Diarrheal disease is still a major cause of mortality and morbidity worldwide; thus a large body of research has been produced describing its risks. We review more than four decades of literature on diarrheal disease epidemiology. These studies detail a progression in the conceptual understanding of transmission of enteric pathogens and demonstrate that diarrheal disease is caused by many interdependent pathways. However, arguments by diarrheal disease researchers in favor of attending to interaction and interdependencies have only recently yielded more formal systems-level approaches. Therefore, interdependence has not yet been highlighted in significant new research initiatives or policy decisions. We argue for a systems-level framework that will contextualize transmission and inform prevention and control efforts so that they can integrate transmission pathways. These systems approaches should be employed to account for community effects (i.e., interactions among individuals and/or households).

中文翻译：

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走向肠道病原体传播的系统方法：从个体独立到社区相互依赖。


腹泻病仍然是全世界死亡和发病的主要原因；因此，已经进行了大量研究来描述其风险。我们回顾了四十多年有关腹泻病流行病学的文献。这些研究详细介绍了对肠道病原体传播概念理解的进展，并证明腹泻疾病是由许多相互依赖的途径引起的。然而，腹泻病研究人员支持关注相互作用和相互依赖性的论点直到最近才产生了更正式的系统级方法。因此，在重大的新研究计划或政策决定中尚未强调相互依存性。我们主张建立一个系统级框架，将传播背景化并为预防和控制工作提供信息，以便它们能够整合传播途径。应采用这些系统方法来解释社区效应（即个人和/或家庭之间的相互作用）。