The most accurate estimates of the causes of child deaths to date, published in this week’s issue of The Lancet, reveal that worldwide more than 70% of the 10·6 million child deaths that occur annually are attributable to six causes: pneumonia (19%), diarrhoea (18%), malaria (8%), neonatal sepsis or pneumonia (10%), preterm delivery (10%), and asphyxia at birth (8%).
Robert Black (Johns Hopkins Bloomberg School of Public Health, Baltimore, USA) and colleagues in an independent group on child health epidemiology, along with those from the World Health Organisation (WHO), analysed available data from publications and ongoing studies in 2000 to 2003 to obtain new estimates for mortality by cause in children younger than age 5 years. They found the four communicable disease categories account more than half (54%) of all child deaths. Infection of the blood or pneumonia in newborn babies and pneumonia in older children constitute 29% of all deaths. Undernutrition is an underlying cause of 53% of all deaths in children aged younger than 5 years. The investigators also calculated the total numbers and proportional distributions of deaths in children younger than age 5 years by cause for the six WHO-defined regions. Among deaths in children, 42% occur in the WHO Africa region, and an additional 29% occur in the south-east Asia region.
The authors state that the causes of child deaths can be addressed through existing, available, and affordable interventions. Reducing deaths in the neonatal period will confront health systems with new challenges, especially in low-income countries they add. (See The Lancet Neonatal Survival Series, March 2005)