Infection-related mortality in children in two European countries, 2015-2023: An interrupted time-series analysis

Area of Science:

• Public Health
• Epidemiology
• Pediatrics

Background:

• Infections are a major cause of childhood mortality globally.
• Non-pharmaceutical interventions (NPI) during the COVID-19 pandemic impacted communicable disease transmission.
• The effect of these NPIs on paediatric infection-related mortality requires assessment.

Purpose of the Study:

• To evaluate the impact of NPIs on paediatric infection-related mortality.
• To quantify changes in mortality rates associated with NPI implementation and subsequent periods.
• To identify potential for sustained reduction in childhood infection deaths.

Main Methods:

• Population-based interrupted time-series analysis (2015-2023) using national data from France and Switzerland.
• Analysis of monthly infection-related mortality in individuals under 18 years.
• Comparison of mortality rate ratios (MRR) between pre-NPI, NPI, and post-NPI birth cohorts.

Main Results:

• A total of 8272 infection-related deaths occurred among 32,619 paediatric deaths.
• During the NPI period, infection-related mortality decreased by 16% (95% CI: -23% to -7%).
• This reduction represents an estimated 221 fewer deaths (95% CI: 90 to 371).
• Birth cohorts from 2019 and 2020 showed significantly lower infection-related MRR compared to pre-NPI cohorts (MRR=0.80).

Conclusions:

• The observed reduction in paediatric infection deaths during the NPI period is significant.
• This finding emphasizes the substantial burden of preventable childhood mortality.
• Targeted preventive strategies could offer sustainable reductions in infection-related deaths outside of pandemic settings.