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Meleki ER, Mongella S, Furia FF. A study protocol for predictors of post-discharge mortality among children aged 5-14 years admitted to tertiary hospitals in Tanzania: A prospective observational cohort study. PLoS One 2024; 19:e0287243. [PMID: 38776310 PMCID: PMC11111011 DOI: 10.1371/journal.pone.0287243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 05/06/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION Globally, millions of children and adolescents die every year from treatable and preventable causes. Sub-Saharan Africa accounted for 55% of deaths of children aged 5-14 years in 2017. Despite this high burden, minimal effort has been directed toward reducing mortality among older children and adolescents in comparison to under-fives. Mortality rates of children post-discharge vary between 1-18% in limited-resource countries and are reported to exceed in-hospital mortality. In Tanzania, there is limited data regarding post-discharge mortality and its predictors among children aged 5-14 years. OBJECTIVES This study aims to determine the post-discharge mortality rate and its predictors among children aged 5-14 years admitted to pediatric wards at MNH, MOI, and JKCI. METHODS AND ANALYSIS This will be a prospective observational cohort study that will be conducted among children aged 5-14 years admitted to pediatric wards at Muhimbili National Hospital, Jakaya Kikwete Cardiac Institue, and Muhimbili Orthopedic Institue in Dar-Es-Salaam, Tanzania. Data will be collected using a structured questionnaire and will include socio-demographic characteristics, clinical factors, and patients' outcomes. Post-discharge follow-up will be done at months 1, 2, and 3 after discharge via phone call. Data will be analyzed using SPSS version 23. The association of demographic, social economic, and clinical factors with the outcome of all causes, 3 months post-discharge mortality will be determined by Cox regression, and survival rates will be displayed through Kaplan-Meier curves. DISCUSSION This study will determine post-discharge mortality among children aged 5-14 years and its predictors in Tanzania. This information is expected to provide baseline data that will be useful for raising awareness of clinicians on how to prioritize and plan a proper follow-up of children following hospital discharge. These data may also be used to guide policy development to address and reduce the high burden of older children and adolescent mortality and may be used for future studies including those aiming to develop prediction models for post-discharge mortality among older children and adolescents.
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Affiliation(s)
- Elton Roman Meleki
- Department of Pediatrics and Child Health Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Stella Mongella
- Department of Pediatrics and Child Health Jakaya Kikwete Cardiac Institute, Dar-es-Salaam, Tanzania
| | - Francis Fredrick Furia
- Department of Pediatrics and Child Health Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
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Boschi-Pinto C, Curvello HGDR, Fonseca SC, Kale PL, Kawa H, Guimarães JCC. What do children aged 5 to 14 years die from in the state of Rio de Janeiro, Brazil? Trend analysis of the period 2000-2019. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023282.11672022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category “Assault by unspecified firearm” (boys, 10 to 14 years) and “Unspecified drowning and submersion” (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.
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Affiliation(s)
- Cynthia Boschi-Pinto
- Universidade Federal Fluminense, Brazil; Universidade Federal Fluminense, Brazil
| | | | | | | | - Helia Kawa
- Universidade Federal Fluminense, Brazil; Universidade Federal Fluminense, Brazil
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Boschi-Pinto C, Curvello HGDR, Fonseca SC, Kale PL, Kawa H, Guimarães JCC. What do children aged 5 to 14 years die from in the state of Rio de Janeiro, Brazil? Trend analysis of the period 2000-2019. CIENCIA & SAUDE COLETIVA 2023; 28:473-485. [PMID: 36651401 DOI: 10.1590/1413-81232023282.11672022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/12/2022] [Indexed: 01/18/2023] Open
Abstract
This study investigated the magnitude and trends of cause-specific mortality among children 5 to 14 years of age in the state of Rio de Janeiro (RJ) from 2000 to 2019. We performed an ecological study, using data from the Mortality Information System (MIS). We calculated mortality rates per 100,000 children by chapters, groups, and categories of causes of death (ICD-10). Trends were estimated by joinpoint regression. Mortality rates among children aged 10 to 14 years were higher than those among children 5 to 9. The five leading causes of death were the same in both age groups, but they ranked differently. The two leading ones were external causes and neoplasms (31% and 15% among children aged 5 to 9 years; 45% and 11% among children aged 10 to 14 years). Among children 5 to 9 years, the mortality trend showed an annual decline (8%) from 2011 to 2015. Among children aged 10 to 14 years, the annual decline was 1.3% from 2000 to 2019. Mortality due to external causes decreased in both age groups, except for the category "Assault by unspecified firearm" (boys, 10 to 14 years) and "Unspecified drowning and submersion" (boys, 5 to 9 years). Mortality caused by neoplasms remained steady in both age groups. Infectious and respiratory diseases decreased differently between the two groups. Most causes of death are preventable or treatable, indicating the need for health and intersectoral investments.
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Affiliation(s)
- Cynthia Boschi-Pinto
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense. R. Marquês do Paraná 303, 3º andar, Prédio Anexo ao HUAP, Centro. 24030-210 Niterói RJ Brasil. .,Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal Fluminense. Niterói RJ Brasil
| | - Helen Grace da Rocha Curvello
- Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal Fluminense. Niterói RJ Brasil
| | - Sandra Costa Fonseca
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense. R. Marquês do Paraná 303, 3º andar, Prédio Anexo ao HUAP, Centro. 24030-210 Niterói RJ Brasil.
| | - Pauline Lorena Kale
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Helia Kawa
- Departamento de Epidemiologia e Bioestatística, Instituto de Saúde Coletiva, Universidade Federal Fluminense. R. Marquês do Paraná 303, 3º andar, Prédio Anexo ao HUAP, Centro. 24030-210 Niterói RJ Brasil. .,Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal Fluminense. Niterói RJ Brasil
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de Lima MM, Favacho ARDM, Souza-Santos R, da Gama SGN. Characteristics and temporal trends of mortality rates in children and adolescents in Mato Grosso and Brazil, 2009-2020. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2022491. [PMID: 36477187 PMCID: PMC9887964 DOI: 10.1590/s2237-96222022000300017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE to analyze the characteristics and temporal trend of mortality rates in the population aged 5 to 14 years in Mato Grosso state and in Brazil, from 2009 to 2020. METHODS this was an ecological time-series study, based on data taken from the Mortality Information System. Descriptive and trend analyses were performed, using the joinpoint regression model and calculating the average annual percentage change (AAPC). RESULTS in Brazil and in Mato Grosso state, deaths were predominantly male, preventable and due to external causes. A falling trend was identified for Brazil (5-9 years AAPC: -2.9; 95%CI -4.3;-1.6 and 10-14 years AAPC: -2.5; 95%CI -3.3;-1.8), while a stationary trend was found in Mato Grosso (5-9 years AAPC: -2.0; 95%CI -5.6;1.7 and 10-14 years AAPC: -0.1; 95%CI -5.9;6.1). CONCLUSION the stable trend of mortality at high levels demands urgent interventions to reduce it.
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Affiliation(s)
- Mônia Maia de Lima
- Fundação Oswaldo Cruz, Programa de Pós-Graduação em Epidemiologia,
Equidade e Saúde Pública, Campo Grande, MS, Brazil
| | | | - Reinaldo Souza-Santos
- Escola Nacional de Saúde Pública, Departamento de Endemias Samuel
Pessoa, Rio de Janeiro, RJ, Brazil
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Sharma D, Kiran T, Goel K, Junaid KP, Rajagopal V, Gupta M, Kaundal H, Sharma S, Bahl A. Comprehensive assessment of age-specific mortality rate and its incremental changes using a composite measure: A sub-national analysis of rural Indian women. Front Med (Lausanne) 2022; 9:1046072. [PMID: 36523773 PMCID: PMC9745315 DOI: 10.3389/fmed.2022.1046072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/07/2022] [Indexed: 09/19/2023] Open
Abstract
Background Diverse socio-economic and cultural issues contribute to adverse health outcomes and increased mortality rates among rural Indian women across different age categories. The present study aims to comprehensively assess age-specific mortality rates (ASMR) and their temporal trends using a composite measure at the sub-national level for rural Indian females to capture cross-state differences. Materials and methods A total of 19 states were included in the study to construct a composite age-specific mortality index for 2011 (base year) and 2018 (reference year) and examine the incremental changes in the index values across these years at the sub-national level in India. Sub-index values were calculated for each component age group and were subsequently used to compute the composite ASMR index using the geometric mean method. Based on the incremental changes, the performance of states was categorized into four different typologies. Results Improvement in mortality index scores in the 0-4 years age group was documented for all states. The mortality rates for the 60+ age group were recorded to be high for all states. Kerala emerged as the overall top performer in terms of mortality index scores, while Bihar and Jharkhand were at the bottom of the mortality index table. The overall mortality composite score has shown minor improvement from base year to reference year at all India level. Conclusion An overall reduction in the mortality rates of rural Indian women has been observed over the years in India. However, in states like Bihar and Jharkhand, mortality is high and has considerable scope for improvement. The success of public health interventions to reduce the under-five mortality rate is evident as the female rural mortality rates have reduced sizably for all states. Nevertheless, there is still sizable scope for reducing mortality rates for other component age groups. Additionally, there is a need to divert attention toward the female geriatric (60+ years) population as the mortality rates are still high.
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Affiliation(s)
- Divya Sharma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tanvi Kiran
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kapil Goel
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - K. P. Junaid
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vineeth Rajagopal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Gupta
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Himika Kaundal
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Saraswati Sharma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankit Bahl
- Plan India, Community Center 1, New Delhi, India
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Menashe-Oren A, Masquelier B. The shifting rural-urban gap in mortality over the life course in low- and middle-income countries. Population Studies 2022; 76:37-61. [PMID: 35075983 DOI: 10.1080/00324728.2021.2020326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Studies have shown that children in rural areas face excess risks of dying, but the little research on spatial inequalities in adult mortality has reached mixed conclusions. We examine rural-urban differences in mortality in 53 low- and middle-income countries. We consider how the rural-urban mortality gap evolves from birth to age 60 by estimating mortality based on birth and sibling histories from 138 Demographic and Health Surveys run between 1992 and 2018. We observe excess rural mortality until age 15, finding the largest differences between urban and rural sectors among 1-59-month-olds. While we cannot claim higher mortality among urban adults than those in rural areas, we find a reduced gap between the sectors over the life course and a diminishing urban advantage in adult mortality with age. This shift over the life course reflects a divergence in the epidemiologic transition between the rural and urban sectors.
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Banerjee S, SubirBiswas, Roy S, Pal M, Hossain MG, Bharati P. Nutritional and immunization status of under-five children of India and Bangladesh. BMC Nutr 2021; 7:77. [PMID: 34852848 PMCID: PMC8638544 DOI: 10.1186/s40795-021-00484-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The nutritional and immunization status of children can play an important role in determining their future health status of a particular country. The aim of the present study is to investigate the nutritional and immunization status of under-five children in India and Bangladesh, and to find the difference in the status between these two countries. METHODS We have used the National Family Health Survey data, 2015-2016 of India and Bangladesh Demographic Health Survey, 2017-2018 datasets. The sample sizes are 222,418, among them 8759 and 8759 children for India and Bangladesh respectively. The nutritional status of under-five children is measured by standard anthropometric indicators of height-for-age (HAZ) and weight-for-age (WAZ). Regarding child immunization status, only BCG, DPT, polio and measles vaccinations are considered for the present study. Multiple binary logistic model has been used for analysing the data. RESULTS This study reveals that the prevalence of stunting and underweight of under-five children in India are higher than Bangladeshi children. Secondary and higher educated mothers are more likely of having normal HAZ and WAZ children than up to primary educated mothers for both countries. Chances of having normal HAZ and WAZ are higher among non-poor category for both countries. The present study also shows that immunization status of Bangladeshi children is better than Indian children except measles. Religion of mother also shows influence on immunization status of children in India whereas Bangladesh shows no significant results regarding religion. Mother's educational attainment and wealth index show influence on immunization status among children for both countries. CONCLUSIONS The study concludes that a remarkable number of under-five children are suffering from under nutrition for both countries, however Bangladeshi children have better nutritional and immunization status compared to Indian children. Higher wealth index, better educational attainment and lower unemployment of Bangladeshi mothers may be the causes for better nutritional and immunization status of children. Mother's socio-economic factors have significant impact on determining the child's health status. Our findings can help to government of Indian and Bangladesh for taking health policy to improve under-five children nutritional and immunization status.
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Affiliation(s)
- Sreeparna Banerjee
- Department of Anthropology, West Bengal State University, Berunanpukuria, PO-Malikapur, Barasat, West Bengal 700126 India
| | - SubirBiswas
- Department of Anthropology, West Bengal State University, Berunanpukuria, PO-Malikapur, Barasat, West Bengal 700126 India
| | - Shimul Roy
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal 721102 India
| | - Manoranjan Pal
- Economic Research Unit, Indian Statistical Institute, 203 BT Road, Kolkata, West Bengal 700 108 India
| | - Md. Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Premananda Bharati
- Biological Anthropology, Indian Statistical Institute, 203 BT Road, Kolkata, West Bengal 700 108 India
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Ngari MM, Obiero C, Mwangome MK, Nyaguara A, Mturi N, Murunga S, Otiende M, Iversen PO, Fegan GW, Walson JL, Berkley JA. Mortality during and following hospital admission among school-aged children: a cohort study. Wellcome Open Res 2021; 5:234. [PMID: 33195820 PMCID: PMC7656274 DOI: 10.12688/wellcomeopenres.16323.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Far less is known about the reasons for hospitalization or mortality during and after hospitalization among school-aged children than among under-fives in low- and middle-income countries. This study aimed to describe common types of illness causing hospitalisation; inpatient mortality and post-discharge mortality among school-age children at Kilifi County Hospital (KCH), Kenya. Methods: A retrospective cohort study of children 5−12 years old admitted at KCH, 2007 to 2016, and resident within the Kilifi Health Demographic Surveillance System (KHDSS). Children discharged alive were followed up for one year by quarterly census. Outcomes were inpatient and one-year post-discharge mortality. Results: We included 3,907 admissions among 3,196 children with a median age of 7 years 8 months (IQR 74−116 months). Severe anaemia (792, 20%), malaria (749, 19%), sickle cell disease (408, 10%), trauma (408, 10%), and severe pneumonia (340, 8.7%) were the commonest reasons for admission. Comorbidities included 623 (16%) with severe wasting, 386 (10%) with severe stunting, 90 (2.3%) with oedematous malnutrition and 194 (5.0%) with HIV infection. 132 (3.4%) children died during hospitalisation. Inpatient death was associated with signs of disease severity, age, bacteraemia, HIV infection and severe stunting. After discharge, 89/2,997 (3.0%) children died within one year during 2,853 child-years observed (31.2 deaths [95%CI, 25.3−38.4] per 1,000 child-years). 63/89 (71%) of post-discharge deaths occurred within three months and 45% of deaths occurred outside hospital. Post-discharge mortality was positively associated with weak pulse, tachypnoea, severe anaemia, HIV infection and severe wasting and negatively associated with malaria. Conclusions: Reasons for admissions are markedly different from those reported in under-fives. There was significant post-discharge mortality, suggesting hospitalisation is a marker of risk in this population. Our findings inform guideline development to include risk stratification, targeted post-discharge care and facilitate access to healthcare to improve survival in the early months post-discharge in school-aged children.
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Affiliation(s)
- Moses M Ngari
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya.,The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Christina Obiero
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Martha K Mwangome
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya.,The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Amek Nyaguara
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Neema Mturi
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Sheila Murunga
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Mark Otiende
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Per Ole Iversen
- Department of Nutrition, IBM, University of Oslo, Oslo, Norway.,Department of Haematology, Oslo University Hospital, Oslo, Norway.,Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa
| | - Gregory W Fegan
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya.,Swansea Trials Unit, Swansea University Medical School, Swansea, UK
| | - Judd L Walson
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya.,Departments of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, Seattle, USA
| | - James A Berkley
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya.,The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya.,Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
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Ngari MM, Obiero C, Mwangome MK, Nyaguara A, Mturi N, Murunga S, Otiende M, Iversen PO, Fegan GW, Walson JL, Berkley JA. Mortality during and following hospital admission among school-aged children: a cohort study. Wellcome Open Res 2021; 5:234. [PMID: 33195820 PMCID: PMC7656274 DOI: 10.12688/wellcomeopenres.16323.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/03/2023] Open
Abstract
Background: Far less is known about the reasons for hospitalization or mortality during and after hospitalization among school-aged children than among under-fives in low- and middle-income countries. This study aimed to describe common types of illness causing hospitalisation; inpatient mortality and post-discharge mortality among school-age children at Kilifi County Hospital (KCH), Kenya. Methods: A retrospective cohort study of children 5-12 years old admitted at KCH, 2007 to 2016, and resident within the Kilifi Health Demographic Surveillance System (KHDSS). Children discharged alive were followed up for one year by quarterly census. Outcomes were inpatient and one-year post-discharge mortality. Results: We included 3,907 admissions among 3,196 children with a median age of 7 years 8 months (IQR 74-116 months). Severe anaemia (792, 20%), malaria (749, 19%), sickle cell disease (408, 10%), trauma (408, 10%), and severe pneumonia (340, 8.7%) were the commonest reasons for admission. Comorbidities included 623 (16%) with severe wasting, 386 (10%) with severe stunting, 90 (2.3%) with oedematous malnutrition and 194 (5.0%) with HIV infection. 132 (3.4%) children died during hospitalisation. Inpatient death was associated with signs of disease severity, age, bacteraemia, HIV infection and severe stunting. After discharge, 89/2,997 (3.0%) children died within one year during 2,853 child-years observed (31.2 deaths [95%CI, 25.3-38.4] per 1,000 child-years). 63/89 (71%) of post-discharge deaths occurred within three months and 45% of deaths occurred outside hospital. Post-discharge mortality was positively associated with weak pulse, tachypnoea, severe anaemia, HIV infection and severe wasting and negatively associated with malaria. Conclusions: Reasons for admissions are markedly different from those reported in under-fives. There was significant post-discharge mortality, suggesting hospitalisation is a marker of risk in this population. Our findings inform guideline development to include risk stratification, targeted post-discharge care and facilitate access to healthcare to improve survival in the early months post-discharge in school-aged children.
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Affiliation(s)
- Moses M Ngari
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Christina Obiero
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Martha K Mwangome
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Amek Nyaguara
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Neema Mturi
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Sheila Murunga
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Mark Otiende
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
| | - Per Ole Iversen
- Department of Nutrition, IBM, University of Oslo, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa
| | - Gregory W Fegan
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
- Swansea Trials Unit, Swansea University Medical School, Swansea, UK
| | - Judd L Walson
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- Departments of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, Seattle, USA
| | - James A Berkley
- KEMRI/Wellcome Trust Research Programme, P.O Box 230 - 80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
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Dong Y, Hu P, Song Y, Dong B, Zou Z, Wang Z, Xu R, Luo D, Gao D, Wen B, Ma Y, Ma J, Tian X, Huang X, Narayan A, Patton GC. National and Subnational Trends in Mortality and Causes of Death in Chinese Children and Adolescents Aged 5-19 Years From 1953 to 2016. J Adolesc Health 2020; 67:S3-S13. [PMID: 32665069 DOI: 10.1016/j.jadohealth.2020.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/31/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to analyze the recent trends of mortality and rankings of causes of death in Chinese children and adolescents from 1953 to 2016. METHODS Data on mortality and causes of death in Chinese children and adolescents aged 5-19 years were extracted from the China Health Statistics Yearbook and the Global Burden of Disease Study from 1953 to 2016. Mortality variations were analyzed by year, age, sex, province, and causes of death. RESULTS The mortality of Chinese children and adolescents aged 5-19 years declined steadily from 1953 (366.03/100,000) to 2016 (27.21), with the largest reduction in adolescents aged 15-19 years and the smallest reduction in those aged 10-14 years. Large subnational disparities for all-cause mortality existed in national 31 provinces with higher mortality in western regions compared with eastern regions, but with narrowing disparities between 1981 and 2010. Injuries dominated the causes of death compared with noncommunicable diseases and communicable, maternal and neonatal, and nutritional diseases from 1990 (58.13/100,000 vs. 32.10 and 14.31) to 2016 (22.65 vs. 13.00 and 2.93). In 2016, the leading three causes of death were road injuries (8.30/100,000), drowning (7.25), and leukemia (2.60). Drowning was the leading cause of death for 5- to 14-year-olds, but road injuries have been the leading cause for 15- to 19-year-olds of both sexes since 2010. CONCLUSIONS Although mortality in Chinese adolescents now stands at just 7% of rates in the 1950s, there is a need to address continuing inequalities across sex, economic status, and region.
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Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Peijin Hu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Zhenghe Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Dongmei Luo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Disi Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Bo Wen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Xiaobo Tian
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - Xiaona Huang
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - Anuradha Narayan
- Health, Nutrition & WASH Section of UNICEF China Office, Beijing, China
| | - George C Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
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11
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Xu XH, Dong H, Li L, Liu WH, Lin GZ, Ou CQ. Trends and seasonality in cause-specific mortality among children under 15 years in Guangzhou, China, 2008-2018. BMC Public Health 2020; 20:1117. [PMID: 32678015 PMCID: PMC7364532 DOI: 10.1186/s12889-020-09189-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study analyzed the trends and seasonality in mortality among children aged 0-14 years in Guangzhou, China during 2008-2018. Understanding the epidemiology of this public health problem can guide policy development for children mortality prevention. METHODS A population-based epidemiological retrospective study was conducted. Seven thousand two hundred sixty-five individual data of children mortality were obtained from the Guangzhou Center for Disease Control and Prevention (CDC). The Poisson regression was used to quantify the annual average reduction rate and the difference in mortality rate between sex and age groups. Incidence ratio with 95% confidence interval (CI) was estimated to determine the temperaol variations in mortality by month, season, school term, day of the week and between holidays and other days. RESULTS Between 2008 and 2018, the children mortality rate in Guangzhou decreased from 54.0 to 34.3 per 100,000 children, with an annual reduction rate of 4.6% (95% CI: 1.1%-8.1%), especially the under-5 mortality rate decreased by 8.3% (95% CI: 4.8%-11.6%) per year. Decline trends varied by causes of death, even with an upward trend for the mortality of asphyxia and neurological diseases. The risk of death among males children was 1.33 times (95% CI: 1.20-1.47) of that of females. The distribution of causes of death differed by age group. Maternal and perinatal, congenital and pneumonia were the top three causes of death in infants and cancer accounted for 17% of deaths in children aged 1-14 years. Moreover, the injury-related mortality showed significant temporal variations with higher risk during the weekend. And there was a summer peak for drowning and a winter peak for asphyxia. CONCLUSIONS Guangzhou has made considerable progress in reducing mortality over the last decade. The findings of characteristics of children mortality would provide important information for the development and implementation of integrated interventions targeted specific age groups and causes of death.
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Affiliation(s)
- Xiao-Han Xu
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Hang Dong
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, Guangdong, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Wen-Hui Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, Guangdong, China
| | - Guo-Zhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, Guangdong, China.
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
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12
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Feng G, Zeng Y, Tian J, Wang X, Tai J, Song F, Zhang X, Xu X, Chen J, Shi T, Ni X. Disease spectrum analysis of hospitalized children in China: A study of 18 tertiary children's hospitals. Pediatr Investig 2019; 3:159-164. [PMID: 32851311 PMCID: PMC7331357 DOI: 10.1002/ped4.12144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 08/25/2019] [Indexed: 11/11/2022] Open
Abstract
IMPORTANCE Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender- and age-specific disease spectrum for hospitalized children under 15 years old is still unclear. OBJECTIVE To explore the gender- and age-based distribution of diseases in hospitalized children under 15 years in China. METHODS Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender- and age-specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). RESULTS The most common diseases were those of the respiratory system (25.7% of all 2 232 142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%). The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1-3 years, 25.2% for those aged 4-6 years, and 12.2% for those aged 7-14 years). INTERPRETATION This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender- and age-specific distribution among children in China.
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Affiliation(s)
- Guoshuang Feng
- Big Data and Engineering Research CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
- Beijing Advanced Innovation Center for Big Data‐Based Precision MedicineBeihang University & Capital Medical UniversityBeijingChina
| | - Yueping Zeng
- Medical Record Management OfficeBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Jian Tian
- Hospital Administration OfficeBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Xinyu Wang
- Big Data and Engineering Research CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Jun Tai
- Department of Otolaryngology Head and SurgeryBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
- Department of Scientific ResearchBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Fei Song
- Medical Record Management OfficeBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Xin Zhang
- Big Data and Engineering Research CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Xin Xu
- Information CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Jun Chen
- Big Data and Engineering Research CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Tieliu Shi
- The Center for Bioinformatics and Computational Biology, and the Institute of Biomedical SciencesSchool of Life SciencesEast China Normal UniversityShanghaiChina
| | - Xin Ni
- Big Data and Engineering Research CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
- Beijing Advanced Innovation Center for Big Data‐Based Precision MedicineBeihang University & Capital Medical UniversityBeijingChina
- Department of Otolaryngology Head and SurgeryBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
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Dey NC, Parvez M, Islam MR, Mistry SK, Levine DI. Effectiveness of a community-based water, sanitation, and hygiene (WASH) intervention in reduction of diarrhoea among under-five children: Evidence from a repeated cross-sectional study (2007-2015) in rural Bangladesh. Int J Hyg Environ Health 2019; 222:1098-1108. [PMID: 31439422 DOI: 10.1016/j.ijheh.2019.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/25/2019] [Accepted: 08/15/2019] [Indexed: 11/29/2022]
Abstract
Diarrhoea, the most common disease directly related to water, sanitation, and hygiene (WASH), still remains one of the most significant health problems among children under-five worldwide. In this reality, BRAC, the largest NGO in the world initiated a comprehensive WASH intervention in 50 upazilas (sub-districts) of Bangladesh in 2007 which was later scaled up to cover 150 upazilas in two subsequent phases. The intervention period of the programme was 2007-2011. The present study encompassed 30 upazilas of the first phase of intervention. The aim of the study was to investigate the effectiveness of this intervention on reduction of diarrhoea among under-five children, and to identify the factors associated with childhood diarrhoea. A repeated cross-sectional study design was followed, and a population-based survey was carried out on four occasions: baseline (2007), midline (2009), endline (2011), and post-endline (2015) among 4,775 households. This analysis considers only households having at least one under-five children. Absence of handwashing practice with soap after defecation and before eating food, unclean latrine condition, and unsafe disposal of child faeces were identified as significant risk factors associated with under-five diarrhoea from Log-binomial regression. The prevalence of under-five diarrhoea within the past 2 weeks of the survey declined from 13.7% at baseline to 3.6% at end-line (p < 0.001) in the WASH intervention area. However, the progress seemingly stalled after 2011, which may have occurred due to the lack of improvement in unsafe disposal of child faeces and unclean latrine condition after the intervention period. Study findings suggest that, to reduce the prevalence of childhood diarrhoea it is important to promote safe disposal of child faeces, maintaining cleanliness of latrines, and washing hand with soap at critical times, beyond merely increasing the sanitation coverage. Findings also underline the necessity of maintaining a small-scale monitoring component involving local community, such as a WatSan committee (a local committee comprising the user communities for supervising WASH related activities) for periodic monitoring at household level for a certain period after the program intervention works to make the behavioural change more sustainable and to keep the reduction rate of under-five diarrhoeal prevalence steady.
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Affiliation(s)
- Nepal C Dey
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; SID Foundation, Dhaka, 1216, Bangladesh.
| | - Mahmood Parvez
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Mir Raihanul Islam
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
| | - Sabuj K Mistry
- Environmental Health Sciences, BRAC James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh; Center for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
| | - David I Levine
- Haas School of Business, University of California, Berkeley, CA, 94720-1900, USA.
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Masquelier B, Hug L, Sharrow D, You D, Hogan D, Hill K, Liu J, Pedersen J, Alkema L. Global, regional, and national mortality trends in older children and young adolescents (5-14 years) from 1990 to 2016: an analysis of empirical data. LANCET GLOBAL HEALTH 2019; 6:e1087-e1099. [PMID: 30223984 PMCID: PMC6139755 DOI: 10.1016/s2214-109x(18)30353-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/19/2018] [Accepted: 07/11/2018] [Indexed: 02/07/2023]
Abstract
Background From 1990 to 2016, the mortality of children younger than 5 years decreased by more than half, and there are plentiful data regarding mortality in this age group through which we can track global progress in reducing the under-5 mortality rate. By contrast, little is known on how the mortality risk among older children (5–9 years) and young adolescents (10–14 years) has changed in this time. We aimed to estimate levels and trends in mortality of children aged 5–14 years in 195 countries from 1990 to 2016. Methods In this analysis of empirical data, we expanded the United Nations Inter-agency Group for Child Mortality Estimation database containing data on children younger than 5 years with 5530 data points regarding children aged 5–14 years. Mortality rates from 1990 to 2016 were obtained from nationally representative birth histories, data on household deaths reported in population censuses, and nationwide systems of civil registration and vital statistics. These data were used in a Bayesian B-spline bias-reduction model to generate smoothed trends with 90% uncertainty intervals, to determine the probability of a child aged 5 years dying before reaching age 15 years. Findings Globally, the probability of a child dying between the ages 5 years and 15 years was 7·5 deaths (90% uncertainty interval 7·2–8·3) per 1000 children in 2016, which was less than a fifth of the risk of dying between birth and age 5 years, which was 41 deaths (39–44) per 1000 children. The mortality risk in children aged 5–14 years decreased by 51% (46–54) between 1990 and 2016, despite not being specifically targeted by health interventions. The annual number of deaths in this age group decreased from 1·7 million (1·7 million–1·8 million) to 1 million (0·9 million–1·1 million) in 1990–2016. In 1990–2000, mortality rates in children aged 5–14 years decreased faster than among children aged 0–4 years. However, since 2000, mortality rates in children younger than 5 years have decreased faster than mortality rates in children aged 5–14 years. The annual rate of reduction in mortality among children younger than 5 years has been 4·0% (3·6–4·3) since 2000, versus 2·7% (2·3–3·0) in children aged 5–14 years. Older children and young adolescents in sub-Saharan Africa are disproportionately more likely to die than those in other regions; 55% (51–58) of deaths of children of this age occur in sub-Saharan Africa, despite having only 21% of the global population of children aged 5–14 years. In 2016, 98% (98–99) of all deaths of children aged 5–14 years occurred in low-income and middle-income countries, and seven countries alone accounted for more than half of the total number of deaths of these children. Interpretation Increased efforts are required to accelerate reductions in mortality among older children and to ensure that they benefit from health policies and interventions as much as younger children. Funding UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.
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Affiliation(s)
- Bruno Masquelier
- Centre of Demographic Research, Université Catholique de Louvain, Louvain-la-Neuve, Belgium.
| | - Lucia Hug
- Division of Data, Research, and Policy, UNICEF, New York, NY, USA
| | - David Sharrow
- Division of Data, Research, and Policy, UNICEF, New York, NY, USA
| | - Danzhen You
- Division of Data, Research, and Policy, UNICEF, New York, NY, USA
| | - Daniel Hogan
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Kenneth Hill
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jing Liu
- Fafo Technical Consulting, Beijing, China
| | - Jon Pedersen
- Fafo Institute for Labour and Social Research, Oslo, Norway
| | - Leontine Alkema
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
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Fadel SA, Boschi-Pinto C, Yu S, Reynales-Shigematsu LM, Menon GR, Newcombe L, Strong KL, Wang Q, Jha P. Trends in cause-specific mortality among children aged 5-14 years from 2005 to 2016 in India, China, Brazil, and Mexico: an analysis of nationally representative mortality studies. Lancet 2019; 393:1119-1127. [PMID: 30876707 PMCID: PMC6418656 DOI: 10.1016/s0140-6736(19)30220-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/07/2019] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND With global survival increasing for children younger than 5 years of age, attention is required to reduce the approximately 1 million deaths of children aged 5-14 years occurring every year. Causes of death at these ages remain poorly documented. We aimed to explore trends in mortality by causes of death in India, China, Brazil, and Mexico, which are home to about 40% of the world's children aged 5-14 years and experience more than 200 000 deaths annually at these ages. METHODS We examined data on 244 401 deaths in children aged 5-14 years from four nationally representative data sources that obtained direct distributions of causes of death: the Indian Million Death Study, the Chinese Disease Surveillance Points, mortality data from the Mexican Instituto Nacional de Estadística y Geografía, and mortality data from the Brazilian Institute of Geography and Statistics. We present data on 12 main disease groups in all countries, with breakdown by communicable and nutritional diseases, non-communicable diseases, injuries, and ill-defined causes. To calculate age-specific and sex-specific death rates for each cause, we applied the national cause of death distribution to the UN mortality envelopes for 2005-16 for each country. FINDINGS Unlike Brazil, China, and Mexico, communicable diseases still account for nearly half of deaths in India in children aged 5-14 years (73 920 [46·1%] of 160 330 estimated deaths in 2016). In 2016, India had the highest death rates in nearly every category, including from communicable diseases. Fast declines among girls in communicable disease mortality narrowed the gap by 2016 with boys in India (32·6 deaths per 100 000 girls vs 26·2 per 100 000 boys) and China (1·7 vs 1·5). In China, injuries accounted for the greatest proportions of deaths (20 970 [53·2%] of 39 430 estimated deaths, in which drowning was a leading cause). The homicide death rate at ages 10-14 years was higher for boys than for girls in Brazil, increasing annually by an average of 0·7% (0·3-1·1). In India and China, the suicide death rates were higher for girls than for boys at ages 10-14 years. By contrast, in Mexico it was higher for boys than for girls, increasing annually by an average of 2·8% (2·0-3·6). Deaths from transport injuries, drowning, and cancer are common in all four countries, with transport accidents among the top three causes of death for both sexes in all countries, except for Indian girls, and cancer in the top three causes for both sexes in Mexico, Brazil, and China. INTERPRETATION Most of the deaths that occurred between 2005 and 2016 in children aged 5-14 years in India, China, Brazil, and Mexico arose from preventable or treatable conditions. This age group is important for extending some of the global disease-specific targets developed for children younger than 5 years of age. Interventions to control non-communicable diseases and injuries and to strengthen cause of death reporting systems are also required. FUNDING WHO and the University of Toronto Connaught Global Challenge.
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Affiliation(s)
- Shaza A Fadel
- Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | | | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Geetha R Menon
- Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Leslie Newcombe
- Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Kathleen L Strong
- Maternal, Newborn, Child and Adolescent Health Department, WHO, Geneva, Switzerland
| | - Qiqi Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Prabhat Jha
- Centre for Global Health Research, St Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
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16
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Liu L, Patton G. Shedding light on a million annual deaths in mid-childhood. Lancet 2019; 393:1075-1076. [PMID: 30876705 DOI: 10.1016/s0140-6736(19)30422-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Li Liu
- Department of Population, Family, and Reproductive Health and Institute for International Programs, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - George Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Population Health Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Worthman CM, Dockray S, Marceau K. Puberty and the Evolution of Developmental Science. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2019; 29:9-31. [PMID: 30869841 PMCID: PMC6961839 DOI: 10.1111/jora.12411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
In recent decades, theoretical and methodological advances have operated synergistically to advance understanding of puberty and prompt increasingly comprehensive models that engage with the temporal, psychosocial, and biological dimensions of this maturational milepost. This integrative overview discusses these theoretical and methodological advances and their implications for research and intervention to promote human development in the context of changing maturational schedules and massive ongoing social transformations.
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18
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Patton GC, Azzopardi P. Missing in the middle: measuring a million deaths annually in children aged 5-14 years. LANCET GLOBAL HEALTH 2019; 6:e1048-e1049. [PMID: 30223976 DOI: 10.1016/s2214-109x(18)30417-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Affiliation(s)
- George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3010, Australia; Population Health Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Peter Azzopardi
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3010, Australia; Population Health Studies, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Maternal and Child Health Program, Burnet Institute, Melbourne, VIC, Australia; Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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20
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Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, Pinho C, Bhutta ZA, Dandona L, Ferrari A, Ghiwot TT, Hay SI, Kinfu Y, Liang X, Lopez A, Malta DC, Mokdad AH, Naghavi M, Patton GC, Salomon J, Sartorius B, Topor-Madry R, Vollset SE, Werdecker A, Whiteford HA, Abate KH, Abbas K, Damtew SA, Ahmed MB, Akseer N, Al-Raddadi R, Alemayohu MA, Altirkawi K, Abajobir AA, Amare AT, Antonio CAT, Arnlov J, Artaman A, Asayesh H, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Bacha U, Betsu BD, Barac A, Bärnighausen TW, Baye E, Bedi N, Bensenor IM, Berhane A, Bernabe E, Bernal OA, Beyene AS, Biadgilign S, Bikbov B, Boyce CA, Brazinova A, Hailu GB, Carter A, Castañeda-Orjuela CA, Catalá-López F, Charlson FJ, Chitheer AA, Choi JYJ, Ciobanu LG, Crump J, Dandona R, Dellavalle RP, Deribew A, deVeber G, Dicker D, Ding EL, Dubey M, Endries AY, Erskine HE, Faraon EJA, Faro A, Farzadfar F, Fernandes JC, Fijabi DO, Fitzmaurice C, Fleming TD, Flor LS, Foreman KJ, Franklin RC, Fraser MS, Frostad JJ, Fullman N, Gebregergs GB, Gebru AA, Geleijnse JM, Gibney KB, Gidey Yihdego M, Ginawi IAM, Gishu MD, Gizachew TA, Glaser E, Gold AL, Goldberg E, Gona P, Goto A, Gugnani HC, Jiang G, Gupta R, Tesfay FH, Hankey GJ, Havmoeller R, Hijar M, Horino M, Hosgood HD, Hu G, Jacobsen KH, Jakovljevic MB, Jayaraman SP, Jha V, Jibat T, Johnson CO, Jonas J, Kasaeian A, Kawakami N, Keiyoro PN, Khalil I, Khang YH, Khubchandani J, Ahmad Kiadaliri AA, Kieling C, Kim D, Kissoon N, Knibbs LD, Koyanagi A, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kulikoff R, Kumar GA, Lal DK, Lam HY, Larson HJ, Larsson A, Laryea DO, Leung J, Lim SS, Lo LT, Lo WD, Looker KJ, Lotufo PA, Magdy Abd El Razek H, Malekzadeh R, Markos Shifti D, Mazidi M, Meaney PA, Meles KG, Memiah P, Mendoza W, Abera Mengistie M, Mengistu GW, Mensah GA, Miller TR, Mock C, Mohammadi A, Mohammed S, Monasta L, Mueller U, Nagata C, Naheed A, Nguyen G, Nguyen QL, Nsoesie E, Oh IH, Okoro A, Olusanya JO, Olusanya BO, Ortiz A, Paudel D, Pereira DM, Perico N, Petzold M, Phillips MR, Polanczyk GV, Pourmalek F, Qorbani M, Rafay A, Rahimi-Movaghar V, Rahman M, Rai RK, Ram U, Rankin Z, Remuzzi G, Renzaho AMN, Roba HS, Rojas-Rueda D, Ronfani L, Sagar R, Sanabria JR, Kedir Mohammed MS, Santos IS, Satpathy M, Sawhney M, Schöttker B, Schwebel DC, Scott JG, Sepanlou SG, Shaheen A, Shaikh MA, She J, Shiri R, Shiue I, Sigfusdottir ID, Singh J, Silpakit N, Smith A, Sreeramareddy C, Stanaway JD, Stein DJ, Steiner C, Sufiyan MB, Swaminathan S, Tabarés-Seisdedos R, Tabb KM, Tadese F, Tavakkoli M, Taye B, Teeple S, Tegegne TK, Temam Shifa G, Terkawi AS, Thomas B, Thomson AJ, Tobe-Gai R, Tonelli M, Tran BX, Troeger C, Ukwaja KN, Uthman O, Vasankari T, Venketasubramanian N, Vlassov VV, Weiderpass E, Weintraub R, Gebrehiwot SW, Westerman R, Williams HC, Wolfe CDA, Woodbrook R, Yano Y, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaki MES, Zegeye EA, Zuhlke LJ, Murray CJL, Vos T. Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr 2017; 171:573-592. [PMID: 28384795 PMCID: PMC5540012 DOI: 10.1001/jamapediatrics.2017.0250] [Citation(s) in RCA: 250] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/16/2017] [Indexed: 01/06/2023]
Abstract
Importance Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. Objective To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Evidence Review Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Findings Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. Conclusions and Relevance Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.
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Affiliation(s)
- Nicholas Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hmwe Hmwe Kyu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Leo Zoeckler
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Katie Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Christine Pinho
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurgaon-122002, National Capital Region, India
| | - Alize Ferrari
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
| | - Yohannes Kinfu
- Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alan Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - George C Patton
- Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia
| | - Joshua Salomon
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Benn Sartorius
- School of Nursing and Public Health, University of KwaZulu-Natal, South African Medical Research Council/University of KwaZulu-Natal Gastrointestinal Cancer Research Center, Durban, South Africa
| | - Roman Topor-Madry
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Stein Emil Vollset
- Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Harvey A Whiteford
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | - Kaja Abbas
- Department of Population Health, Virginia Tech, Blacksburg
| | | | | | - Nadia Akseer
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | | | | | | | | | | | - Carl A T Antonio
- Department of Health Policy and Administration, University of Philippines-Manila, Manila, Philippines
| | - Johan Arnlov
- Department of Medical Services, Uppsala University, Uppsala, Sweden
- Dalarna University, Uppsala, Sweden
| | - Al Artaman
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Ashish Awasthi
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Umar Bacha
- School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | | | | | | | | | - Neeraj Bedi
- College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
| | | | - Adugnaw Berhane
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | | | | | | | - Boris Bikbov
- Department of Nephrology Issues of Transplanted Kidney, V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia
| | - Cheryl Anne Boyce
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alexandra Brazinova
- Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia
| | | | - Austin Carter
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Ferrán Catalá-López
- University of Valencia, Valencia, Spain
- Health Research Institute and CIBERSAM, Valencia, Spain
| | - Fiona J Charlson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - John Crump
- Departmentà Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | | | - Amare Deribew
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Gabrielle deVeber
- The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada
| | - Daniel Dicker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Eric L Ding
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Manisha Dubey
- International Institute for Population Sciences, Mumbai, India
| | | | - Holly E Erskine
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | | | - Andre Faro
- Federal University of Sergipe, Aracaju, Brazil
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Joao C Fernandes
- Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal
| | - Daniel Obadare Fijabi
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | | | - Thomas D Fleming
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Luisa Sorio Flor
- Escola Nacional de Saúde Pública Sergio Arouca/Fiocruz, Rio De Janeiro, Brazil
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Maya S Fraser
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Joseph J Frostad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Katherine B Gibney
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia
| | - Mahari Gidey Yihdego
- Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Mizan-Tepi University, Ethiopia
| | | | | | | | - Elizabeth Glaser
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Audra L Gold
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ellen Goldberg
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Harish Chander Gugnani
- Department of Microbiology, Departments of Epidemiology and Biostatistics, St James School of Medicine, the Quarter, Anguilla
| | - Guohong Jiang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | | | | | - Masako Horino
- Nevada Division of Public and Behavioral Health, Carson City, Nevada
| | | | - Guoqing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | | | | | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- University of Oxford, Oxford, United Kingdom
| | - Tariku Jibat
- Wageningen University, Wageningen, Netherlands
- Addis Ababa University, Addis Ababa, Ethiopia
| | - Catherine O Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jost Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karlas University, Heidelberg, Germany
| | - Amir Kasaeian
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ibrahim Khalil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Christian Kieling
- Federal University of Rio Grande de Sul, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniel Kim
- Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Niranjan Kissoon
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke D Knibbs
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Kristopher J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | - Rachel Kulikoff
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | | | - Hilton Y Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines
| | - Heidi J Larson
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anders Larsson
- Department of Medical Services, Uppsala University, Uppsala, Sweden
| | | | - Janni Leung
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Loon-Tzian Lo
- UnionHealth Associates LLC, St Louis, Missouri
- Alton Mental Health Center, Alton, Illinois
| | - Warren D Lo
- Department of Pediatrics, Department of Neurology, The Ohio State University, Columbus
| | | | - Paulo A Lotufo
- College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Reza Malekzadeh
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Mazidi
- Institute of Genetics and Developmental Biology, Key State Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Peter A Meaney
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | | | | | | | | | - George A Mensah
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Charles Mock
- School of Medicine, School of Global Health, University of Washington, Seattle
| | | | | | - Lorenzo Monasta
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Ulrich Mueller
- Federal Institute for Population Research, Wiesbaden, Germany
| | - Chie Nagata
- National Center for Child Health and Development, Tokyo, Japan
| | - Aliya Naheed
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Grant Nguyen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Quyen Le Nguyen
- Institute for Global Health, Duy Tan University, Da Nang, Vietnam
| | - Elaine Nsoesie
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - In-Hwan Oh
- Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
| | | | | | | | | | - Deepak Paudel
- UK Department for International Development, Lalitpur, Nepal
| | | | - Norberto Perico
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | - Max Petzold
- Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | - Mostafa Qorbani
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Anwar Rafay
- Contect International Health Consultants, Lahore, Punjab, Pakistan
| | - Vafa Rahimi-Movaghar
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahfuzar Rahman
- Research and Evaluation Division, Building Resources Access Communities, Dhaka, Bangladesh
| | | | - Usha Ram
- International Institute for Population Sciences, Mumbai, India
| | - Zane Rankin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | - Luca Ronfani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Rajesh Sagar
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Institute of Health Care and Social Sciences, FOM University, Essen, Germany
| | | | - James G Scott
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sadaf G Sepanlou
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amira Shaheen
- Department of Public Health, An-Najah University, Nablus, Palestine
| | | | - June She
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Work Organizations, Disability Program, University of Helsinki, Helsinki, Finland
| | - Ivy Shiue
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
| | | | | | - Naris Silpakit
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alison Smith
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Jeffrey D Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Caitlyn Steiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Karen M Tabb
- University of Illinois at Urbana-Champaign, Champaign
| | | | | | - Bineyam Taye
- Department of Biology, Colgate University, Hamilton, New York
| | - Stephanie Teeple
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | - Bernadette Thomas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alan J Thomson
- Adaptive Knowledge Management, Victoria, British Columbia, Canada
| | - Ruoyan Tobe-Gai
- National Center for Child Health and Development, Tokyo, Japan
| | | | | | - Christopher Troeger
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | | | | | | | | | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden
- Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | | | | | - Ronny Westerman
- Federal Institute for Population Research, Wiesbaden, Germany
| | | | | | - Rachel Woodbrook
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Yuichiro Yano
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | | | - Seok-Jun Yoon
- Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea
| | | | | | | | | | | | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
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Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, Casey DC, Charlson FJ, Chen AZ, Coates MM, Coggeshall M, Dandona L, Dicker DJ, Erskine HE, Ferrari AJ, Fitzmaurice C, Foreman K, Forouzanfar MH, Fraser MS, Fullman N, Gething PW, Goldberg EM, Graetz N, Haagsma JA, Hay SI, Huynh C, Johnson CO, Kassebaum NJ, Kinfu Y, Kulikoff XR, Kutz M, Kyu HH, Larson HJ, Leung J, Liang X, Lim SS, Lind M, Lozano R, Marquez N, Mensah GA, Mikesell J, Mokdad AH, Mooney MD, Nguyen G, Nsoesie E, Pigott DM, Pinho C, Roth GA, Salomon JA, Sandar L, Silpakit N, Sligar A, Sorensen RJD, Stanaway J, Steiner C, Teeple S, Thomas BA, Troeger C, VanderZanden A, Vollset SE, Wanga V, Whiteford HA, Wolock T, Zoeckler L, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Abreu DMX, Abu-Raddad LJ, Abyu GY, Achoki T, Adelekan AL, Ademi Z, Adou AK, Adsuar JC, Afanvi KA, Afshin A, Agardh EE, Agarwal A, Agrawal A, Kiadaliri AA, Ajala ON, Akanda AS, Akinyemi RO, Akinyemiju TF, Akseer N, Lami FHA, Alabed S, Al-Aly Z, Alam K, Alam NKM, Alasfoor D, Aldhahri SF, Aldridge RW, Alegretti MA, Aleman AV, Alemu ZA, Alexander LT, Alhabib S, Ali R, Alkerwi A, Alla F, Allebeck P, Al-Raddadi R, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amegah AK, Ameh EA, Amini H, Ammar W, Amrock SM, Andersen HH, Anderson BO, Anderson GM, Antonio CAT, Aregay AF, Ärnlöv J, Arsenijevic VSA, Artaman A, Asayesh H, Asghar RJ, Atique S, Avokpaho EFGA, Awasthi A, Azzopardi P, Bacha U, Badawi A, Bahit MC, Balakrishnan K, Banerjee A, Barac A, Barker-Collo SL, Bärnighausen T, Barregard L, Barrero LH, Basu A, Basu S, Bayou YT, Bazargan-Hejazi S, Beardsley J, Bedi N, Beghi E, Belay HA, Bell B, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berhane A, Bernabé E, Betsu BD, Beyene AS, Bhala N, Bhalla A, Biadgilign S, Bikbov B, Abdulhak AAB, Biroscak BJ, Biryukov S, Bjertness E, Blore JD, Blosser CD, Bohensky MA, Borschmann R, Bose D, Bourne RRA, Brainin M, Brayne CEG, Brazinova A, Breitborde NJK, Brenner H, Brewer JD, Brown A, Brown J, Brugha TS, Buckle GC, Butt ZA, Calabria B, Campos-Nonato IR, Campuzano JC, Carapetis JR, Cárdenas R, Carpenter DO, Carrero JJ, Castañeda-Orjuela CA, Rivas JC, Catalá-López F, Cavalleri F, Cercy K, Cerda J, Chen W, Chew A, Chiang PPC, Chibalabala M, Chibueze CE, Chimed-Ochir O, Chisumpa VH, Choi JYJ, Chowdhury R, Christensen H, Christopher DJ, Ciobanu LG, Cirillo M, Cohen AJ, Colistro V, Colomar M, Colquhoun SM, Cooper C, Cooper LT, Cortinovis M, Cowie BC, Crump JA, Damsere-Derry J, Danawi H, Dandona R, Daoud F, Darby SC, Dargan PI, das Neves J, Davey G, Davis AC, Davitoiu DV, de Castro EF, de Jager P, Leo DD, Degenhardt L, Dellavalle RP, Deribe K, Deribew A, Dharmaratne SD, Dhillon PK, Diaz-Torné C, Ding EL, dos Santos KPB, Dossou E, Driscoll TR, Duan L, Dubey M, Duncan BB, Ellenbogen RG, Ellingsen CL, Elyazar I, Endries AY, Ermakov SP, Eshrati B, Esteghamati A, Estep K, Faghmous IDA, Fahimi S, Faraon EJA, Farid TA, Farinha CSES, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JG, Fernandes JC, Fischer F, Fitchett JRA, Flaxman A, Foigt N, Fowkes FGR, Franca EB, Franklin RC, Friedman J, Frostad J, Fürst T, Futran ND, Gall SL, Gambashidze K, Gamkrelidze A, Ganguly P, Gankpé FG, Gebre T, Gebrehiwot TT, Gebremedhin AT, Gebru AA, Geleijnse JM, Gessner BD, Ghoshal AG, Gibney KB, Gillum RF, Gilmour S, Giref AZ, Giroud M, Gishu MD, Giussani G, Glaser E, Godwin WW, Gomez-Dantes H, Gona P, Goodridge A, Gopalani SV, Gosselin RA, Gotay CC, Goto A, Gouda HN, Greaves F, Gugnani HC, Gupta R, Gupta R, Gupta V, Gutiérrez RA, Hafezi-Nejad N, Haile D, Hailu AD, Hailu GB, Halasa YA, Hamadeh RR, Hamidi S, Hancock J, Handal AJ, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Havmoeller R, Heckbert SR, Heredia-Pi IB, Heydarpour P, Hilderink HBM, Hoek HW, Hogg RS, Horino M, Horita N, Hosgood HD, Hotez PJ, Hoy DG, Hsairi M, Htet AS, Htike MMT, Hu G, Huang C, Huang H, Huiart L, Husseini A, Huybrechts I, Huynh G, Iburg KM, Innos K, Inoue M, Iyer VJ, 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J, Tran BX, Truelsen T, Trujillo U, Tura AK, Tuzcu EM, Uchendu US, Ukwaja KN, Undurraga EA, Uthman OA, Dingenen RV, van Donkelaar A, Vasankari T, Vasconcelos AMN, Venketasubramanian N, Vidavalur R, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Wagner JA, Wagner GR, Wallin MT, Wang L, Watkins DA, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Westerman R, White RA, Wijeratne T, Wilkinson JD, Williams HC, Wiysonge CS, Woldeyohannes SM, Wolfe CDA, Won S, Wong JQ, Woolf AD, Xavier D, Xiao Q, Xu G, Yakob B, Yalew AZ, Yan LL, Yano Y, Yaseri M, Ye P, Yebyo HG, Yip P, Yirsaw BD, Yonemoto N, Yonga G, Younis MZ, Yu S, Zaidi Z, Zaki MES, Zannad F, Zavala DE, Zeeb H, Zeleke BM, Zhang H, Zodpey S, Zonies D, Zuhlke LJ, Vos T, Lopez AD, Murray CJL. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388:1459-1544. [PMID: 27733281 PMCID: PMC5388903 DOI: 10.1016/s0140-6736(16)31012-1] [Citation(s) in RCA: 4031] [Impact Index Per Article: 503.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. METHODS We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. INTERPRETATION At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. FUNDING Bill & Melinda Gates Foundation.
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Petroni S, Patel V, Patton G. Suicide in adolescent girls - Authors' reply. Lancet 2016; 387:1814. [PMID: 27203500 DOI: 10.1016/s0140-6736(16)00693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Suzanne Petroni
- International Center for Research on Women, Washington, DC 20036, USA.
| | - Vikram Patel
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - George Patton
- Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Australia
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Kwizera A, Dünser MW. A Global Perspective on Acute Respiratory Distress Syndrome and the Truth about Hypoxia in Resource-limited Settings. Am J Respir Crit Care Med 2016; 193:5-7. [DOI: 10.1164/rccm.201509-1819ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mathers C. Deaths of older children: what do the data tell us? LANCET GLOBAL HEALTH 2015; 3:e579-80. [DOI: 10.1016/s2214-109x(15)00094-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
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