Of the 7.6 million deaths worldwide among children under 5 years of age in 2010, 18% were caused by pneumonia, while 14% were the result of a complication of a preterm birth, researchers from Johns Hopkins Bloomberg School of Public Health and an international team of experts reported in The Lancet. The authors added that diarrhea is the third leading cause of deaths among very young children.

The researchers analyzed data on the distribution of child deaths around the world in 2010. They report that 40% of them were among infants under four weeks old (naonates). 64% of all the deaths were caused by or attributable to an infectious cause.

Even though total deaths among under 5s worldwide dropped from 2000 to 2010, in order to reach the Millennium Development Goal, the decline will need to be steeper, senior author Robert Black, MD, MPH, wrote.

Dr. Black said:

“The numbers are staggering. Of 7.6 million deaths globally in children younger than 5, 1.4 million or 18 percent were a result of pneumonia, 1.1 million or 14 percent were related to preterm birth complications and 0.8 million or 11 percent were a result of diarrhea.

Despite tremendous efforts to identify relevant data, the causes of only 2.7 percent of deaths in children younger than 5 years were medically certified in 2010. National health systems, as well as registration and medical certification of deaths, need to be promoted and strengthened to enable better accountability for the survival of children.”

The investigators divided death figures into children aged up to 27 days and 1 to 59 months, and linked causes of deaths to individual country statistics.

The number of deaths between 2000 and 2010 fell by over 2 million. At this rate of decline, a mortality reduction of two-thirds between 1990 and 2015 – a Millennium Development Goal by the United Nations – will not be achieved.

The following infectious disease-related deaths did fall enough to reach the goal by 2015:

Below are some of their highlighted findings for deaths among children aged up to 5 years in 2010:

  • Total 7.6 million

  • 4•879 million (64•0%) were caused by an infection or infectious disease

  • 3•072 million (40•3%) were aged up to 30 days

  • 1•078 million (14.1%) were linked to preterm birth complications

  • 0•717 million (9.4%) were caused by intrapartum-related complications

  • The leading causes of deaths among neonates were sepsis/meningitis, 0.939 (5.2%)

  • The leading causes of deaths among older children were pneumonia (1.071 million, 14.1%), diarrhea (0.751 million, 9.9%), malaria (0.564 million, 7.4%)

Lead author, Li Liu, PhD, MHS, said:

“Pneumonia, measles and diarrhea contributed the most reduction between 2000 and 2010, however, the reduction was not significant enough to achieve Millennium Development Goal number 4. Among the 3 leading causes of death from 2000-2010, diarrhea declined the fastest at 4 percent, followed by pneumonia at 3 percent and preterm birth complications at only 2 percent.

Child survival strategies should direct resources toward the leading causes of child mortality, with attention focusing on infectious and neonatal causes.”

The authors added:

“More rapid decreases from 2010-2015 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.”

Written by Christian Nordqvist