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Member Research & Reports

Member Research & Reports

Johns Hopkins: Widely Used Public Health Surveys May Underestimate the Global Burden of Childhood Diarrhea

Public health surveys used in as many as 90 countries may be missing the number of recent diarrhea episodes among children by asking parents and caregivers to recall events two weeks out versus one week out, suggests a study from researchers at Johns Hopkins Bloomberg School of Public Health.

The researchers, whose findings were published March 25 in the International Journal of Epidemiology, compared the responses to two large public health surveys that were worded almost identically, and concluded that the survey with a two-week recall period, which has been the standard in the field, is less accurate than the survey with a one-week recall period.

Dr. Natalie G. Exum, assistant scientist in the department of environmental health and engineering, was the principal investigator. The department spans the Bloomberg School and the Johns Hopkins Whiting School of Engineering.

Diarrhea is a significant global health concern because there are between one and two billion cases of it every year among children under 5, including about 500,000 fatal cases. In many low- and middle-income countries diarrheal illness is a leading cause of death among young children.

Researchers commonly estimate the burden of diarrheal illness in countries where it is endemic using large-scale, house-to-house surveys of mothers and other caregivers. The most widely used set of surveys, the Demographic and Health Surveys (DHS) sponsored by the U.S. Agency for International Development, ask respondents to recall cases among children in their care in the previous two weeks.

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