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Published on: January 8, 2020

Does comorbidity increase the risk of mortality among children under 3 years of age?

Christa L Fischer Walker1, Jamie Perin, Jodi L Liu

  • 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

BMJ Open
|August 23, 2013
PubMed

Insights

Comorbid diarrhea and acute lower respiratory infection (ALRI) in young children may increase mortality risk. While observed in South Asian studies, wider confidence intervals suggest more research is needed to confirm this link.

Area of Science:

  • Global Health
  • Pediatric Infectious Diseases
  • Epidemiology

Background:

  • Diarrhea and pneumonia are leading causes of death in children under five.
  • Limited data exists on the combined impact of comorbid diarrhea and pneumonia on child mortality.

Purpose of the Study:

  • To quantify the relationship between comorbid diarrhea and pneumonia infections and mortality risk in young South Asian children.
  • To analyze the additional mortality risk associated with simultaneous infections.

Main Methods:

  • Secondary data analysis of two prospective cohort studies in South Asia.
  • Inclusion of children under three years with regular morbidity assessments and mortality surveillance.
  • Utilized a semiparametric additive model to calculate mortality risks for single and comorbid infections.

Main Results:

  • An additional mortality risk was observed for comorbid diarrhea and acute lower respiratory infection (ALRI) in both Nepali (0.0014) and South Indian (0.0032) children.
  • This additional risk is separate from the mortality risk associated with each individual infection.
  • Confidence intervals for the additional risk were wide, indicating limited statistical power.

Conclusions:

  • Simultaneous diarrhea and ALRI episodes in young children are associated with an increased mortality risk.
  • The wide confidence intervals highlight the need for further, more powerful studies to confirm these findings.
  • Additional research is crucial to accurately estimate the effect size of comorbidity on child mortality.
Abstract

Keywords:
Public Health

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