Information about the distribution of causes of and time trends for child mortality
should be periodically updated. We report the latest estimates of causes of child
mortality in 2010 with time trends since 2000.
Updated total numbers of deaths in children aged 0-27 days and 1-59 months were applied
to the corresponding country-specific distribution of deaths by cause. We did the
following to derive the number of deaths in children aged 1-59 months: we used vital
registration data for countries with an adequate vital registration system; we applied
a multinomial logistic regression model to vital registration data for low-mortality
countries without adequate vital registration; we used a similar multinomial logistic
regression with verbal autopsy data for high-mortality countries; for India and China,
we developed national models. We aggregated country results to generate regional and
global estimates.
Of 7·6 million deaths in children younger than 5 years in 2010, 64·0% (4·879 million)
were attributable to infectious causes and 40·3% (3·072 million) occurred in neonates.
Preterm birth complications (14·1%; 1·078 million, uncertainty range [UR] 0·916-1·325),
intrapartum-related complications (9·4%; 0·717 million, 0·610-0·876), and sepsis or
meningitis (5·2%; 0·393 million, 0·252-0·552) were the leading causes of neonatal
death. In older children, pneumonia (14·1%; 1·071 million, 0·977-1·176), diarrhoea
(9·9%; 0·751 million, 0·538-1·031), and malaria (7·4%; 0·564 million, 0·432-0·709)
claimed the most lives. Despite tremendous efforts to identify relevant data, the
causes of only 2·7% (0·205 million) of deaths in children younger than 5 years were
medically certified in 2010. Between 2000 and 2010, the global burden of deaths in
children younger than 5 years decreased by 2 million, of which pneumonia, measles,
and diarrhoea contributed the most to the overall reduction (0·451 million [0·339-0·547],
0·363 million [0·283-0·419], and 0·359 million [0·215-0·476], respectively). However,
only tetanus, measles, AIDS, and malaria (in Africa) decreased at an annual rate sufficient
to attain the Millennium Development Goal 4.
Child survival strategies should direct resources toward the leading causes of child
mortality, with attention focusing on infectious and neonatal causes. More rapid decreases
from 2010-15 will need accelerated reduction for the most common causes of death,
notably pneumonia and preterm birth complications. Continued efforts to gather high-quality
data and enhance estimation methods are essential for the improvement of future estimates.
The Bill & Melinda Gates Foundation.
Copyright © 2012 Elsevier Ltd. All rights reserved.