Gray R H
Department of Obstetrics and Gynaecology and Child Health, University of the West Indies, Kingston, Jamaica, WI.
West Indian Med J. 1999 Sep;48(3):106-9.
Childhood mortality and morbidity patterns in the English-speaking Caribbean have changed significantly over the past 40 years. Acute respiratory illness, physical injury and conditions originating in the perinatal period have replaced malnutrition, gastroenteritis and other infectious diseases as major causes of illness and death in Caribbean children. Although population growth has slowed down, about one-third of the population of the English-speaking Caribbean remains under the age of 15 years. Infant mortality rates have also fallen but the major contributor to this decline has been a reduction in post-neonatal deaths. The decrease in mortality and morbidity from infectious diseases has led to a prominence of disorders originating in the perinatal period, psychosocial problems and chronic childhood disorders. Adverse economic conditions are held culpable for the re-emergence of protein energy malnutrition (PEM) and pulmonary tuberculosis in some territories. There is an urgent need to focus attention on the areas of perinatal and adolescent health, childhood disability, accidental and non-accidental injury, sexual abuse and human immunodeficiency virus (HIV) infection. Immunization programmes also require continuing support and expansion. These tasks cannot be accomplished without meaningful long term investment of financial and human resources in the health and educational services of the region.
在过去40年里，加勒比地区说英语国家儿童的死亡率和发病率模式发生了显著变化。急性呼吸道疾病、身体损伤以及围产期疾病已取代营养不良、肠胃炎和其他传染病，成为加勒比地区儿童患病和死亡的主要原因。尽管人口增长有所放缓，但加勒比地区说英语国家约三分之一的人口仍未满15岁。婴儿死亡率也有所下降，但这一下降的主要原因是新生儿后期死亡人数的减少。传染病导致的死亡率和发病率的下降，使得围产期疾病、心理社会问题和儿童慢性疾病日益突出。一些地区蛋白质能量营养不良（PEM）和肺结核再度出现，人们认为恶劣的经济状况是罪魁祸首。迫切需要关注围产期和青少年健康、儿童残疾、意外和非意外伤害、性虐待以及人类免疫缺陷病毒（HIV）感染等领域。免疫规划也需要持续的支持和扩展。如果没有对该地区卫生和教育服务进行有意义的长期资金和人力资源投入，这些任务就无法完成。
