Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends
Li Liu1, Hope L Johnson, Simon Cousens
1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Insights
Child mortality decreased significantly between 2000 and 2010, with infectious and neonatal causes being the leading drivers. Pneumonia and preterm birth complications require accelerated reduction for further progress in child survival.
Area of Science:
- Global Health
- Epidemiology
- Pediatrics
Background:
- Child mortality data requires regular updates to inform effective survival strategies.
- This study presents the latest estimates of child mortality causes and trends up to 2010.
Purpose of the Study:
- To provide updated global and regional estimates of the causes of child mortality in 2010.
- To analyze time trends in child mortality causes from 2000 to 2010.
- To inform child survival strategies by identifying key mortality drivers.
Main Methods:
- Utilized country-specific death distributions applied to updated mortality numbers for neonates and children aged 1-59 months.
- Employed vital registration data, multinomial logistic regression models (with vital registration or verbal autopsy data), and national models for India and China.
- Aggregated country-level results to derive regional and global estimates.
Main Results:
- In 2010, 64% of 7.6 million deaths in children under 5 were due to infectious causes, with 40.3% occurring in neonates.
- Leading neonatal causes included preterm birth complications (14.1%) and intrapartum-related complications (9.4%).
- Pneumonia (14.1%), diarrhea (9.9%), and malaria (7.4%) were leading causes in older children. Global child deaths decreased by 2 million from 2000-2010, with pneumonia, measles, and diarrhea contributing most.
Conclusions:
- Child survival strategies must prioritize infectious and neonatal causes of mortality.
- Accelerated reduction of pneumonia and preterm birth complications is crucial for 2010-2015 progress.
- High-quality data collection and improved estimation methods are vital for future accuracy.
Background:
Information about the distribution of causes of and time trends for child mortality should be periodically updated. We report the latest estimates of causes of child mortality in 2010 with time trends since 2000.
Methods:
Updated total numbers of deaths in children aged 0-27 days and 1-59 months were applied to the corresponding country-specific distribution of deaths by cause. We did the following to derive the number of deaths in children aged 1-59 months: we used vital registration data for countries with an adequate vital registration system; we applied a multinomial logistic regression model to vital registration data for low-mortality countries without adequate vital registration; we used a similar multinomial logistic regression with verbal autopsy data for high-mortality countries; for India and China, we developed national models. We aggregated country results to generate regional and global estimates.
Findings:
Of 7·6 million deaths in children younger than 5 years in 2010, 64·0% (4·879 million) were attributable to infectious causes and 40·3% (3·072 million) occurred in neonates. Preterm birth complications (14·1%; 1·078 million, uncertainty range [UR] 0·916-1·325), intrapartum-related complications (9·4%; 0·717 million, 0·610-0·876), and sepsis or meningitis (5·2%; 0·393 million, 0·252-0·552) were the leading causes of neonatal death. In older children, pneumonia (14·1%; 1·071 million, 0·977-1·176), diarrhoea (9·9%; 0·751 million, 0·538-1·031), and malaria (7·4%; 0·564 million, 0·432-0·709) claimed the most lives. Despite tremendous efforts to identify relevant data, the causes of only 2·7% (0·205 million) of deaths in children younger than 5 years were medically certified in 2010. Between 2000 and 2010, the global burden of deaths in children younger than 5 years decreased by 2 million, of which pneumonia, measles, and diarrhoea contributed the most to the overall reduction (0·451 million [0·339-0·547], 0·363 million [0·283-0·419], and 0·359 million [0·215-0·476], respectively). However, only tetanus, measles, AIDS, and malaria (in Africa) decreased at an annual rate sufficient to attain the Millennium Development Goal 4.
Interpretation:
Child survival strategies should direct resources toward the leading causes of child mortality, with attention focusing on infectious and neonatal causes. More rapid decreases from 2010-15 will need accelerated reduction for the most common causes of death, notably pneumonia and preterm birth complications. Continued efforts to gather high-quality data and enhance estimation methods are essential for the improvement of future estimates.
Funding:
The Bill & Melinda Gates Foundation.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:28International Nursing Organizations II
The WHO provides expert team support, including funding, vaccines, testing, and treatment tools at the country level to fight...
01:22Life Tables
01:22Applications of Life Tables
01:21Causality in Epidemiology
00:57Population Growth