Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals
Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019. We updated cause-specific mortality estimates for neonat...
Saved in:
| Published in: | The lancet child & adolescent health Vol. 6; no. 2; p. 106 |
|---|---|
| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
01.02.2022
|
| Subjects: | |
| ISSN: | 2352-4650, 2352-4650 |
| Online Access: | Get more information |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.
We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.
In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.
Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.
Bill & Melinda Gates Foundation; WHO. |
|---|---|
| AbstractList | Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.
We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.
In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.
Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.
Bill & Melinda Gates Foundation; WHO. Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.BACKGROUNDCauses of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.METHODSWe updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.FINDINGSIn 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.INTERPRETATIONProgress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.Bill & Melinda Gates Foundation; WHO.FUNDINGBill & Melinda Gates Foundation; WHO. |
| Author | Villavicencio, Francisco Yeung, Diana Prieto-Merino, David Liu, Li Mulick, Amy Cousens, Simon Black, Robert E Lopez, Gerard Perin, Jamie Strong, Kathleen L |
| Author_xml | – sequence: 1 givenname: Jamie surname: Perin fullname: Perin, Jamie organization: Department of International Health, Johns Hopkins University, Baltimore, MD, USA – sequence: 2 givenname: Amy surname: Mulick fullname: Mulick, Amy organization: Epidemiology and Population Health, London School of Tropical Medicine & Hygiene, London, UK – sequence: 3 givenname: Diana surname: Yeung fullname: Yeung, Diana organization: Department of International Health, Johns Hopkins University, Baltimore, MD, USA – sequence: 4 givenname: Francisco surname: Villavicencio fullname: Villavicencio, Francisco organization: Department of International Health, Johns Hopkins University, Baltimore, MD, USA – sequence: 5 givenname: Gerard surname: Lopez fullname: Lopez, Gerard organization: Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland – sequence: 6 givenname: Kathleen L surname: Strong fullname: Strong, Kathleen L organization: Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland – sequence: 7 givenname: David surname: Prieto-Merino fullname: Prieto-Merino, David organization: Epidemiology and Population Health, London School of Tropical Medicine & Hygiene, London, UK – sequence: 8 givenname: Simon surname: Cousens fullname: Cousens, Simon organization: Epidemiology and Population Health, London School of Tropical Medicine & Hygiene, London, UK – sequence: 9 givenname: Robert E surname: Black fullname: Black, Robert E organization: Department of International Health, Johns Hopkins University, Baltimore, MD, USA – sequence: 10 givenname: Li surname: Liu fullname: Liu, Li email: lliu26@jhu.edu organization: Department of International Health, Johns Hopkins University, Baltimore, MD, USA; Department of Population, Family, and Reproductive Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: lliu26@jhu.edu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34800370$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkM1O3EAQhEfRouxCeISgPm4kDPPjnzG3iMCChMQB7qv2uB0mGs8Yz5hoH4Z3xSGLxKmqWlXfoQ_ZwgdPjH0X_ExwUZ4_SFXILC9zuZbiB-dKiCz_wlb7c8EXn_ySHcf4h3MutBYVz7-ypcr1PKr4ir1uXGjQncJIv23w_xz6Fjym9wQGp0gRQgeTb2nMCujDmNDZtAPrQc7YTNQX8wimocVELcRdTNTPADNf0e2ijfDXpiew_eCseSdH6MII6YngYYoJrcfGEfyiF3Jh6Mkn2AR08Rs76Gah470escfrq8fLm-zufnN7-fMuI1XWKSskKa2NaIu6wbIytcrbllDgHJRBoyqjUJadFoXosJOyIDJGi07zhmQpj9j6P3YYw_NEMW17Gw05h57CFLey5FzqMq_quXqyr05NT-12GG2P42778VH5BrxMfXE |
| ContentType | Journal Article |
| Copyright | Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1016/S2352-4642(21)00311-4 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2352-4650 |
| ExternalDocumentID | 34800370 |
| Genre | Research Support, Non-U.S. Gov't Journal Article |
| GrantInformation | Bill & Melinda Gates Foundation; WHO. |
| GrantInformation_xml | – fundername: World Health Organization grantid: 001 |
| GroupedDBID | 0R~ 53G AAEDW AALRI AAMRU AAQFI AAXUO AAYWO ABMAC ACVFH ADBBV ADCNI ADVLN AEUPX AFPUW AFTJW AGCQF AIGII AITUG AKBMS AKRWK AKYEP ALMA_UNASSIGNED_HOLDINGS AMRAJ APXCP CGR CUY CVF EBS ECM EFKBS EIF EJD FDB HX~ K-O NPM ROL 7X8 |
| ID | FETCH-LOGICAL-e369t-52e388c1d59ba67c934ddea1aa673cac37c3a26f8151faf225eecc81f80be262 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 826 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000750210000013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 2352-4650 |
| IngestDate | Thu Sep 25 09:01:27 EDT 2025 Mon Jul 21 05:45:30 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 2 |
| Language | English |
| License | Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-e369t-52e388c1d59ba67c934ddea1aa673cac37c3a26f8151faf225eecc81f80be262 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | http://www.thelancet.com/article/S2352464221003114/pdf |
| PMID | 34800370 |
| PQID | 2600286479 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2600286479 pubmed_primary_34800370 |
| PublicationCentury | 2000 |
| PublicationDate | 2022-02-00 20220201 |
| PublicationDateYYYYMMDD | 2022-02-01 |
| PublicationDate_xml | – month: 02 year: 2022 text: 2022-02-00 |
| PublicationDecade | 2020 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England |
| PublicationTitle | The lancet child & adolescent health |
| PublicationTitleAlternate | Lancet Child Adolesc Health |
| PublicationYear | 2022 |
| References | 34921809 - Lancet Child Adolesc Health. 2022 Jan;6(1):e4. doi: 10.1016/S2352-4642(21)00382-5. |
| References_xml | – reference: 34921809 - Lancet Child Adolesc Health. 2022 Jan;6(1):e4. doi: 10.1016/S2352-4642(21)00382-5. |
| SSID | ssj0001881704 |
| Score | 2.672908 |
| Snippet | Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 106 |
| SubjectTerms | Cause of Death - trends Child Mortality - trends Child, Preschool Female Global Health Humans Infant Infant Mortality - trends Male Models, Statistical Sustainable Development World Health Organization |
| Title | Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/34800370 https://www.proquest.com/docview/2600286479 |
| Volume | 6 |
| WOSCitedRecordID | wos000750210000013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8NAEF7Uinjx_agvRvCgYOhmN002XkTE6sGWQnvorWz2AT2Y1Kb13_hfnU1S0osgeAlkYWGz--3k29mZbwi5ETSSRmjhJdbHAwoyZi-hkiKRo4FWXCKFKCTz36NeT4xGcb9yuOVVWOXSJhaGWmfK-chbTkidiTCI4sfpp-eqRrnb1aqExjppcKQyDtXRSNQ-FuHk54KivlybeQGykTqJpzWoGgN2y_w7h24c7O9Es_jhdHb_O9Q9slNRTXgqsbFP1kx6QLa61WX6Ifku9f7vwRVncIT8HmSqYekeBCUXuckhs-ASzWZeGz4Kro68HSYpFNnifvyAnWAxdY4DDbUuNLaWaifgPL0wWQlcB-TJgLwTBnXyFqwEL8FrhnviiAw7L8PnN6-q1uAZHsZzPNEaLoTydTtOZBipmAdoOqUv8YUrqXiES89CK5BjWGnRjhiEj_CtoIlhITsmG2mWmlMCNgoSTTWjiXV6Y4lMbKQkR0jFWrPQNMn1ct7HuBncDYdMTbbIx_XMN8lJuXjjaanaMeaBcGI79OwPvc_JNnNpDkV09gVpWPxsc0k21dd8ks-uCpThs9fv_gBh6N0a |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Global%2C+regional%2C+and+national+causes+of+under-5+mortality+in+2000-19%3A+an+updated+systematic+analysis+with+implications+for+the+Sustainable+Development+Goals&rft.jtitle=The+lancet+child+%26+adolescent+health&rft.au=Perin%2C+Jamie&rft.au=Mulick%2C+Amy&rft.au=Yeung%2C+Diana&rft.au=Villavicencio%2C+Francisco&rft.date=2022-02-01&rft.issn=2352-4650&rft.eissn=2352-4650&rft.volume=6&rft.issue=2&rft.spage=106&rft_id=info:doi/10.1016%2FS2352-4642%2821%2900311-4&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2352-4650&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2352-4650&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2352-4650&client=summon |