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Early childhood mortality from community-acquired infections
W O Cooper1, G B Hickson, E F Mitchel
1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
Insights
Children with multiple siblings or low birth weight face significantly higher risks of death from infections. Targeted interventions and early medical care are crucial for these vulnerable pediatric populations.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Infectious diseases remain a significant cause of mortality in young children.
- Identifying specific risk factors is essential for effective prevention strategies.
Purpose of the Study:
- To identify maternal and child characteristics predicting death from community-acquired infections in children under 5.
- To determine if these factors can identify children at excess risk of mortality from infection.
Main Methods:
- Historical cohort study of 1,014,976 children born in Tennessee (1985-1994).
- Data sourced from birth and death certificates, with medical record review for outcome confirmation.
- Follow-up included 3,351,568 child-years.
Main Results:
- 247 deaths from infection occurred (7.4 per 100,000 child-years), with respiratory infections causing about half.
- Children with ≥3 older siblings had a 3-fold increased risk of death from infection.
- Children with birth weight <1,500g had a 10-fold increased risk; those with both characteristics had a ~20-fold increased risk.
Conclusions:
- Maternal and child factors, including sibling number and birth weight, are independent predictors of infectious disease mortality.
- Vulnerable children identified by these factors require targeted interventions and close medical follow-up.
- Focusing on infection prevention in at-risk groups can reduce pediatric mortality.
Abstract:
In this study, the authors identified maternal and child characteristics that were independent predictors of death from infectious diseases acquired in the community and determined if these factors could be used to identify groups of children with excess risk of mortality from infection. A historical cohort study was conducted of children less than 5 years of age between 1985 and 1994 (the study period), who were born in Tennessee, and had complete information on their birth certificates. The primary outcome was death from infection identified from death certificates and confirmed through medical record review. Among the 1,014,976 children less than 5 years of age, who contributed 3,351,568 child-years of follow-up, there were 247 deaths from infections (7.4 deaths from infections per 100,000 child-years). Respiratory infections accounted for approximately one half of the deaths. Children having three or more older siblings or birth weight of less than 1,500 g had a 3-fold and 10-fold increased risk of death from infection, respectively, while children with both characteristics had a nearly 20-fold increased risk that persisted beyond the first year of life. Interventions should be focused on prevention of these infections in vulnerable children. At-risk children should be targeted for careful follow-up and early hospitalization when signs of infection develop.