Communicable disease and neonatal problems are still major killers of
http://www.100md.com
《英国医生杂志》
Nearly three out of four deaths worldwide in children under 5 years old are due to communicable diseases or problems occurring in the neonatal period, show new figures from the World Health Organization.
The figures, which were published last week, are based on more accurate estimates than those used previously (Lancet 2005;365:1147?2).
The report estimates that six causes accounted for 73% of the more than 10 million deaths worldwide of children in each year in 2000-3. These were pneumonia (19% of deaths), diarrhoea (18%), malaria (8%), neonatal sepsis or pneumonia (10%), preterm delivery (10%), and asphyxia at birth (8%). Communicable diseases accounted for more than half (54%) of these deaths.
Forty two per cent of the deaths in this age group were in Africa and 29% in South East Asia.
Malnutrition was considered to be an underlying cause in just over half the deaths (53%), and similar percentages of children died from diarrhoea (61%), malaria (57%), pneumonia (52%), and measles (45%).
The figures are part of a WHO programme to improve the accuracy of information about the causes of child death—which are not recorded in many parts of the world—to boost efforts to increase survival of children.
The Child Health Epidemiology Reference Group, which WHO established in 2001, developed new methods to estimate the figures, thus enabling them to refine the data on childhood mortality from specific causes and to extrapolate figures from studies in small areas to national and regional estimates.
They also categorised general causes of deaths into specific causes. For example, "deaths occurring in the perinatal period" were divided into deaths caused by premature delivery, asphyxia at birth, and sepsis or pneumonia in newborns. The researchers also checked that the estimates attributed to different causes of death added up to the total number of deaths.
Robert Black, professor of international health at Johns Hopkins Bloomberg School of Public Health, Baltimore, and one of the study抯 authors, said: "We need more accurate information to know which interventions are most important to reduce deaths in children." The figures showed that pneumonia, diarrhoea, and malaria remained the major killers of children in this age group, he said.
In an accompanying commentary Peter Byass, from the International School of Public Health, Epidemiology and Public Health Sciences, Ume?University, Sweden, and Tedros Ghebreyesus, minister of state in the Federal Ministry of Health, Addis Ababa, write: "Childhood mortality is strongly inversely correlated with per-capita health expenditure. In today抯 world, an Ethiopian child is over 30 times more likely than a western European to die before his or her fifth birthday." More partnerships between rich and poor countries were needed to develop health services in Africa, they say.(Susan Mayor)
The figures, which were published last week, are based on more accurate estimates than those used previously (Lancet 2005;365:1147?2).
The report estimates that six causes accounted for 73% of the more than 10 million deaths worldwide of children in each year in 2000-3. These were pneumonia (19% of deaths), diarrhoea (18%), malaria (8%), neonatal sepsis or pneumonia (10%), preterm delivery (10%), and asphyxia at birth (8%). Communicable diseases accounted for more than half (54%) of these deaths.
Forty two per cent of the deaths in this age group were in Africa and 29% in South East Asia.
Malnutrition was considered to be an underlying cause in just over half the deaths (53%), and similar percentages of children died from diarrhoea (61%), malaria (57%), pneumonia (52%), and measles (45%).
The figures are part of a WHO programme to improve the accuracy of information about the causes of child death—which are not recorded in many parts of the world—to boost efforts to increase survival of children.
The Child Health Epidemiology Reference Group, which WHO established in 2001, developed new methods to estimate the figures, thus enabling them to refine the data on childhood mortality from specific causes and to extrapolate figures from studies in small areas to national and regional estimates.
They also categorised general causes of deaths into specific causes. For example, "deaths occurring in the perinatal period" were divided into deaths caused by premature delivery, asphyxia at birth, and sepsis or pneumonia in newborns. The researchers also checked that the estimates attributed to different causes of death added up to the total number of deaths.
Robert Black, professor of international health at Johns Hopkins Bloomberg School of Public Health, Baltimore, and one of the study抯 authors, said: "We need more accurate information to know which interventions are most important to reduce deaths in children." The figures showed that pneumonia, diarrhoea, and malaria remained the major killers of children in this age group, he said.
In an accompanying commentary Peter Byass, from the International School of Public Health, Epidemiology and Public Health Sciences, Ume?University, Sweden, and Tedros Ghebreyesus, minister of state in the Federal Ministry of Health, Addis Ababa, write: "Childhood mortality is strongly inversely correlated with per-capita health expenditure. In today抯 world, an Ethiopian child is over 30 times more likely than a western European to die before his or her fifth birthday." More partnerships between rich and poor countries were needed to develop health services in Africa, they say.(Susan Mayor)