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Pneumonia, preterm birth complications leading causes of death in young children
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Approximately half of the 6.3 million children who died before aged 5 years in 2013 died of infectious causes, according to study findings in The Lancet.
Li Liu, PhD, of Johns Hopkins Bloomberg School of Public Health, and colleagues assessed vital registration and verbal autopsy data to estimate global, regional and national distributions of causes of child mortality for neonates and children aged 1 to 59 months between 2000 and 2013.
Li Liu
Pneumonia, diarrhea and malaria were the leading infectious causes of death in this group. Pneumonia caused 14.9% of all deaths, diarrhea caused 9.2% and malaria caused 7.3% overall.
Forty-four percent (n=2.761 million) of deaths in those younger than 5 years occurred among neonates. Preterm birth complications, intrapartum-related complications, and neonatal sepsis or meningitis or other infections were the most common causes of neonatal deaths. Approximately 15% of neonates died of preterm birth complications, 10.5% died of intrapartum complications, and 6.7% died of neonatal sepsis or meningitis or other infections.
Injury caused a significant number of deaths among children younger than 5 years, accounting for 5.2% of deaths. Congenital abnormalities caused 4.4% of child deaths.
Nearly 50% of deaths in those younger than 5 years in 2013 occurred in sub-Saharan Africa; 32.1% occurred in southern Asia.
In sub-Saharan Africa, 61.5% of deaths (n=1.914 million) were caused by infectious causes. Ninety-seven percent of deaths caused by malaria occurred in sub-Saharan Africa. Similarly, 90.4% of deaths caused by HIV/AIDS occurred in sub-Saharan Africa. Pneumonia and preterm birth complications also were leading causes of death in the region, accounting for 15.8% and 10.5% of deaths in those younger than 5 years, respectively.
Southern Asia had the highest number of neonatal deaths, at approximately 1.086 million. Preterm birth complications, pneumonia and intrapartum-related complications were the leading causes of death. They accounted for 21.8%, 14.4%, and 11% of deaths in the region, respectively.
India, Nigeria, Pakistan, Democratic Republic of the Congo and China had the highest number of deaths among children younger than 5 years. Together, they accounted for 49.3% of the world’s deaths in those younger than 5 years and 52.5% of neonatal deaths in 2013.
The overall number of deaths among children younger than 5 years decreased from 9.887 million in 2000 to 6.282 million in 2013. During this time, mortality in those younger than 5 years decreased from 77.4 to 45.6 per 1,000 live births. Deaths caused by pneumonia, diarrhea and measles experienced the greatest reductions.
From 2000 to 2013, mortality in those younger than 5 years decreased at an average rate of 4.1% per year; less than the 4.4% needed to reach the U.N. Millennium Development Goal Four by 2015.
“Although great progress has been made in child survival in the past two decades, with most of this progress in the past decade, it has not been enough,” the researchers wrote. “Millions of children are still dying of preventable causes at a time when we have the means to deliver cost-effective interventions.”
Disclosure: The researchers report no relevant financial disclosures.
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