非洲和亚洲特定病因的儿童死亡率：来自深入健康与人口监测系统站点的证据。
Cause-specific childhood mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.
作者信息
Streatfield P Kim, Khan Wasif A, Bhuiya Abbas, Hanifi Syed M A, Alam Nurul, Ouattara Mamadou, Sanou Aboubakary, Sié Ali, Lankoandé Bruno, Soura Abdramane B, Bonfoh Bassirou, Jaeger Fabienne, Ngoran Eliezer K, Utzinger Juerg, Abreha Loko, Melaku Yohannes A, Weldearegawi Berhe, Ansah Akosua, Hodgson Abraham, Oduro Abraham, Welaga Paul, Gyapong Margaret, Narh Clement T, Narh-Bana Solomon A, Kant Shashi, Misra Puneet, Rai Sanjay K, Bauni Evasius, Mochamah George, Ndila Carolyne, Williams Thomas N, Hamel Mary J, Ngulukyo Emmanuel, Odhiambo Frank O, Sewe Maquins, Beguy Donatien, Ezeh Alex, Oti Samuel, Diallo Aldiouma, Douillot Laetitia, Sokhna Cheikh, Delaunay Valérie, Collinson Mark A, Kabudula Chodziwadziwa W, Kahn Kathleen, Herbst Kobus, Mossong Joël, Chuc Nguyen T K, Bangha Martin, Sankoh Osman A, Byass Peter
机构信息
Matlab HDSS, Bangladesh; International Centre for Diarrhoeal Disease Research, Bangladesh; INDEPTH Network, Accra, Ghana.
International Centre for Diarrhoeal Disease Research, Bangladesh; INDEPTH Network, Accra, Ghana; Bandarban HDSS, Bangladesh.
出版信息
Glob Health Action. 2014 Oct 29;7:25363. doi: 10.3402/gha.v7.25363. eCollection 2014.
BACKGROUND
Childhood mortality, particularly in the first 5 years of life, is a major global concern and the target of Millennium Development Goal 4. Although the majority of childhood deaths occur in Africa and Asia, these are also the regions where such deaths are least likely to be registered. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering deaths and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.
OBJECTIVE
To present a description of cause-specific mortality rates and fractions over the first 15 years of life as documented by INDEPTH Network sites in sub-Saharan Africa and south-east Asia.
DESIGN
All childhood deaths at INDEPTH sites are routinely registered and followed up with verbal autopsy (VA) interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provided person-time denominators for mortality rates. Cause-specific mortality rates and cause-specific mortality fractions are presented according to WHO 2012 VA cause groups for neonatal, infant, 1-4 year and 5-14 year age groups.
RESULTS
A total of 28,751 childhood deaths were documented during 4,387,824 person-years over 18 sites. Infant mortality ranged from 11 to 78 per 1,000 live births, with under-5 mortality from 15 to 152 per 1,000 live births. Sites in Vietnam and Kenya accounted for the lowest and highest mortality rates reported.
CONCLUSIONS
Many children continue to die from relatively preventable causes, particularly in areas with high rates of malaria and HIV/AIDS. Neonatal mortality persists at relatively high, and perhaps sometimes under-documented, rates. External causes of death are a significant childhood problem in some settings.
背景
儿童死亡率，尤其是5岁前儿童的死亡率，是全球主要关注的问题，也是千年发展目标4的目标。虽然大多数儿童死亡发生在非洲和亚洲，但这些地区也是儿童死亡登记可能性最小的地区。深入网络通过整理来自特定健康和人口监测点的详细个人数据来努力缓解这一问题。通过在许多这样的监测点登记死亡并进行死因推断访谈以确定死因，使用标准化方法，该网络旨在生成其他途径无法获得的基于人群的死亡率统计数据。
目的
描述撒哈拉以南非洲和东南亚深入网络监测点记录的15岁前特定病因死亡率及比例。
设计
深入网络监测点的所有儿童死亡均进行常规登记，并通过死因推断访谈进行随访。对于本研究，将死因推断档案转换为世界卫生组织2012年死因推断标准格式，并使用InterVA-4模型进行处理以确定死因。常规监测数据还提供了死亡率的人时分母。根据世界卫生组织2012年死因推断病因组，呈现新生儿、婴儿、1-4岁和5-14岁年龄组的特定病因死亡率和特定病因死亡比例。
结果
在18个监测点的4387824人年期间，共记录了28751例儿童死亡。婴儿死亡率为每1000例活产11至78例，5岁以下儿童死亡率为每1000例活产15至152例。越南和肯尼亚的监测点报告的死亡率最低和最高。
结论
许多儿童继续死于相对可预防的原因，特别是在疟疾和艾滋病毒/艾滋病高发地区。新生儿死亡率持续处于较高水平，而且有时可能记录不足。在某些情况下，外部死因是儿童面临的一个重要问题。
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