Trends in cause-specific mortality among children aged 5 14 years - - PowerPoint PPT Presentation

▶
trends in cause specific mortality among children aged 5
SMART_READER_LITE
LIVE PREVIEW

Trends in cause-specific mortality among children aged 5 14 years - - PowerPoint PPT Presentation

Oct 10, 2022 662 likes •845 views

Trends in cause-specific mortality among children aged 5 14 years from 2005 to 2016 in India, China, Brazil, and Mexico: an analysis of nationally representative mortality studies Release Date: The Lancet, March 12, 2019 cghr.org/child

slide-1
SLIDE 1

Trends in cause-specific mortality among children aged 5–14 years from 2005 to 2016 in India, China, Brazil, and Mexico: an analysis of nationally representative mortality studies

Release Date: The Lancet, March 12, 2019 cghr.org/child

slide-2
SLIDE 2

Collaborators:

  • Centre for Global Health Research, Toronto, Canada: Dr.

Shaza A Fadel, Leslie Newcombe, Prof. Prabhat Jha

  • Instituto de Saude Coletiva, Universidad Federal Fluminense,

Niteroi, Brazil: Prof. Cynthia Boschi-Pinto

  • China Center for Disease Control and Prevention: Prof.

Shicheng Yu, Qiqi Wang

  • Instituto Nacional de Salud Publica, Cuernavaca, Mexico: Luz

Myriam Reynales-Shigematsu

  • Indian Council of Medical Research, New Delhi, India: Dr.

Geetha R Menon

  • World Health Organization, Geneva, Switzerland: Kathleen L

Strong Funded by:

  • The World Health Organization
  • University of Toronto Connaught Global Challenge
slide-3
SLIDE 3

Background

  • Almost 1 million children aged 5-14 years died in 2016. (United Nations Inter-

Agency Group for Child Mortality Estimation [UN-IGME], 2018)

  • The causes of their death and how those have changed over times has not

been well studied or reported.

  • Direct evidence of causes of death are not routinely collected in many lower

and middle income countries, where most of the estimated deaths for children aged 5-14 years occur.

  • India, China, Brazil, and Mexico have more than ten years of high quality,

nationally-representative mortality data. We provide direct evidence from these sources on how causes of death for children aged 5–14 years for India, China, Brazil, and Mexico changed from 2005 to 2016.

  • These four countries account for 40% of 1.2 billion children aged 5-14 years

(UNWPP, 2017) and ~23% of deaths for this age group (UN-IGME, 2018).

slide-4
SLIDE 4

Key messages

  • Most deaths of children aged five to 14 in India, China, Brazil and Mexico

arise from preventable or treatable conditions.

  • In India, death rates from communicable diseases such as pneumonia,

tuberculosis and vaccine-preventable diseases were nearly 20 times higher than in China, and 10 times higher than in Brazil and Mexico.

  • China saw more deaths by drowning than any of the other countries. Boys

aged five to 14 had higher death rates than girls from nearly all injuries.

  • Higher suicide rates for girls than boys in India, but not the other countries.

Increasing rates of interpersonal violence for boys 10-14 in Brazil.

  • Deaths from road traffic injuries, neurological conditions, drowning and

childhood cancers were common leading causes in all four countries.

slide-5
SLIDE 5

Nationally-representative data sources: Sample systems

China (2004-2010, 2012-16) China’s Disease Surveillance Points (DSP) is sample- based mortality surveillance system coordinated by the Chinese Center for Disease Control and

  • Prevention. The DSP expanded from 161 sites in

2004 to 605 sites covering 324 million people in urban and rural areas in 2013, making it provincially-representative. The integrated mortality system combined the maternal and child surveillance, DSP, and vital registration since 2013. India (2005-2013) The Registrar General of India implemented the Million Death Study within the Sample Registration System Births and deaths were monitored in over 1.3 million homes in over 7000 randomly selected areas from the previous national census. Verbal autopsy records were each double coded by 2 of 400 trained physicians.

Liu et al. Bulletin of the World Health Organization 2016;94:46-57. doi: http://dx.doi.org/10.2471/BLT.15.153148

(http://censusindia.gov.in/2011- Common/Sample_Registration_System.html).

slide-6
SLIDE 6

Mexico (2005-2016) Mexico’s vital registration mortality data are publically available (http://www.inegi.org.mx/) from Mexican Instituto Nacional de Estadística y Geografía (INEGI). Nearly 95% of deaths in Mexico are registered and less than 2% of the causes are ill-defined, indicating the high quality of medical certification. Brazil (2005-2016) Brazil’s vital registration mortality data is publically

  • available. For causes of death from the Brazilian Ministry
  • f Health’s Banco de dados dos Sistemas de Informação

sobre Mortalidade (SIM) (http://datasus.saude.gov.br/informacoes-de- saude/servicos2/transferencia-de-arquivos). Population level from the Brazilian Institute of Geography and

  • Statistics. More than 90% of deaths are registered, but

with wide regional variation in quality.

Nationally-representative data sources: Vital registration

Mexico

1 cm = 217 km

· Mexico City ·

Brazil

1 cm = 368 km

· · Brasilia

slide-7
SLIDE 7

Death rates from communicable causes, especially for girls, in India were 20 times higher than in China and 10 times higher than in Brazil and Mexico

Deaths per 100 000 population

2005 2010 2015 2005 2010 2015 2005 2010 2015 2005 2010 2015

Girls 5-14 Boys 5-14

30 60 90

2005 2016 2010 2005 2016 2010 2005 2016 2010 2005 2016 2010

India Brazil

  • A. Communicable, nutritional

Brazil China India Mexico

slide-8
SLIDE 8

Sharp declines in preventable communicable causes, such as diarrhoea, pneumonia, and vaccine preventable diseases in India and China

  • A. India

5 10 15 20 Diarrhoea Pneumonia Malaria Men/Enc Vaccine Girls Boys

  • B. China

1 2 3 4 5

Deaths per 100 000 population

Diarrhoea Pneumonia Tuberculosis Men/Enc Vaccine

slide-9
SLIDE 9

India has higher baseline death rates for non-communicable COD than China, Brazil, and Mexico

2005 2010 2015 2005 2010 2015 2005 2010 2015 2005 2010 2015

Girls 5-14 Boys 5-14

Deaths per 100 000 population

15 30

2005 2016 2010 2005 2016 2010 2005 2016 2010 2005 2016 2010

  • B. Non-communicable

Brazil China India Mexico

slide-10
SLIDE 10

Highest death rates from NCDs were for Cancer and Neurological disease. Boys had higher death rates from cancer, particularly in Mexico and Brazil.

  • A. Cancer

2 4 6 8 2005 2016 2005 2016 2005 2016 2005 2016

India China Brazil Mexico

  • B. Neurological

2005 2010 2015 2005 2010 2015 2005 2010 2015 2005 2010 2015

Girls 5-14 Boys 5-14

Deaths per 100 000 population

Cancer

Brazil China India Mexico

slide-11
SLIDE 11

Highest death rates in China, Brazil, and Mexico are from injuries for boys

15 30

2005 2016 2010 2005 2016 2010 2005 2016 2010 2005 2016 2010

Girls 5-14 Boys 5-14

  • C. Injuries

Deaths per 100 000 population

Brazil China India Mexico

slide-12
SLIDE 12

Decreasing road traffic mortality in Brazil and Mexico for children aged 5-14 years. High death rates from drowning in China and India, especially for boys.

4 8 12 16 2005 20162005 20162005 20162005 2016

India China Mexico

  • A. Drowning 5-14

2 4 6 8 2005 20162005 20162005 20162005 2016

  • B. Transport accidents 5-14]

Deaths per 100 000 population

Brazil China India Mexico

slide-13
SLIDE 13

More girls than boys commit suicide in India and China, but unlike in India suicide mortality sharply declined in China. Suicide mortality is increasing in Mexico.

1 2 3 4 2005 20162005 20162005 20162005 2016

  • D. Suicide 10-14 years

Deaths per 100 000 population

Brazil China India Mexico

slide-14
SLIDE 14

Majority of homicides, and not suicides, for children aged 10-14 years in Brazil and Mexico were fire-arm related

Brazil

2 4 6 2005 2016 2 4 6 2005 2016

Mexico

2 4 6 2005 2016

Brazil

2 4 6 2005 2016

Mexico

  • B. Homicide Boys

1 2 3 2005 2016

Brazil Mexico

1 2 3 2005 2016

Brazil

1 2 3 2005 2016

Mexico

1 2 3 2005 2016

All homicide or suicide

  • A. Homicide Girls

Deaths per 100 000 population Firearm related

  • C. Suicide girls
  • D. Suicide Boys
slide-15
SLIDE 15

Implications

  • Understanding causes of death provides clear targets for

prevention and treatment

  • Effective interventions to reduce child mortality exist and

would need to include non-communicable causes and injuries. Country efforts to meet SDG targets for tuberculosis, malaria, cancer, suicide, and road traffic mortality should extend to children aged 5-14 years.

  • Major limitation was the inability to include data from other

high mortality low and middle income countries, esp. in Sub- Saharan Africa. Improved coverage and quality of direct mortality data are needed to measure progress in reducing these death.

slide-16
SLIDE 16

Key messages

  • Most deaths of children aged five to 14 in India, China, Brazil and Mexico

arise from preventable or treatable conditions.

  • In India, death rates from communicable diseases such as pneumonia,

tuberculosis and vaccine-preventable diseases were nearly 20 times higher than in China, and 10 times higher than in Brazil and Mexico.

  • China saw more deaths by drowning than any of the other countries. Boys

aged five to 14 had higher death rates than girls from nearly all injuries

  • Higher suicide rates for girls than boys in India, but not the other countries.

Increasing rates of interpersonal violence for boys 10-14 in Brazil.

  • Deaths from road traffic injuries, neurological conditions, drowning and

childhood cancers were common leading causes in all four countries .

slide-17
SLIDE 17

cghr.org/child

@CGHR_org

  • Link to full paper and appendix (free)
  • Press Release
  • PowerPoint Presentation
  • Link for data request
  • Video Press Release
  • Links to Other CGHR Research