França Elisabeth Barboza, Lansky Sônia, Rego Maria Albertina Santiago, Malta Deborah Carvalho, França Julia Santiago, Teixeira Renato, Porto Denise, Almeida Marcia Furquim de, Souza Maria de Fatima Marinho de, Szwarcwald Célia Landman, Mooney Meghan, Naghavi Mohsen, Vasconcelos Ana Maria Nogales
Programa de Pós-graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
Secretaria Municipal de Saúde de Belo Horizonte - Belo Horizonte (MG), Brasil.
Rev Bras Epidemiol. 2017 May;20Suppl 01(Suppl 01):46-60. doi: 10.1590/1980-5497201700050005.
: To analyze under-5 mortality rates and leading causes in Brazil and states in 1990 and 2015, using the Global Burden of Disease Study (GBD) 2015 estimates.
: The main sources of data for all-causes under-5 mortality and live births estimates were the mortality information system, surveys, and censuses. Proportions and rates per 1,000 live births (LB) were calculated for total deaths and leading causes.
: Estimates of under-5 deaths in Brazil were 191,505 in 1990, and 51,226 in 2015, 90% of which were infant deaths. The rates per 1,000 LB showed a reduction of 67.6% from 1990 to 2015, achieving the proposed target established by the Millennium Development Goals (MDGs). The reduction generally was more than 60% in states, with a faster reduction in the poorest Northeast region. The ratio of the highest and lowest rates in the states decreased from 4.9 in 1990 to 2.3 in 2015, indicating a reduction in socioeconomic regional disparities. Although prematurity showed a 72% reduction, it still remains as the leading cause of death (COD), followed by diarrheal diseases in 1990, and congenital anomalies, birth asphyxia and septicemia neonatal in 2015.
: Under-5 mortality has decreased over the past 25 years, with reduction of regional disparities. However, pregnancy and childbirth-related causes remain as major causes of death, together with congenital anomalies. Intersectoral and specific public health policies must be continued to improve living conditions and health care in order to achieve further reduction of under-5 mortality rates in Brazil.
利用2015年全球疾病负担研究（GBD）的估计数据，分析1990年和2015年巴西及各邦5岁以下儿童死亡率及其主要死因。
5岁以下儿童全死因死亡率和活产估计数的主要数据来源是死亡信息系统、调查和人口普查。计算了每1000例活产中的死亡总数和主要死因的比例及死亡率。
1990年巴西5岁以下儿童死亡估计数为191,505例，2015年为51,226例，其中90%为婴儿死亡。每1000例活产的死亡率从1990年到2015年下降了67.6%，实现了千年发展目标（MDGs）设定的预期目标。各邦的降幅普遍超过60%，最贫困的东北地区降幅更快。各邦最高和最低死亡率之比从1990年的4.9降至2015年的2.3，表明社会经济区域差距有所缩小。尽管早产率下降了72%，但它仍是主要死因，1990年其次是腹泻病，2015年是先天性异常、出生窒息和新生儿败血症。
在过去25年里，5岁以下儿童死亡率有所下降，区域差距也有所缩小。然而，与妊娠和分娩相关的原因以及先天性异常仍然是主要死因。必须继续实施跨部门和具体的公共卫生政策，以改善生活条件和医疗保健，从而进一步降低巴西5岁以下儿童死亡率。
