Diarrheal Disease

Diarrheal Disease—Still a Leading Child Killer1 

Diarrheal deaths have dropped significantly since 2000, falling from 1.2 million to 185,000 in 2017 – a decline of 85%2,3.

  • Yet children continue to experience an average of three episodes of diarrhea per year4.
  • A case of severe diarrhea, especially during important developmental stages, can have a lasting effect on a child’s growth.
  • Diarrhea can also make children more susceptible to death from other causes like pneumonia.

Impact on Growth and Development

Even when treatment is available, children still suffer from illness.

  • In a recent study in African and Asia, children who experienced a single episode of moderate to severe diarrhea had an 8.5-fold increased risk of death and grew significantly less in length during the two months following their illness compared to similar children who do not experience an episode of diarrhea1.
  • Over several decades, studies have pointed to a vicious cycle of malnutrition and diarrhea during the first two years of life that affects brain development and has a profound and lasting effect on children’s growth, school performance, and cognitive development5-8.
  • Recent studies have shown early childhood diarrhea impacts children’s intellectual functioning well into late childhood8.

Doctors at the Gondama community health centre in southern Sierra Leone successfully saved the life of Aisha Kamara’s son Abdul, after he contracted severe diarrhea.  Other African children are not so lucky. Rotavirus is the leading cause of diarrheal deaths in the world among under-fives. (Gavi/Ryan Youngblood)


1.Kotloff, K.L., et al., Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. . Lancet, 2013. 382(9888): p. 209-222. 

2.UNICEF, One is too many: Ending child deaths from pneumonia and diarrhoea. 2016. 

3. Global Burden of Diseases Collaborative Network, Global Burden of Disease Study 2017 (GBD 2017) Results. 2017, Institute for Health Metrics and Evaluation (IHME).


4.Walker, C.L., et al., Global burden of childhood pneumonia and diarrhoea. Lancet, 2013. 381(9875): p. 1405-16. 

5.Guerrant, D.I., et al., Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg, 1999. 61(5): p. 707-13. 

6.Niehaus, M.D., et al., Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. Am J Trop Med Hyg, 2002. 66(5): p. 590-3. 

7.Lima, A.A. and R.L. Guerrant, Persistent diarrhea in children: epidemiology, risk factors, pathophysiology, nutritional impact, and management. Epidemiol Rev, 1992. 14: p. 222-42. 

8.Pinkerton, R., et al., Early Childhood Diarrhea Predicts Cognitive Delays in Later Childhood Independently of Malnutrition. Am J Trop Med Hyg, 2016. 95(5): p. 1004-1010. 


The ROTA Council was created in collaboration with an advisory group of 24 child health leaders from around the world. We promote the use of rotavirus vaccines as part of a comprehensive approach to addressing diarrheal disease.

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