Study Provides New Estimates of Causes of Child
By Tim Parsons
School of Public Health
Seventy-three percent of the 10.6 million child deaths
worldwide each year are the result of six causes:
pneumonia, diarrhea, malaria, neonatal sepsis, pre-term
delivery and asphyxia at birth. Researchers at the Johns
Hopkins Bloomberg School
of Public Health and the World Health Organization have
developed the most accurate estimates to date of the causes
of death of children under age 5. The estimates, which are
published in the March 26 edition of The Lancet, will help
guide public health policies and programs that address
child mortality worldwide.
According to the study, four communicable disease
categories account for 54 percent of all child deaths
globally. Pneumonia accounts for 19 percent of all child
deaths; diarrhea, 17 percent; malaria, 8 percent; and
neonatal sepsis, 10 percent. Undernutrition is an
underlying cause in more than half of all deaths before age
5. More than 37 percent of all child deaths occur during
the first 28 days of life, the neonatal period. The
researchers noted that child mortality is greatest in
Africa. The study shows that 42 percent of child deaths
under age 5 occur in Africa, which is also where 94 percent
of all child deaths attributed to malaria occur.
"Achievement of the WHO's goal of reducing child
mortality by two-thirds from the 1990 rate will depend on
renewed efforts to prevent and control pneumonia, diarrhea
and undernutrition in all regions, and malaria in the
Africa region," said Robert Black, chair of the
Department of International
Health at the Bloomberg School. Black chaired the WHO
Child Health Epidemiology Reference Group, which developed
the new estimates by analyzing data and developing
statistical models from previous publications and ongoing
studies. The estimates cover a period from 2000 to 2003.
"In all regions of the world, deaths in the neonatal
period, primarily due to pre-term delivery, sepsis or
pneumonia and birth asphyxia, should also be addressed. The
new estimates of the causes of child deaths should be used
to guide public health policies and programs," he said.
Previous research by Black and others has shown that
many of the causes of child mortality could be prevented
with existing and proven measures.
Funding for the new study was provided by the Bill and
Melinda Gates Foundation.
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