Causes of childhood deaths in Bangladesh: an update
Causes of childhood deaths in Bangladesh: an update
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DOI：
10.1080/080352501750258775
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发表时间：
2001-06-01
期刊：
影响因子：
3.8
通讯作者：
Black, RE
中科院分区：
文献类型：
--
作者：
Baqui, AH;Sabir, AA;Black, RE
了解儿童死亡的原因对于卫生部门的规划很重要，因为这些原因与现有的干预措施有关。由于孟加拉国没有生命登记系统，而且很少有合格的医生负责处理儿童死亡，因此人们对传统来源的儿童死亡原因知之甚少。为了确定儿童死亡的原因结构，在孟加拉国1993/94年人口和健康调查全国样本中进行了口头和尸检访谈。口头验尸是一种根据对近亲或其他照顾者的采访来找出死因的方法。在BDHS 1993/94年至BDHS 1996/97年期间，孟加拉国14岁儿童死亡率下降了约27.0%。这一令人印象深刻的下降促使使用BDHS 1996/97年全国样本进行口头尸检研究，以确定原因结构是否发生了变化。在两次调查中，都使用了相同的口头尸检工具和收集数据的方法，以及相同的计算机算法来确定死因。对英国国土安全部1993/94年和1996/97年按死因分类的死亡率的比较表明，几乎所有原因造成的死亡率都有所下降，但只有急性呼吸道感染、持续性腹泻和溺水的死亡率显著下降。新生儿破伤风、急性水样腹泻和营养不良导致的死亡丝毫没有减少。结论：尽管急性呼吸窘迫综合征的死亡率显著下降，但这种疾病仍然是孟加拉儿童最重要的已知死亡原因。新生儿破伤风和麻疹加在一起约占5岁以下儿童死亡的10%。通过改善可获得的儿童生存干预措施的机会和质量，可以进一步改善儿童存活率。
Knowledge of the causes of child death is important for health-sector planning since they relate to available interventions. Little is known about causes of child death in Bangladesh from the conventional sources since there is no vital registration system and very few deaths are attended by a qualified physician. To determine the cause structure of child deaths, verbal, autopsy interviews were conducted in the Bangladesh Demographic and Health Survey (BDHS) 1993/94 national sample. Verbal autopsy is a method of finding out the causes of death based on an interview with the next of kin or other caregivers. Between BDHS 1993/94 and BDHS 1996/97, 14-y-old child mortality in Bangladesh declined by about 27.0%. This impressive decline prompted a verbal autopsy study using the BDHS 1996/97 national sample to determine whether the cause structure had changed. The same verbal autopsy instrument and methods to collect the data and the same computer algorithm to assign causes of death were used in both surveys. Comparison of BDHS 1993/94 and 1996/97 cause-specific mortality rates revealed that deaths due to almost all causes had declined, although significantly so only for acute respiratory infections (ARI), persistent diarrhoea and drowning. Deaths due to neonatal tetanus, acute watery diarrhoea and undernutrition had not decreased at all.Conclusion: Despite an impressive decline in deaths due to ARI, this condition remains the most important known cause of death in Bangladeshi children. Neonatal tetanus and measles together account for about 10% of deaths in children under 5 y. Further improvements in child survival are possible by improving access to and quality of available child survival interventions.