Study provides detailed look at what kills world's children

ANDRÉ PICARD

From Friday's Globe and Mail

An estimated 10.6 million of the world's children under the age of 5 die each year, and the vast majority of those deaths could be prevented through simple measures like alleviating poverty, basic nutrition and vaccination, according to a new study.

The research, published in Friday's edition of the medical journal The Lancet, is touted as the most accurate childhood mortality data ever compiled.

The research reveals that a handful of causes account for three out of every four child deaths worldwide. The leading causes include:

Pneumonia, three million deaths: Pneumonia is an inflammation of the lungs that is particularly dangerous to newborns and children with compromised immune systems.

Pneumonia can be caused by a virus or bacteria, or occur as a complication of other illnesses. Many cases can be prevented through vaccination, and it can generally be cured easily and cheaply.

Diarrhea, 1.8 million deaths: Diarrhea is a serious danger to children because it causes dehydration. The disease can be caused by bacteria, viruses or parasites, many of which are contracted from drinking unclean water. Most cases of diarrhea are preventable and it is easily treatable.

Premature birth, 1.1 million deaths: Many premature births are due to malnutrition and disease.

Asphyxia at birth, 850,000 deaths: That so many babies are suffocating during the birthing process underscores that there is very little assistance available to women around the world and a lack of even the most basic instruments such as scissors to cut the umbilical cord.

Malaria, 850,000 deaths: The disease is caused by a parasite and transmitted by mosquitoes.

In Africa, a child dies of malaria every second, even though the disease is preventable and treatable.

Measles, 425,000 deaths: A highly contagious infection of the respiratory system, measles is caused by a virus. The measles vaccine, which has eliminated the disease from the developed world, is highly effective and costs pennies.

HIV-AIDS, 320,000 deaths: Children principally contract HIV-AIDS from their infected mothers. Inexpensive medications can prevent most mother-to-child transmissions.

Traumatic injuries, 320,000 deaths: With precarious living circumstances, many children are routinely exposed to dangers from falls, drowning and motor vehicles.

At least 4.4 million deaths occur in Africa, and 3.1 million in Southeast Asia.

About 40 per cent of the childhood deaths occur within one month of birth.

The report, prepared by a team led by Dr. Robert Black of the department of international health at Johns Hopkins Bloomberg School of Public Health in Baltimore, Md., said poor nutrition is an underlying factor in at least half of all deaths in children under the age of 5.

And while most of these deaths are, theoretically, easily preventable with “existing, available and affordable interventions,” he said making headway will not be easy.

“Reducing deaths in the neonatal period will confront weak health systems with new challenges, especially in low-income countries,” Dr. Black said.

In an commentary also published in The Lancet, Dr. Peter Byass, a researcher in the department of public health at Umea University in Umea, Sweden, said the new figures demonstrate that the “most important single determinant of childhood death has to be poverty.”

He noted that, on average, a Canadian consumes more health-care resources in a single day than an Ethiopian does in an entire year, and this sort of gross disparity underlies the death of millions of children annually.

The World Health Organization has, as one of its millennium development goals, set out to reduce childhood mortality by two-thirds between 1990 and 2015.

Much of the work to produce the new report was highly technical but designed to produce far more accurate estimates of childhood deaths, on the premise that accurate numbers are essential to developing public-health policies and programs.

In Canada, about 2,500 children under the age of 5 die each year, principally due to congenital anomalies (birth defects), traumatic injuries, cancer and respiratory diseases like asthma.

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