Preventable infectious diseases were responsible for almost two-thirds of deaths in children under five worldwide, according to figures published today.
A study by Robert Black from John Hopkins Bloomberg School of Public Health, USA, concluded that more work had to be undertaken if Millennium Development Goal 4 to reduce death rates in children under five by two-thirds between 1990 and 2015 was to be achieved.
Writing in The Lancet, he said in the past decade, the rate for under-fives reduced at an average rate of 2.6 per cent per year – less than 4.4 per cent of the annual rate of decrease needed to reach the goal. Of the 7.6 million deaths of children under five worldwide in 2010, almost two-thirds were as a result of preventable disease.
“The attainment of MDG4 is possible only if life-saving maternal, newborn, and child health interventions are rapidly scaled up in high-burden regions and countries and across major causes in the next few years,” he writes.
The researchers assessed registration systems, household surveys, verbal autopsy, and other sources across 193 countries to estimate the causes of death of children younger than 5 years for 2010 by country, region, and globally.
They found two-fifths of deaths occurred within the first month of life. Preterm birth was second only to pneumonia as the leading cause of child death in 2010, which indicated the “crucial importance of the reduction of neonatal deaths if countries are to achieve MDG4”, write the authors.
In the same year, one third of deaths in children under five years occurred in southeast Asia and half in Africa.
In Africa, 73 per cent (2.6 million) of all child deaths in Africa were as a result of infections, including 96 per cent of all deaths due to malaria and 90 per cent due to AIDS. In comparison, neonatal causes were the leading cause of death (1.096 million deaths) in southeast Asia.
India, Nigeria, Pakistan, Democratic Republic of Congo, and China accounted for 3.754 million deaths in children under the age of five and contributed to half the deaths from infections and more than half the deaths due to neonatal causes.
The authors conclude: "Across all the previous and current rounds of causes of childhood death estimation, pneumonia and preterm birth complications consistently rank as the leading causes at the global level. Our trend analysis shows that accelerated reductions are needed in the two major causes and in the two high-burden regions to achieve MDG4 by 2015.”
But in a Comment article, Zulfiqar Bhutta from The Aga Khan University, Karachi, Pakistan, writes: “Too much emphasis has been placed in recent years on global numbers and mortality, and less on understanding the determinants and direction of trends.”
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