Infectious disease-related mortality continues to decline in children

**Viner RM. Lancet. 2011;doi:10.1016/S0140-6736(11)60106-2.**

Issue: April 2011

Injury-related mortalities are leading to spikes in mortality among males aged 15 to 24 years. Conversely, infectious disease-related mortality rates in children aged younger than 5 years continue to decline, according to a study published online this week.

Russell M. Viner, PhD, of the University College London Institute of Child Health, and colleagues said WHO data are indicating death rates in young men are now two to three times higher than in boys aged 1 to 4 years, with most of these increases attributed to injuries.

A strong international focus on reducing mortality in children aged younger than 5 years has not been matched by a similar response in older groups, although more than two-fifths of the world’s population is in the 5- to 24-year-old age group, Viner and colleagues said.

The researchers analyzed mortality data for 50 countries between 1955 and 2004. The researchers looked at causes of death (communicable and non-communicable diseases and injury), age group and sex, and they calculated death rates averaged during three 5-year periods.

The data indicated that in the 1950s, mortality in the 1- to 4-year-old age group greatly exceeded that of all other age groups in all regions studied. But in the 50 years up to 2004, death rates in children aged 1 to 9 years declined 80% to 93%, mostly due to reductions in deaths from infectious disease.

In contrast, reductions in mortality in those aged 15 to 24 years were only about half of that in children. The researchers said injuries were largely to blame for increasing mortality rates in this population, causing about 70% to 75% of all deaths in males aged 10 to 24 years in all regions studied. Violence and suicide also were key causes, contributing to about one-third of deaths in males aged 10 to 24 years.

“Future global health targets should include the causes of death in people aged 10-24 years, and should extend beyond HIV infection and maternal mortality to include injury and mental health,” the researchers concluded.

In an accompanying editorial, Michael Resnick, MD, of the University of Minnesota in Minneapolis, wrote: “Adolescence represents the second crucial window for prevention and health promotion. Effectively addressing the social determinants of health in the second decade of life can interrupt the processes by which disadvantage becomes adverse destiny, including premature mortality.”

Disclosure: The researchers reported no relevant financial disclosures.

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