Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years: an analysis of the Global Burden of Disease Study 2017 . Lancet Infectious Diseases, October 30, 2019.

Authors - GBD 2017 Diarrhoeal Disease Collaborators: Collaborators listed at the end of the Article

An excerpt - Diarrhea was responsible for an estimated 533 768 deaths among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhea mortality per 100 000 globally decreased by 69·6% between 1990 and 2017.

Among the risk factors considered in this study, those responsible for the largest declines in the diarrhea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4).

Diarrhea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhea mortality.

Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhea that have already reduced diarrhea mortality could further avert many thousands of deaths due to this illness.