Greenwood B M, Greenwood A M, Bradley A K, Tulloch S, Hayes R, Oldfield F S
Ann Trop Paediatr. 1987 Jun;7(2):91-9. doi: 10.1080/02724936.1987.11748482.
A survey of deaths in children under the age of 7 years was made over a 1-year period in a rural area of The Gambia with few facilities for curative medicine but with a good record of infant immunizations. One hundred and eighty-four deaths were investigated. Only 12% of deaths occurred in a hospital or health centre but an attempt was made to establish a cause of death by interviewing the family of each dead child and by examining any health records that were available. The infant mortality rate was 142 per 1000 live births and the child mortality rate (death in children aged 1-4 years) 43 per 1000 per year. Acute respiratory infections, malaria and chronic diarrhoea with marasmus were the most frequent causes of death after the 1st month of life. Few children died of diseases that could have been prevented by routine immunizations. An effective immunization programme has probably had some effect on deaths in infancy and early childhood but it will be necessary to find ways of preventing deaths from malaria, acute respiratory infections and chronic diarrhoea/marasmus at the primary health care level if infant and childhood mortality are to be reduced further in rural areas of The Gambia.
在冈比亚的一个农村地区，对7岁以下儿童的死亡情况进行了为期1年的调查。该地区治疗性医疗设施匮乏，但婴儿免疫接种记录良好。共调查了184例死亡病例。只有12%的死亡发生在医院或健康中心，但通过走访每个死亡儿童的家庭并查阅所有可用的健康记录，试图确定死因。婴儿死亡率为每1000例活产142例，儿童死亡率（1至4岁儿童死亡）为每年每1000例43例。出生后第1个月后，急性呼吸道感染、疟疾以及伴有消瘦的慢性腹泻是最常见的死亡原因。很少有儿童死于可通过常规免疫预防的疾病。有效的免疫规划可能对婴儿期和幼儿期的死亡产生了一定影响，但如果要在冈比亚农村地区进一步降低婴儿和儿童死亡率，就必须找到在初级卫生保健层面预防疟疾、急性呼吸道感染和慢性腹泻/消瘦导致死亡的方法。
