Using big data and mobile health to manage diarrhoeal disease in children in low-income and middle-income countries: societal barriers and ethical implications

Diarrhoea is an important cause of morbidity and mortality in children from low-income and middle-income countries (LMICs), despite advances in the management of this condition. Understanding of the causes of diarrhoea in children in LMICs has advanced owing to large multinational studies and big data analytics computing the disease burden, identifying the important variables that have contributed to reducing this burden. The advent of the mobile phone has further enabled the management of childhood diarrhoea by providing both clinical support to health-care workers (such as diagnosis and management) and communicating preventive measures to carers (such as breastfeeding and vaccination reminders) in some settings. There are still challenges in addressing the burden of diarrhoeal diseases, such as incomplete patient information, underrepresented geographical areas, concerns about patient confidentiality, unequal partnerships between study investigators, and the reactive approach to outbreaks. A transparent approach to promote the inclusion of researchers in LMICs could address partnership imbalances. A big data umbrella encompassing cloud-based centralised databases to analyse interlinked human, animal, agricultural, social, and climate data would provide an informative solution to the development of appropriate management protocols in LMICs.