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全球新生儿及儿童医疗保健:联合国儿童基金会报告

Neonatal and pediatric healthcare worldwide: A report from UNICEF.

作者信息

Guerrera Giacomo

机构信息

Press Office UNICEF Italian Nat Com, via Palestro 68, 00185 Roma, Italy.

出版信息

Clin Chim Acta. 2015 Dec 7;451(Pt A):4-8. doi: 10.1016/j.cca.2015.03.004. Epub 2015 Mar 12.

Abstract

The 2013 UNICEF annual report on child mortality concluded that between 1990 and 2013, the annual number of deaths among children under-5 years of age has fallen to 6.6 million (uncertainty range, 6.3 to 7.0 million), corresponding to a 48% reduction from the 12.6 million deaths in 1990 (uncertainty range, 12.4 to 12.9 million). About half of under-5 deaths occur in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. By 2050, close to 40% of all live births will take place in Sub-Saharan Africa and 37% of the world's children under age five will live in the region. Most deaths can be attributable to preventable diseases. Pneumonia, diarrhea and malaria together killed roughly 2.2 million children under age five in 2012, accounting for a third of all under-five deaths. Emerging evidence has shown that children are at greater risk of dying before age five if they are born in rural areas, poor households, or to a mother denied basic education. While under-5 mortality was consistently reduced over the past 20 years, few progresses in reducing neonatal mortality as well as maternal mortality have been done. UNICEF is a leading partner in the Global Alliance for Vaccines and Immunization (GAVI), a far-reaching public-private partnership dedicated to increasing children's access to vaccines in poor countries. Early diagnosis and appropriate low-cost therapy of maternal and neonatal diseases are the challenges of the coming years. Therefore, there is the need to promote new experimental and clinical researches and to translate results in clinical practice. Laboratory medicine is strategic for promoting and validating innovative methods for managing the most important causes of maternal, neonatal and under-5 deaths, as well as to consistently reduce the gap between bench and bedside. This may be achieved by a close cooperation between laboratory medicine and industries for the development of new diagnostic tools, especially low-cost disposables easily usable by everyone, namely mothers, for an earlier and specific therapeutic treatments of such diseases like sepsis and infections.

摘要

联合国儿童基金会2013年儿童死亡率年度报告得出结论,1990年至2013年期间,5岁以下儿童的年死亡人数已降至660万(不确定范围为630万至700万),与1990年的1260万死亡人数(不确定范围为1240万至1290万)相比减少了48%。约一半的5岁以下儿童死亡仅发生在五个国家:印度、尼日利亚、刚果民主共和国、巴基斯坦和中国。到2050年,近40%的新生儿将在撒哈拉以南非洲出生,37%的5岁以下儿童将生活在该地区。大多数死亡可归因于可预防疾病。2012年,肺炎、腹泻和疟疾共导致约220万5岁以下儿童死亡,占所有5岁以下儿童死亡人数的三分之一。新证据表明,如果儿童出生在农村地区、贫困家庭或母亲未接受基础教育的家庭,他们在5岁前死亡的风险更大。虽然过去20年5岁以下儿童死亡率持续下降,但在降低新生儿死亡率以及孕产妇死亡率方面进展甚微。联合国儿童基金会是全球疫苗免疫联盟(GAVI)的主要合作伙伴,这是一个影响深远的公私合作伙伴关系,致力于增加贫困国家儿童获得疫苗的机会。孕产妇和新生儿疾病的早期诊断和适当的低成本治疗是未来几年面临的挑战。因此需要推动新的实验和临床研究,并将研究结果转化为临床实践。检验医学对于推广和验证管理孕产妇、新生儿和5岁以下儿童死亡最重要原因的创新方法以及持续缩小实验室与临床之间的差距具有战略意义。这可以通过检验医学与产业界密切合作开发新诊断工具来实现,特别是开发人人都能轻松使用的低成本一次性用品,即母亲们能够使用这些用品对败血症和感染等疾病进行更早、更具针对性的治疗。

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