While considerable recent progress has been made against childhood diarrheal diseases, the number of children dying from diarrhoea remains unacceptably high. This week, PLOS Medicine publishes a report based upon the work of over 150 international experts who convened to review and discuss research priorities to address this global problem. Zulfiqar Bhutta from the Aga Khan University in Pakistan and colleagues report that the most important priority is for more research on implementation of known interventions.
Research questions involving improving implementation, especially through behaviour change and other delivery strategies, ranked most highly during the experts' deliberations. Oral rehydration and zinc were also seen as priorities, including research questions asking to identify driving factors of caregiver demand for oral rehydration solutions and zinc, and development of an ORS formulation that reduces stool output, were ranked highly.
The authors say that "in tandem with the Global Action Plan for Diarrhoea and Pneumonia, concerted efforts by a range of stakeholders in implementation research will be needed to equitably scale up already proven, effective interventions."
Funding: Funding was provided by an unrestricted grant from the Bill & Melinda Gates Foundation to Aga Khan University and through it to the Program for Global Paediatric Research, Hospital for Sick Children, Toronto for undertaking this exercise. All co-authors volunteered their time to conduct this exercise. The funders had no role in the study design, data collection, analysis, decision to publish or preparation of the manuscript.
Competing Interests: VC is the principal investigator on a research grant from Unilever Plc that aims to understand behaviour associated with handwashing with soap. ML holds a patent as co-inventor of live oral cholera vaccine strain CVD 103-HgR, which has been licensed by the vaccine company PaxVax, who are supporting the clinical development program towards national regulatory agency licensure of the vaccine. MS is on the editorial board of PLOS Medicine. PMS sits on the Medical Scientific Advisory Board for Alberta Inflammatory Bowel Disease Research Consortium. PMS sits on Medical Advisory Boards for Abbott Nutrition, Mead Johnson Nutrition, and Proctor and Gamble; PMS sits on the Research Advisory Board for Antibe Therapeutics and is a stockholder. PMS also currently holds a research contract from Institut Rosell-Lallemand Inc. (Montreal, Quebec, Canada) to study the effectiveness of a short-chain fructo-oligosaccharide (sc-FOS) prebiotic preparation in ameliorating intestinal epithelial injury in response to bacterial enteric pathogens using both polarized model epithelia in tissue culture and a murine model of colitis, undertaken in the Research Institute at the Hospital for Sick Children in Toronto, Canada where the funds are held in a research funding account. The studies are also supported by research funding from the Canadian Institutes of Health Research (2008) and previously by a Fay Shapiro-Cutler grant-in-aid from the Crohn's and Colitis Foundation of Canada (2007). ZAB is on the editorial board of PLOS Medicine, and is the principal investigator of the grant from the Bill & Melinda Gates Foundation to coordinate the development of the Global Action Plan for Pneumonia and Diarrhoea. All other authors report no competing interests.
Citation: Wazny K, Zipursky A, Black R, Curtis V, Duggan C, et al. (2013) Setting Research Priorities to Reduce Mortality and Morbidity of Childhood Diarrhoeal Disease in the Next 15 Years. PLoS Med 10(5): e1001446. doi:10.1371/journal.pmed.1001446
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Contact:
Aga Khan University
The Husein Laljee Dewraj Professor & Chairman
Department of Paediatrics & Child Health
Karachi, 74800
PAKISTAN
+92-300-8236813
zulfiqar.bhutta@aku.edu
Journal
PLoS Medicine