WHO estimates of the causes of death in children
WHO estimates of the causes of death in children
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DOI：
10.1016/s0140-6736(05)71877-8
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发表时间：
2005-03-01
期刊：
影响因子：
168.9
通讯作者：
Black, RE
中科院分区：
文献类型：
--
作者：
Bryce, J;Boschi-Pinto, C;Black, RE
儿童生存努力只有在基于有关死亡原因的准确信息的情况下才能有效。在这里，我们报告了4年的努力，WHO，以提高这一信息的准确性。方法WHO建立了外部儿童健康流行病学参考小组（CHERG）在2001年开发的比例估计死亡的儿童年龄小于5岁归因于肺炎，腹泻，疟疾，麻疹，和死亡的主要原因在生命的前28天。使用了各种方法，包括单原因和多原因比例死亡率模型。在2000- 2003年，六个原因占每年1060万5岁以下儿童死亡的73%：肺炎（19%）、腹泻（18%）、疟疾（8%）、新生儿肺炎或败血症（10%）、早产、分娩（10%）和出生时窒息（8%）。四类传染病占所有儿童死亡的一半以上（54%）。除疟疾外，世卫组织所有区域的最大传染病杀手相似;全球94%的疟疾死亡发生在非洲区域。在所有5岁以下儿童死亡中，营养不良是53%的根本原因。解释实现将儿童死亡率从1990年的水平降低三分之二的千年发展目标将取决于世卫组织所有区域预防和控制肺炎、腹泻和营养不良以及非洲区域预防和控制疟疾的新努力。在所有区域，还应解决主要由于早产、败血症或肺炎以及出生窒息造成的新生儿期死亡问题。这些对儿童死亡原因的估计应用来指导公共卫生政策和方案。
Background Child survival efforts can be effective only if they are based on accurate information about causes of deaths. Here, we report on a 4-year effort by WHO to improve the accuracy of this information.Methods WHO established the external Child Health Epidemiology Reference Group (CHERG) in 2001 to develop estimates of the proportion of deaths in children younger than age 5 years attributable to pneumonia, diarrhoea, malaria, measles, and the major causes of death in the first 28 days of life. Various methods, including single-cause and multi-cause proportionate mortality models, were used. The role of undemutrition as an underlying cause of death was estimated in collaboration with CHERG.Findings In 2000-03, six causes accounted for 73% of the 10.6 million yearly deaths in children younger than age 5 years: pneumonia (19%), diarrhoea (18%), malaria (8%), neonatal pneumonia or sepsis (10%), preterm, delivery (10%), and asphyxia at birth (8%). The four communicable disease categories account for more than half (54%) of all child deaths. The greatest communicable disease killers are similar in all WHO regions with the exception of malaria; 94% of global deaths attributable to this disease occur in the Africa region. Undernutrition is an underlying cause of 53% of all deaths in children younger than age 5 years.Interpretation Achievement of the millennium development goal of reducing child mortality by two-thirds from the 1990 rate will depend on renewed efforts to prevent and control pneumonia, diarrhoea, and undernutrition in all WHO regions, and malaria in the Africa region. In all regions, deaths in the neonatal period, primarily due to preterm delivery, sepsis or pneumonia, and birth asphyxia should also be addressed. These estimates of the causes of child deaths should be used to guide public-health policies and programmes.