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2018 ; 2
(5
): 321-337
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Causes of death among children aged 5-14 years in the WHO European Region: a
systematic analysis for the Global Burden of Disease Study 2016
#MMPMID29732397
Kyu HH
; Stein CE
; Boschi Pinto C
; Rakovac I
; Weber MW
; Dannemann Purnat T
; Amuah JE
; Glenn SD
; Cercy K
; Biryukov S
; Gold AL
; Chew A
; Mooney MD
; O'Rourke KF
; Sligar A
; Murray CJL
; Mokdad AH
; Naghavi M
Lancet Child Adolesc Health
2018[May]; 2
(5
): 321-337
PMID29732397
show ga
BACKGROUND: The mortality burden in children aged 5-14 years in the WHO European
Region has not been comprehensively studied. We assessed the distribution and
trends of the main causes of death among children aged 5-9 years and 10-14 years
from 1990 to 2016, for 51 countries in the WHO European Region. METHODS: We used
data from vital registration systems, cancer registries, and police records from
1980 to 2016 to estimate cause-specific mortality using the Cause of Death
Ensemble model. FINDINGS: For children aged 5-9 years, all-cause mortality rates
(per 100?000 population) were estimated to be 46·3 (95% uncertainty interval [UI]
45·1-47·5) in 1990 and 19·5 (18·1-20·9) in 2016, reflecting a 58·0% (54·7-61·1)
decline. For children aged 10-14 years, all-cause mortality rates (per 100?000
population) were 37·9 (37·3-38·6) in 1990 and 20·1 (18·8-21·3) in 2016,
reflecting a 47·1% (43·8-50·4) decline. In 2016, we estimated 10?740 deaths (95%
UI 9970-11?542) in children aged 5-9 years and 10?279 deaths (9652-10?897) in
those aged 10-14 years in the WHO European Region. Injuries (road injuries,
drowning, and other injuries) caused 4163 deaths (3820-4540; 38·7% of total
deaths) in children aged 5-9 years and 4468 deaths (4162-4812; 43·5% of total) in
those aged 10-14 years in 2016. Neoplasms caused 2161 deaths (1872-2406; 20·1% of
total deaths) in children aged 5-9 years and 1943 deaths (1749-2101; 18·9% of
total deaths) in those aged 10-14 years in 2016. Notable differences existed in
cause-specific mortality rates between the European subregions, from a two-times
difference for leukaemia to a 20-times difference for lower respiratory
infections between the Commonwealth of Independent States (CIS) and EU15 (the 15
member states that had joined the European Union before May, 2004).
INTERPRETATION: Marked progress has been made in reducing the mortality burden in
children aged 5-14 years over the past 26 years in the WHO European Region. More
deaths could be prevented, especially in CIS countries, through intervention and
prevention efforts focusing on the leading causes of death, which are road
injuries, drowning, and lower respiratory infections. The findings of our study
could be used as a baseline to assess the effect of implementation of programmes
and policies on child mortality burden. FUNDING: WHO and Bill & Melinda Gates
Foundation.