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Statistics
While cause-specific mortality may be difficult to accurately ascertain,
many childhood deaths in developing countries can be attributed to five
main causes, or a combination of the causes: acute respiratory infection,
diarrhoea, measles, malaria and malnutrition.
WHO - Multicountry
Evaluation
An Uncertain Divide: Under-five deaths
by cause
Estimates of under-five deaths by cause are important for targeting
interventions to reduce child mortality and to monitor progress. Although
the total of under-five deaths is relatively well known, the proportion
related to each cause is much more uncertain and hence no numbers are
used on the chart. There are several reasons. First, vital registration
systems that provide cause of death data in industrialised countries
do not exist in most developing countries. Second, children often die
from multiple causes, and deciding which is the primary cause can be
difficult. In addition, malnutrition is associated with half the deaths.
Third, small-scale studies must be used to estimate cause for the majority
of under-five deaths. Most of these studies refer to the first half
of the 1990s and earlier, and hence provide no data on changes in the
last half of the decade. As an example of the uncertainty, estimates
for measles deaths vary between 1% and 8%
Acute Respiratory Infection (ARI)
ARI is a leading cause of mortality in children under the age of five
in developing countries. Respiratory infections caused by viruses or
bacteria, can manifest in any area of the respiratory tract, including
the nose, middle ear, throat, voice box, air passage, and lungs. Respiratory
syncytial virus (RSV) and parainfluenza virus type 3 are the main causes
of acute respiratory infection in early childhood. Pneumonia, an infection
of the lungs, is the most serious respiratory infection and often can
be treated with affordable oral antibiotics since the primary cause
of infection is bacteria. Children suffering from other conditions,
such as malnutrition or measles, are particularly susceptible to pneumonia.
To prevent deaths when children develop ARI, it is crucial that the
signs are recognised - a cough accompanied by difficult or short, rapid
breathing - and that appropriate health care is sought immediately.
Diarrhoeal Disease
Diarrhoea remains one of the major causes of death among the world's
children. Most die of dehydration - the loss of large quantities of
water and salt from the body. Many of these deaths can be prevented
with the use of oral rehydration therapy (ORT) at first onset of diarrhoea.
Diarrhoea is caused by ingesting certain bacteria, viruses or parasites
found in faecal matter which may be spread through water, food, hands,
eating and drinking utensils, flies, and dirt under fingernails. Diarrhoea
may present in different forms and have various treatment protocols:
persistent diarrhoea (more than 14 days), acute watery diarrhoea, or
dysentery (blood in stool). Other diseases that can occur concurrently
with diarrhoea include measles and malaria. Malnutrition also often
accompanies diarrhoea.
Measles
Measles is a highly contagious disease caused by a virus which is spread
easily from one person to another through the air when an infected person
coughs or sneezes and a susceptible person inhales the organism. Symptoms
include fever, runny nose, cough, and sore eyes, followed by a blotchy
rash usually starting on the face and spreading down the body. Children
with measles are susceptible to pneumonia. The best protection against
measles is immunisation. In addition, vitamin A supplements have been
found to reduce the severity of both measles and diarrhoea.
Malaria
Malaria is a widespread tropical disease caused by a parasite transmitted
to humans by mosquitoes. Young children are particularly vulnerable
because they have not developed the partial immunity that results from
surviving repeated infections. The disease may occur year-round or seasonally.
Symptoms of malaria include fever with shivering and sweating, headache,
and pain in the back, joints, or body. There may also be loss of appetite,
cough, vomiting, and diarrhoea, however fever may be the only sign of
malaria, making it difficult to distinguish. Malaria may cause several
weeks or months of poor health due to repeated attacks of fever, anaemia,
and general weakness. Children can deteriorate rapidly over 1-2 days,
becoming very ill, going into coma (cerebral malaria) or shock, or manifesting
convulsions, severe anaemia and acidosis. Malnutrition should be recognised
as possible co-existing condition. Prevention methods for malaria include
the use of insecticide-impregnated bednets in endemic areas. In most
cases, children with malaria can be quickly and effectively treated
with a course of inexpensive, oral anti-malarial tablets that are appropriate
for the area (i.e. without parasitic drug resistance).
Malnutrition
Malnutrition contributes to about half of all childhood deaths. Poor
feeding practices - inadequate breastfeeding, offering the wrong foods
at the wrong age, and giving food in insufficient quantities - contribute
to malnutrition. Infection, particularly frequent or persistent diarrhoea,
pneumonia, measles and malaria, also undermines nutritional status,
leaving malnourished children even more vulnerable to disease. Efforts
to prevent malnutrition include the promotion of breastfeeding, the
improvement of feeding practices, and the provision of routine micronutrient
supplements for children who need them.
Data sources
Childinfo: UNICEF's statistics.
Macrointernational,
for DHS surveys
World bank data sources (includes
MDGs) - specifically on childhood
development , health
Documentation
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