Infectious diseases of poverty: children on the front line : enteric infections and acute respiratory infections

Beyond the classic notions of the predominance of infectious and parasitic diseases in the paediatric population, which pays the heaviest price in terms of morbidity and mortality (10 million of the 17 million annual deaths due to infectious diseases occur in children in the most disadvantaged regions of the planet), medical, epidemiological and socio-economic aspects are largely ignored, and their recognition should considerably modify the management of paediatric infection in endemic regions. I wanted to highlight a number of typical examples. (1) If we consider the etiology of paediatric infectious diseases not in terms of individual pathogens (tuberculosis bacilli, malaria, HIV), acute and chronic diarrhoea and acute respiratory infections take the lead. This observation should have a major impact on diagnosis, treatment and prevention strategies. (2) Mortality and morbidity only partially reflect the public health impact of paediatric infections, unless more global parameters such as DALY(Disability-Adjusted Life Years) are used to measure their true societal and economic impact. (3) The quality of governance, and in particular appropriate leadership from heads of state, is essential to controlling the spread of pandemics such as AIDS. (4) Redoubled efforts should be devoted to research and partnership efforts to take charge of campaigns to control or even eradicate neglected tropical infections in endemic regions.