Global, regional, and national causes of child mortality in 2008: a systematic analysis
Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. We used multicause proportionate mortality models to estimate deaths in neonates aged 0–2...
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| Vydáno v: | The Lancet (British edition) Ročník 375; číslo 9730; s. 1969 - 1987 |
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| Hlavní autoři: | , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Kidlington
Elsevier Ltd
05.06.2010
Elsevier Elsevier Limited |
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| ISSN: | 0140-6736, 1474-547X, 1474-547X |
| On-line přístup: | Získat plný text |
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| Abstract | Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years.
We used multicause proportionate mortality models to estimate deaths in neonates aged 0–27 days and children aged 1–59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world.
Of the estimated 8·795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5·970 million), with the largest percentages due to pneumonia (18%, 1·575 million, uncertainty range [UR] 1·046 million–1·874 million), diarrhoea (15%, 1·336 million, 0·822 million–2·004 million), and malaria (8%, 0·732 million, 0·601 million–0·851 million). 41% (3·575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1·033 million, UR 0·717 million–1·216 million), birth asphyxia (9%, 0·814 million, 0·563 million–0·997 million), sepsis (6%, 0·521 million, 0·356 million–0·735 million), and pneumonia (4%, 0·386 million, 0·264 million–0·545 million). 49% (4·294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.
These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions.
WHO, UNICEF, and Bill & Melinda Gates Foundation. |
|---|---|
| AbstractList | Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years.
We used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world.
Of the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.
These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions.
WHO, UNICEF, and Bill & Melinda Gates Foundation. Summary Background Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. Methods We used multicause proportionate mortality models to estimate deaths in neonates aged 0–27 days and children aged 1–59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world. Findings Of the estimated 8·795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5·970 million), with the largest percentages due to pneumonia (18%, 1·575 million, uncertainty range [UR] 1·046 million–1·874 million), diarrhoea (15%, 1·336 million, 0·822 million–2·004 million), and malaria (8%, 0·732 million, 0·601 million–0·851 million). 41% (3·575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1·033 million, UR 0·717 million–1·216 million), birth asphyxia (9%, 0·814 million, 0·563 million–0·997 million), sepsis (6%, 0·521 million, 0·356 million–0·735 million), and pneumonia (4%, 0·386 million, 0·264 million–0·545 million). 49% (4·294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. Interpretation These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions. Funding WHO, UNICEF, and Bill & Melinda Gates Foundation. Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. Methods - We used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world. Findings - Of the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. Interpretation - These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions. Funding - WHO, UNICEF, and Bill & Melinda Gates Foundation. Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. We used multicause proportionate mortality models to estimate deaths in neonates aged 0–27 days and children aged 1–59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world. Of the estimated 8·795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5·970 million), with the largest percentages due to pneumonia (18%, 1·575 million, uncertainty range [UR] 1·046 million–1·874 million), diarrhoea (15%, 1·336 million, 0·822 million–2·004 million), and malaria (8%, 0·732 million, 0·601 million–0·851 million). 41% (3·575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1·033 million, UR 0·717 million–1·216 million), birth asphyxia (9%, 0·814 million, 0·563 million–0·997 million), sepsis (6%, 0·521 million, 0·356 million–0·735 million), and pneumonia (4%, 0·386 million, 0·264 million–0·545 million). 49% (4·294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions. WHO, UNICEF, and Bill & Melinda Gates Foundation. Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years.BACKGROUNDUp-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years.We used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world.METHODSWe used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world.Of the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.FINDINGSOf the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China.These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions.INTERPRETATIONThese country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions.WHO, UNICEF, and Bill & Melinda Gates Foundation.FUNDINGWHO, UNICEF, and Bill & Melinda Gates Foundation. Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the major causes of death in children younger than 5 years. We used multicause proportionate mortality models to estimate deaths in neonates aged 0-27 days and children aged 1-59 months, and selected single-cause disease models and analysis of vital registration data when available to estimate causes of child deaths. New data from China and India permitted national data to be used for these countries instead of predictions based on global statistical models, as was done previously. We estimated proportional causes of death for 193 countries, and by application of these proportions to the country-specific mortality rates in children younger than 5 years and birth rates, the numbers of deaths by cause were calculated for countries, regions, and the world. Of the estimated 8.795 million deaths in children younger than 5 years worldwide in 2008, infectious diseases caused 68% (5.970 million), with the largest percentages due to pneumonia (18%, 1.575 million, uncertainty range [UR] 1.046 million-1.874 million), diarrhoea (15%, 1.336 million, 0.822 million-2.004 million), and malaria (8%, 0.732 million, 0.601 million-0.851 million). 41% (3.575 million) of deaths occurred in neonates, and the most important single causes were preterm birth complications (12%, 1.033 million, UR 0.717 million-1.216 million), birth asphyxia (9%, 0.814 million, 0.563 million-0.997 million), sepsis (6%, 0.521 million, 0.356 million-0.735 million), and pneumonia (4%, 0.386 million, 0.264 million-0.545 million). 49% (4.294 million) of child deaths occurred in five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China. These country-specific estimates of the major causes of child deaths should help to focus national programmes and donor assistance. Achievement of Millennium Development Goal 4, to reduce child mortality by two-thirds, is only possible if the high numbers of deaths are addressed by maternal, newborn, and child health interventions. WHO, UNICEF, and Bill & Melinda Gates Foundation. |
| Author | Liu, Li Cousens, Simon Rudan, Igor Campbell, Harry Lawn, Joy E Cibulskis, Richard Black, Robert E Johnson, Hope L Eisele, Thomas Bassani, Diego G Walker, Christa Fischer Mathers, Colin Jha, Prabhat |
| Author_xml | – sequence: 1 givenname: Robert E surname: Black fullname: Black, Robert E email: rblack@jhsph.edu organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 2 givenname: Simon surname: Cousens fullname: Cousens, Simon organization: London School of Hygiene and Tropical Medicine, London, UK – sequence: 3 givenname: Hope L surname: Johnson fullname: Johnson, Hope L organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 4 givenname: Joy E surname: Lawn fullname: Lawn, Joy E organization: Saving Newborn Lives/Save the Children, Cape Town, South Africa – sequence: 5 givenname: Igor surname: Rudan fullname: Rudan, Igor organization: University of Edinburgh Medical School, Edinburgh, UK – sequence: 6 givenname: Diego G surname: Bassani fullname: Bassani, Diego G organization: Centre for Global Health Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada – sequence: 7 givenname: Prabhat surname: Jha fullname: Jha, Prabhat organization: Centre for Global Health Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada – sequence: 8 givenname: Harry surname: Campbell fullname: Campbell, Harry organization: University of Edinburgh Medical School, Edinburgh, UK – sequence: 9 givenname: Christa Fischer surname: Walker fullname: Walker, Christa Fischer organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 10 givenname: Richard surname: Cibulskis fullname: Cibulskis, Richard organization: Global Malaria Programme, WHO, Geneva, Switzerland – sequence: 11 givenname: Thomas surname: Eisele fullname: Eisele, Thomas organization: Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA – sequence: 12 givenname: Li surname: Liu fullname: Liu, Li organization: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA – sequence: 13 givenname: Colin surname: Mathers fullname: Mathers, Colin organization: Department of Health Statistics and Informatics, WHO, Geneva, Switzerland |
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| ContentType | Journal Article |
| Contributor | Binkin, Nancy Awasthi, Shally Liu, Li Peterson, Herbert Bahl, Rajiv Inoue, Mie Kumar, Rajesh Weidemann, Carolyn Cherian, Thomas Lamberti, Laura Cousens, Simon Rudan, Igor Bassani, Diego Aryee, Martin Brown, David Filippi, Veronique Johnson, Hope Joseph, Veronique Chan, Kit Muhe, Lulu Guo, Yan Campbell, Harry Fat, Doris Ma Hutubessy, Raymond Ezzati, Majid Lawn, Joy Fontaine, Olivier Walker, Neff Young, Mark Pinto, Cynthia Boschi Katz, Joanne Gore, Fiona Jha, Prabhat Bhutta, Zulfiqar Boerma, Ties Steketee, Richard Lanata, Claudio Black, Robert E Martines, Jose Qazi, Shamim Eisele, Thomas Chopra, Mickey Oza, Shefali Caulfield, Laura Kalter, Henry Theodoratou, Evropi Bryce, Jennifer Walker, Christa Fischer Oestergaard, Mikkel Adler, Alma |
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| Copyright | 2010 Elsevier Ltd Elsevier Ltd 2015 INIST-CNRS Copyright 2010 Elsevier Ltd. All rights reserved. Copyright Elsevier Limited Jun 5-Jun 11, 2010 Copyright 2010 Elsevier Ltd. All rights reserved. |
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| DOI | 10.1016/S0140-6736(10)60549-1 |
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| Keywords | Human Medicine 2008 Statistical analysis Mortality Cause Regional Child Epidemiology Public health |
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| References | Crowcroft, Stein, Duclos, Birmingham (bib20) 2003; 3 Lawn, Cousens, Zupan (bib15) 2005; 365 Victora, Adair, Fall (bib30) 2008; 371 Watt, Wolfson, O'Brien (bib24) 2009; 374 bib13 bib10 Lawn, Wilczynska-Ketende, Cousens (bib16) 2006; 35 (bib11) 2009 (bib12) 2006 (bib22) 2009 Jha, Gajalakshmi, Gupta (bib25) 2006; 3 (bib14) 1998; 61 (bib9) 2009 (bib6) 2008; 371 Wolfson, Strebel, Gacic-Dobo, Hoekstra, McFarland, Hersh (bib21) 2007; 369 Bryce, Boschi-Pinto, Shibuya, Black (bib5) 2005; 365 Rudan, Chan, Zhang (bib27) 2010; 375 Black, Allen, Bhutta (bib29) 2008; 371 Jones, Steketee, Black, Bhutta, Morris (bib2) 2003; 362 (in press). You, Wardlaw, Salama, Jones (bib1) 2010; 375 Jha, Jacob, Gajalakshmi (bib26) 2008; 358 Bhutta, Ahmed, Black (bib4) 2008; 371 O'Brien, Wolfson, Watt (bib23) 2009; 374 bib7 Darmstadt, Bhutta, Cousens, Adam, Walker, de Bernis (bib3) 2005; 365 bib8 bib19 Johnson HL, Liu L, Fischer-Walker C, Black RE. Estimating the distribution of causes of death among children age 1–59 months in high mortality countries with incomplete death certification. (bib28) 2008 (bib18) 2009 Bhutta (10.1016/S0140-6736(10)60549-1_bib4) 2008; 371 Black (10.1016/S0140-6736(10)60549-1_bib29) 2008; 371 (10.1016/S0140-6736(10)60549-1_bib9) 2009 Jones (10.1016/S0140-6736(10)60549-1_bib2) 2003; 362 Victora (10.1016/S0140-6736(10)60549-1_bib30) 2008; 371 Darmstadt (10.1016/S0140-6736(10)60549-1_bib3) 2005; 365 (10.1016/S0140-6736(10)60549-1_bib14) 1998; 61 Rudan (10.1016/S0140-6736(10)60549-1_bib27) 2010; 375 Crowcroft (10.1016/S0140-6736(10)60549-1_bib20) 2003; 3 O'Brien (10.1016/S0140-6736(10)60549-1_bib23) 2009; 374 (10.1016/S0140-6736(10)60549-1_bib12) 2006 Wolfson (10.1016/S0140-6736(10)60549-1_bib21) 2007; 369 (10.1016/S0140-6736(10)60549-1_bib22) 2009 Lawn (10.1016/S0140-6736(10)60549-1_bib16) 2006; 35 Watt (10.1016/S0140-6736(10)60549-1_bib24) 2009; 374 Lawn (10.1016/S0140-6736(10)60549-1_bib15) 2005; 365 (10.1016/S0140-6736(10)60549-1_bib6) 2008; 371 Jha (10.1016/S0140-6736(10)60549-1_bib25) 2006; 3 You (10.1016/S0140-6736(10)60549-1_bib1) 2010; 375 Bryce (10.1016/S0140-6736(10)60549-1_bib5) 2005; 365 (10.1016/S0140-6736(10)60549-1_bib18) 2009 (10.1016/S0140-6736(10)60549-1_bib28) 2008 (10.1016/S0140-6736(10)60549-1_bib11) 2009 10.1016/S0140-6736(10)60549-1_bib17 Jha (10.1016/S0140-6736(10)60549-1_bib26) 2008; 358 20569823 - Lancet. 2010 Jun 5;375(9730):1941-3 20816541 - Lancet. 2010 Sep 4;376(9743):770-1 |
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| Snippet | Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates for 2008 of the... Summary Background Up-to-date information on the causes of child deaths is crucial to guide global efforts to improve child survival. We report new estimates... |
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| SubjectTerms | Biological and medical sciences Cause of Death - trends Child Child Mortality - trends Child, Preschool Cross-Cultural Comparison Epidemiology Female General aspects Health promotion Humans Infant Infant, Newborn Infectious diseases Internal Medicine Internationality Malaria Male Medical sciences Miscellaneous Models, Statistical Mortality Neonates Public health Public health. Hygiene Public health. Hygiene-occupational medicine Social Planning Statistical models Vector-borne diseases Vital Statistics |
| Title | Global, regional, and national causes of child mortality in 2008: a systematic analysis |
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