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Global Incidence of Diarrheal Diseases-An Update Using an Interpretable Predictive Model Based on XGBoost and SHAP: A
Dan Liang1, Li Wang2, Shuang Liu1
1Department of Immunology and Microbiology, College of Life Science and Technology, Jinan University, Guangzhou 510632, China.
Diarrheal disease incidence is rising globally, especially in older adults, despite decreasing age-standardized rates. Improving water and sanitation access is key to reducing future cases.
Area of Science:
- Public Health
- Epidemiology
- Environmental Health
Background:
- Diarrheal disease is a persistent global public health challenge, disproportionately affecting young children and the elderly.
- Understanding diarrhea incidence trends and influencing factors is vital for effective public health interventions.
Purpose of the Study:
- To analyze temporal trends in diarrhea incidence from 1990-2019 and project future incidence (2020-2040) globally, regionally, and nationally.
- To identify key factors driving diarrhea incidence to inform prevention and control strategies.
Main Methods:
- Utilized the eXtreme Gradient Boosting (XGBoost) model for incidence prediction (2020-2040) incorporating demographic, meteorological, and water/sanitation indicators.
- Employed SHapley Additive exPlanations (SHAP) to interpret model predictions and identify influential variables.
- Calculated Estimated Annual Percentage Change (EAPC) to assess temporal trends in age-standardized incidence rates (ASIRs).
Main Results:
- Globally, diarrhea cases and ASIRs increased from 2010-2019. Incident cases are projected to rise by 2040, while ASIRs are expected to slightly decrease.
- Adults aged 60+ show an increasing incidence rate trend, while children under 5 have the highest number of incident cases.
- Risk factors for increased incidence include age over 60, high precipitation (>3000 mm), high temperatures (>20°C), and high vapor pressure deficit (>1500 Pa).
Conclusions:
- Diarrheal diseases remain a significant concern, with projected increases in cases despite declining global ASIRs.
- While children under 5 are most affected, the rising incidence in adults aged 60+ requires focused attention.
- Enhancing access to safe drinking water and sanitation services is critical for global diarrhea incidence reduction.
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