Economic Burden, Health Burden and Predictive Analysis of Diarrhoea Attributed to Unsafe Water Sources, No Access to Handwashing Facilities, Unsafe Sanitation in Global from 1990 to 2030

This study investigated the health and economic burden of global diarrhoea attributed to unsafe water sources, lack of access to handwashing facilities, and unsafe sanitation. Data from the Global Burden 2019 study were used to collect age-standardized mortality rate (ASMR) and sociodemographic index (SDI) values from 21 regions. The relationship between ASMR or age-standardized disability-adjusted life years (ASDR) and SDI was analyzed with restricted cubic splines (RCS) and quantile regression. The trends of ASMR from 2020 to 2030 in global and five countries with different SDIs were predicted using a Bayesian age-period-cohort model. The economic burden of diarrhea was estimated for the 50 most populous countries, with direct costs assessed via a top-down approach and indirect costs via the human capital method. The global burden of diarrhea had decreased but remained significant. Major risk factors included unsafe water, sanitation, and lack of handwashing facilities. Children aged 1-5 had the highest incidence, and those over 90 had the highest mortality. Low and middle-low SDI areas had heavy health burden. The health burden is higher for men than for women. The RCS results showed that the burden of diarrhoeal diseases caused by these three factors declined as the SDI increased and remained essentially unchanged at an SDI of 0.7. By 2030, the ASMR of diarrhea was projected to decline globally, including in China, the US, Malaysia, Tanzania, and India, except for an increase in Malaysia attributed to unsafe sanitation. In 2019, the countries with heavier economic burdens were Nigeria, China, India, and America. The burden of diarrhea from unsafe water, lack of handwashing facilities, and unsafe sanitation is influenced by SDI, gender, and age. The populations of focus are children and the elderly; Older men and low SDI areas have a heavier health burden. Most of the heavier economic burdens occur in more populous countries with middle and middle-low SDI. Predictive studies provide country-specific recommendations for prevention and control.