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BACKGROUND Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a(More)
BACKGROUND Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional(More)
BACKGROUND Diarrhoeal diseases cause illness and death among children younger than 5 years in low-income countries. We designed the Global Enteric Multicenter Study (GEMS) to identify the aetiology and population-based burden of paediatric diarrhoeal disease in sub-Saharan Africa and south Asia. METHODS The GEMS is a 3-year, prospective, age-stratified,(More)
BACKGROUND In Pakistan, only 59-73% of children 12-23 months of age are fully immunized. This randomized, controlled trial was conducted to assess the impact of a low-literacy immunization promotion educational intervention for mothers living in low-income communities of Karachi on infant immunization completion rates. METHODS Three hundred and sixty-six(More)
BACKGROUND Despite widespread use of intrapartum antibiotic prophylaxis, group B streptococcus remains a leading cause of morbidity and mortality in infants in Europe, the Americas, and Australia. However, estimates of disease burden in many countries outside of these regions is not available. We aimed to examine the current global burden of invasive(More)
Changes in small bowel function early in infancy in developing countries are increasingly being demonstrated, probably accompanied by altered mucosal architecture in most individuals, including reduced enterocyte mass and evidence of immune activation and inflammation in the mucosa. These alterations appear to be the result of factors of uncertain nature in(More)
INTRODUCTION Infections are a major contributor to newborn deaths in developing countries. Majority of these deaths occur at home without coming to medical attention. The Millennium Development Goal for child survival cannot be achieved without substantial reductions in infection-specific neonatal mortality. We describe the burden of neonatal infections in(More)
BACKGROUND Long-term, sustainable programs to address high incidence and death rates from neonatal infections are required for improving child survival. There is an urgent need to define the role of community-based management for neonates with serious bacterial infections--both at home and at first-level facilities. METHODS We reviewed available evidence(More)
Stunting is common in young children in developing countries, and is associated with increased morbidity, developmental delays, and mortality. Its complex pathogenesis likely involves poor intrauterine and postnatal nutrition, exposure to microbes, and the metabolic consequences of repeated infections. Acquired enteropathy affecting both gut structure and(More)
OBJECTIVE To assess parent's knowledge and perceptions surrounding polio and polio vaccination, self-reported participation in polio supplementary immunization activities (SIAs) targeting children aged < 5 years, and reasons for non-participation. METHODS The mixed methods study began with a cross-sectional survey in Karachi, Pakistan. A structured(More)