El Tantawi / Teshome Bekele Elema I / Hala Rashad Elhabashy, Sr / Shaimaa I El-Jaafary / Hajer Elkout / Aisha Elsharkawy / Iqbal RF Elyazar / Aklilu Endalamaw / Daniel Adane Endalew, Sr / Sharareh Eskandarieh / Alireza Esteghamati / Sadaf Esteghamati, Sr / Arash Etemadi / Oluchi Ezekannagha / Mohammad Fareed / Roghiyeh Faridnia / Farshad Farzadfar / Mehdi Fazlzadeh / Valery L Feigin, Sr / Seyed-Mohammad Fereshtehnejad / Eduarda Fernandes / Irina Filip / Florian Fischer / Nataliya A Foigt / Morenike Oluwatoyin Folayan, Sr / Masoud Foroutan / Richard Charles Franklin / Takeshi Fukumoto / Mohamed M Gad / Reta Tsegaye Gayesa / Teshome Gebre, Sr / Ketema Bizuwork Gebremedhin / Gebreamlak Gebremedhn Gebremeskel, Sr / Hailay Abrha Gesesew / Kebede Embaye Gezae / Keyghobad Ghadiri, Sr / Ahmad Ghashghaee / Pramesh Raj Ghimire, Sr / Paramjit Singh Gill, Sr / Tiffany K Gill / Themba G G Ginindza / Nelson G M Gomes / Sameer Vali Gopalani / Alessandra C Goulart / Bárbara Niegia Garcia Goulart / Ayman Grada / Mohammed Ibrahim Mohialdeen Gubari / Harish Chander Gugnani, Sr / Davide Guido / Rafael Alves Guimarães / Yuming Guo, Sr / Rajeev Gupta / Nima Hafezi-Nejad / Dessalegn H Haile, Sr / Gessessew Bugssa Hailu / Arvin Haj-Mirzaian / Arya Haj-Mirzaian / Randah R Hamadeh / Samer Hamidi / Demelash Woldeyohannes Handiso / Hamidreza Haririan, Sr / Ninuk Hariyani / Ahmed I Hasaballah / Md Mehedi Hasan / Edris Hasanpoor / Amir Hasanzadeh / Hadi Hassankhani / Hamid Yimam Hassen / Mohamed I Hegazy / Behzad Heibati / Behnam Heidari / Delia Hendrie, Sr / Nathaniel J Henry / Claudiu Herteliu / Fatemeh Heydarpour / Hagos Degefa de Hidru I / Thomas R Hird / Chi Linh Hoang / Enayatollah Homaie Rad / Praveen Hoogar / Mohammad Hoseini / Naznin Hossain / Mostafa Hosseini / Mehdi Hosseinzadeh / Mowafa Househ / Mohamed Hsairi, Sr / Guoqing Hu / Mohammedaman Mama Hussen / Segun Emmanuel Ibitoye / Ehimario U Igumbor, Sr / Olayinka Stephen Ilesanmi / Milena D Ilic / Mohammad Hasan Imani-Nasab / Usman Iqbal / Seyed Sina Naghibi Irvani / Sheikh Mohammed Shariful Islam / Chinwe Juliana Iwu / Neda Izadi, Sr / Anelisa Jaca / Nader Jahanmehr / Mihajlo Jakovljevic / Amir Jalali / Achala Upendra Jayatilleke / Ravi Prakash Jha / Vivekanand Jha / John S Ji, Sr / Jost B Jonas / Jacek Jerzy Jozwiak / Ali Kabir / Zubair Kabir, Sr / Amaha Kahsay / Hamed Kalani / Tanuj Kanchan / Behzad Karami Matin / André Karch / Mohd Anisul Karim / Hamidreza Karimi-Sari / Surendra Karki / Amir Kasaeian / Gebremicheal Gebreslassie Kasahun / Yawukal chane Kasahun / Habtamu Kebebe Kasaye / Gebrehiwot G Kassa / Getachew Mullu Kassa / Gbenga A Kayode / Ali Kazemi Karyani / Mihiretu M Kebede / Peter Njenga Keiyoro / Abraham Getachew Kelbore, Sr / Andre Pascal Kengne, Sr / Daniel Bekele Ketema / Yousef Saleh Khader / Morteza Abdullatif Khafaie / Nauman Khalid / Rovshan Khalilov / Ejaz Ahmad Khan, Sr / Junaid Khan / Md Nuruzzaman Khan I / Muhammad Shahzeb Khan / Khaled Khatab, Sr / Amir M Khater / Mona M Khater / Maryam Khayamzadeh / Mohammad Khazaei / Salman Khazaei / Mohammad Hossein Khosravi / Jagdish Khubchandani / Ali Kiadaliri / Yun Jin Kim / Ruth W Kimokoti / Adnan Kisa / Sezer Kisa / Niranjan Kissoon, Sr / Shivakumar KM Marulasiddaiah M KMShivakumar, Sr / Sonali Kochhar / Tufa Kolola, Sr / Hamidreza Komaki / Soewarta Kosen / Parvaiz A Koul / Ai Koyanagi / Moritz U G Kraemer / Kewal Krishan / Nuworza Kugbey / G Anil Kumar / Manasi Kumar, Sr / Pushpendra Kumar / Vivek Kumar / Dian Kusuma / Carlo La Vecchia / Ben Lacey / Sheetal D Lad / Dharmesh Kumar Lal / Felix Lam / Faris Hasan Lami, Sr / Prabhat Lamichhane / Van Charles Lansingh / Savita Lasrado / Avula Laxmaiah / Paul H Lee, Sr / Kate E LeGrand / Mostafa Leili / Tsegaye Lolaso Lenjebo / Cheru Tesema Leshargie, Sr / Aubrey J Levine / Shanshan Li, Sr / Shai Linn / Shiwei Liu / Simin Liu / Rakesh Lodha / Joshua Longbottom / Jaifred Christian F Lopez / Hassan Magdy Abd El Razek / Muhammed Magdy Abd El Razek / D R Mahadeshwara Prasad / Phetole Walter Mahasha, Sr / Narayan B Mahotra / Azeem Majeed / Reza Malekzadeh, Sr / Deborah Carvalho Malta / Abdullah A Mamun, Sr / Navid Manafi, Sr / Ana Laura Manda / Narendar Dawani Dawanu Manohar / Mohammad Ali Mansournia / Chabila Christopher Mapoma / Joemer C Maravilla / Gabriel Martinez, Sr / Santi Martini / Francisco Rogerlândio Martins-Melo / Anthony Masaka / Benjamin Ballard Massenburg / Manu Raj Mathur / Benjamin K Mayala / Mohsen Mazidi / Colm McAlinden / Birhanu Geta Meharie / Man Mohan Mehndiratta, Sr / Kala M Mehta / Tefera C Chane Mekonnen / Gebrekiros Gebremichael Meles / Peter T N Memiah / Ziad A Memish, Sr / Walter Mendoza / Ritesh G Menezes / Seid Tiku Mereta / Tuomo J Meretoja, Sr / Tomislav Mestrovic / Bartosz Miazgowski / Kebadnew Mulatu Mihretie, Sr / Ted R Miller / GK Mini / Erkin M Mirrakhimov / Babak Moazen / Bahram Mohajer / Amjad Mohamadi-Bolbanabad / Dara K Mohammad / Karzan Abdulmuhsin Mohammad / Yousef Mohammad / Naser Mohammad Gholi Mezerji / Roghayeh Mohammadibakhsh / Noushin Mohammadifard / Jemal Abdu Mohammed, Sr / Shafiu Mohammed / Farnam Mohebi / Ali H Mokdad / Mariam Molokhia / Lorenzo Monasta / Yoshan Moodley, Sr / Catrin E Moore, Sr / Ghobad Moradi / Masoud Moradi / Mohammad Moradi-Joo / Maziar Moradi-Lakeh / Paula Moraga / Linda Morales / Ilais Moreno Velásquez / Abbas Mosapour / Simin Mouodi / Seyyed Meysam Mousavi / Miliva Mozaffor I / Kindie Fentahun Muchie, Sr / Getahun Fentaw Mulaw, Sr / Sandra B Munro / Moses K Muriithi / Christopher J L Murray / GVS Murthy / Kamarul Imran Musa / Ghulam Mustafa, Sr / Saravanan Muthupandian, Sr / Ashraf F Nabhan / Mehdi Naderi / Ahamarshan Jayaraman Nagarajan / Kovin S Naidoo / Gurudatta Naik / Farid Najafi / Vinay Nangia, Sr / Jobert Richie Nansseu / Bruno Ramos Nascimento, Sr / Javad Nazari / Duduzile Edith Ndwandwe, Sr / Ionut Negoi, Sr / Henok Biresaw Netsere Netsere, Sr / Josephine W Ngunjiri, Sr / Cuong Tat Nguyen / Huong Lan Thi Nguyen / Trang Huyen Nguyen / Dabere Nigatu / Solomon Gedlu Nigatu / Dina Nur Anggraini Ningrum / Chukwudi A Nnaji / Marzieh Nojomi / Vuong Minh Nong / Ole F Norheim, Sr / Jean Jacques Noubiap / Soraya Nouraei Motlagh / Bogdan Oancea / Okechukwu Samuel Ogah / Felix Akpojene Ogbo / In-Hwan Oh / Andrew T Olagunju / Tinuke O Olagunju / Bolajoko Olubukunola Olusanya / Jacob Olusegun Olusanya / Obinna E Onwujekwe, Sr / Eyal Oren / Doris V V Ortega-Altamirano, Sr / Osayomwanbo Osarenotor / Frank B Osei, Sr / Mayowa O Owolabi / Mahesh P A, Sr / Jagadish Rao Padubidri / Smita Pakhale / Sangram Kishor Patel / Angel J Paternina-Caicedo, Sr / Ashish Pathak, Sr / George C Patton / Deepak Paudel, Sr / Kebreab Paulos, Sr / Veincent Christian Filipino Pepito / Alexandre Pereira / Norberto Perico / Aslam Pervaiz / Julia Moreira Pescarini / Bakhtiar Piroozi / Meghdad Pirsaheb / Maarten J Postma / Hadi Pourjafar / Farshad Pourmalek, Sr / Akram Pourshams / Hossein Poustchi / Sergio I Prada, Sr / Narayan Prasad / Liliana Preotescu / Hedley Quintana / Navid Rabiee / Amir Radfar / Alireza Rafiei / Fakher Rahim / Afarin Rahimi-Movaghar / Vafa Rahimi-Movaghar / Mohammad Hifz Ur Rahman / Muhammad Aziz Rahman / SHAFIUR Rahman / Fatemeh Rajati, Sr / Saleem Muhammad Rana, Sr / Chhabi Lal Ranabhat / Davide Rasella / David Laith Rawaf / Salman Rawaf, Sr / Lal Rawal / Wasiq Faraz Rawasia / Vishnu Renjith / Andre M N Renzaho, Sr / Serge Resnikoff, Sr / Melese Abate Reta / Negar Rezaei / Mohammad 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    The Lancet Global Health, Vol 8, Iss 8, Pp e1038-e

    2020  Volume 1060

    Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 ... ...

    Abstract Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 310
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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