Diarrhea, pneumonia, and infectious disease mortality in children aged 5 to 14 years in India.
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ABSTRACT: Background
Little is known about the causes of death in children in India after age five years. The objective of this study is to provide the first ever direct national and sub-national estimates of infectious disease mortality in Indian children aged 5 to 14 years.Methods
A verbal autopsy based assessment of 3 855 deaths is children aged 5 to 14 years from a nationally representative survey of deaths occurring in 2001-03 in 1.1 million homes in India.Results
Infectious diseases accounted for 58% of all deaths among children aged 5 to 14 years. About 18% of deaths were due to diarrheal diseases, 10% due to pneumonia, 8% due to central nervous system infections, 4% due to measles, and 12% due to other infectious diseases. Nationally, in 2005 about 59 000 and 34 000 children aged 5 to 14 years died from diarrheal diseases and pneumonia, corresponding to mortality of 24.1 and 13.9 per 100 000 respectively. Mortality was nearly 50% higher in girls than in boys for both diarrheal diseases and pneumonia.Conclusions
Approximately 60% of all deaths in this age group are due to infectious diseases and nearly half of these deaths are due to diarrheal diseases and pneumonia. Mortality in this age group from infectious diseases, and diarrhea in particular, is much higher than previously estimated.
SUBMITTER: Morris SK
PROVIDER: S-EPMC3101242 | biostudies-literature | 2011
REPOSITORIES: biostudies-literature
Publications
Diarrhea, pneumonia, and infectious disease mortality in children aged 5 to 14 years in India.
Morris Shaun K SK Bassani Diego G DG Awasthi Shally S Kumar Rajesh R Shet Anita A Suraweera Wilson W Jha Prabhat P
PloS one 20110524 5
<h4>Background</h4>Little is known about the causes of death in children in India after age five years. The objective of this study is to provide the first ever direct national and sub-national estimates of infectious disease mortality in Indian children aged 5 to 14 years.<h4>Methods</h4>A verbal autopsy based assessment of 3 855 deaths is children aged 5 to 14 years from a nationally representative survey of deaths occurring in 2001-03 in 1.1 million homes in India.<h4>Results</h4>Infectious d ...[more]
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Project description:BackgroundWith global survival increasing for children younger than 5 years of age, attention is required to reduce the approximately 1 million deaths of children aged 5-14 years occurring every year. Causes of death at these ages remain poorly documented. We aimed to explore trends in mortality by causes of death in India, China, Brazil, and Mexico, which are home to about 40% of the world's children aged 5-14 years and experience more than 200 000 deaths annually at these ages.MethodsWe examined data on 244 401 deaths in children aged 5-14 years from four nationally representative data sources that obtained direct distributions of causes of death: the Indian Million Death Study, the Chinese Disease Surveillance Points, mortality data from the Mexican Instituto Nacional de Estadística y Geografía, and mortality data from the Brazilian Institute of Geography and Statistics. We present data on 12 main disease groups in all countries, with breakdown by communicable and nutritional diseases, non-communicable diseases, injuries, and ill-defined causes. To calculate age-specific and sex-specific death rates for each cause, we applied the national cause of death distribution to the UN mortality envelopes for 2005-16 for each country.FindingsUnlike Brazil, China, and Mexico, communicable diseases still account for nearly half of deaths in India in children aged 5-14 years (73 920 [46·1%] of 160 330 estimated deaths in 2016). In 2016, India had the highest death rates in nearly every category, including from communicable diseases. Fast declines among girls in communicable disease mortality narrowed the gap by 2016 with boys in India (32·6 deaths per 100 000 girls vs 26·2 per 100 000 boys) and China (1·7 vs 1·5). In China, injuries accounted for the greatest proportions of deaths (20 970 [53·2%] of 39 430 estimated deaths, in which drowning was a leading cause). The homicide death rate at ages 10-14 years was higher for boys than for girls in Brazil, increasing annually by an average of 0·7% (0·3-1·1). In India and China, the suicide death rates were higher for girls than for boys at ages 10-14 years. By contrast, in Mexico it was higher for boys than for girls, increasing annually by an average of 2·8% (2·0-3·6). Deaths from transport injuries, drowning, and cancer are common in all four countries, with transport accidents among the top three causes of death for both sexes in all countries, except for Indian girls, and cancer in the top three causes for both sexes in Mexico, Brazil, and China.InterpretationMost of the deaths that occurred between 2005 and 2016 in children aged 5-14 years in India, China, Brazil, and Mexico arose from preventable or treatable conditions. This age group is important for extending some of the global disease-specific targets developed for children younger than 5 years of age. Interventions to control non-communicable diseases and injuries and to strengthen cause of death reporting systems are also required.FundingWHO and the University of Toronto Connaught Global Challenge.
| S-EPMC6418656 | biostudies-literature
Project description:Control of pneumonia and diarrhea mortality in India requires understanding of their etiologies. We combined time series analysis of seasonality, climate region, and clinical syndromes from 243,000 verbal autopsies in the nationally representative Million Death Study. Pneumonia mortality at 1 month-14 years was greatest in January (Rate ratio (RR) 1.66, 99% CI 1.51-1.82; versus the April minimum). Higher RRs at 1-11 months suggested respiratory syncytial virus (RSV) etiology. India's humid subtropical region experienced a unique summer pneumonia mortality. Diarrhea mortality peaked in July (RR 1.66, 1.48-1.85) and January (RR 1.37, 1.23-1.48), while deaths with fever and bloody diarrhea (indicating enteroinvasive bacterial etiology) showed little seasonality. Combining mortality at ages 1-59 months with prevalence surveys, we estimate 40,600 pneumonia deaths from Streptococcus pneumoniae, 20,700 from RSV, 12,600 from influenza, and 7200 from Haemophilus influenzae type b and 24,700 diarrheal deaths from rotavirus occurred in 2015. Careful mortality studies can elucidate etiologies and inform vaccine introduction.
| S-EPMC6759316 | biostudies-literature
Project description:Background:The global burden of disease (GBD) study provides information about fatal and non-fatal health outcomes around the world. Methods:The objective of this work is to describe the burden of mental disorders among children aged 5-14 years in each of the six regions of the World Health Organisation. Data come from the GBD 2015 study. Outcomes: disability-adjusted life-years (DALYs) are the main indicator of GBD studies and are built from years of life lost (YLLs) and years of life lived with disability (YLDs). Results:Mental disorders are among the leading causes of YLDs and of DALYs in Europe and the Americas. Because of the importance of infectious diseases, mental disorders appear marginal in Africa for YLLs although they play an important role in YLDs there. Because the epidemiological transition that has taken place in Europe and the Americas (i.e., a switch from acute and infectious conditions to chronic and mental health issues) is likely to happen sooner or later across the entire planet, mental health problems in youth are likely to become one of the main public health challenges of the twenty-first century. Conclusion:These results should improve health care if policy-makers use them to develop health policies to meet the real needs of populations (especially children) today.
| S-EPMC5896103 | biostudies-literature
Project description:Examination of host genome-wide changes upon encounters with pathogens provides insight into the pathogenesis of infection and disease. When performed comparatively, it may shed light on the mechanisms underlying host susceptibility. In this study, gene expression in the mouse colon was investigated in two cognate lines of mice that differ in their response to Citrobacter rodentium infection; susceptible inbred FVB/N (FVB) and resistant outbred Swiss Webster (SW) mice. Gene expression in the distal colon was investigated prior to infection and at 4 and 9 days post-inoculation using a whole mouse genome Affymetrix array. Computational analysis identified 462 (1%) probe sets differentially expressed by more than 2-fold between uninoculated SW and FVB mice. In response to C. rodentium infection, 5,123 probe sets (11.4%) were significantly modulated in one or both lines of mice. Microarray data were validated by quantitative real time RT-PCR on 35 selected genes (r = 0.87, p < 0.001) and were found to have a 94% concordance. Transcripts represented by 1,547 probe sets (3.4%), were differentially expressed between FVB and SW mice regardless of infection status (host effect). Genes associated with transport were over-represented to a greater extent than immune response-related genes (25% vs. 11% of enrichment, respectively). Electrolyte analysis revealed hypochloremia and hyponatremia in susceptible animals. The results support the hypothesis that mortality in C. rodentium-infected FVB mice is associated with impaired ion transport and development of fatal hypovolemia. These studies contribute to our understanding of the pathogenesis of C. rodentium and suggest novel strategies for the prevention and treatment of diarrhea associated with bacterial infections of the intestinal tract. Keywords: temporal change (post infection)
2007-12-01 | GSE8025 | GEO
Project description:Extended validation of an index predicting mortality among community-dwelling US older adults.Examination of the performance of a previously developed index in predicting 10- and 14-year mortality among respondents to the 1997-2000 National Health Interview Surveys (NHIS) using the original development and validation cohorts. Follow-up mortality data are now available through 2011.16,063 respondents from the original development cohort and 8,027 respondents from the original validation cohort. All participants were community dwelling and ?65 years old.We calculated risk scores for each respondent based on the presence or absence of 11 factors (function, illnesses, behaviors, demographics) that make up the index. Using the Kaplan Meier method, we computed 10- and 14-year mortality estimates for the development and validation cohorts to examine model calibration. We examined model discrimination using the c-index.Participants in the development and validation cohorts were similar. Participants with risk scores 0-4 had 23% risk of 14-year mortality whereas respondents with risk scores (13+) had 89% risk of 14-year mortality. The c-index of the model in both cohorts was 0.73 for predicting 10-year mortality and 0.72 for predicting 14-year mortality. Overall, 18.4% of adults 65-74 years and 60.2% of adults ?75 years have >50% risk of mortality in 10 years.Our index demonstrated excellent calibration and discrimination in predicting 10- and 14-year mortality among community-dwelling US adults ?65 years. Information on long-term prognosis is needed to help clinicians and older adults make more informed person-centered medical decisions and to help older adults plan for the future.
| S-EPMC5478427 | biostudies-literature
Project description:ObjectivesTo assess the disease burden and changing trend of cardiomyopathy in children aged 0-14 years in China from 1990 to 2019.MethodsThis study was based on the Global Burden of Disease Study 2019; the age-specific prevalence rate, mortality rate and disability-adjusted life year (DALY) rate were used for analysis. Estimated annual percentage change (EAPC) in burden rate and its 95% confidence interval were calculated. The data of China were compared with the global average level.ResultsIn 2019, the numbers of prevalence, deaths, and DALYs of cardiomyopathy in children aged 0-14 years in China were 4,493 [95% uncertainty interval (UI): 2687 ~ 6,838], 434 (95%UI: 337 ~ 565) and 37,522 (95%UI: 29,321 ~ 48,891), with declining amplitudes of 16.32, 70.56, and 70.74%, compared with 1990, respectively. In 2019, the prevalence rate of cardiomyopathy in Chinese children aged 0-14 years was 2.00/100,000 (95%UI: 1.2/100,000 ~ 3.04/100,000), higher than 1990 [1.66/100,000 (95%UI:1.00/100,000 ~ 2.53/100,000)]; mortality rate was 0.19/100,000 (95%UI: 0.15/100,000 ~ 0.25/100,000), significantly lower than 1990 [0.46/100,000 (95%UI: 0.25/100,000 ~ 0.95/100,000)]; DALY rate was 16.69/100,000 (95%UI: 13.04/100,000 ~ 21.75/100,000), also significantly lower than 1990 [39.71/100,000 (95%UI: 22.06/100,000 ~ 82.8/100,000)]. All burden rates of cardiomyopathy in Chinese children aged 0-14 years old were all lower than the global averages of 2019; the burden rates of male children were higher than female children. In all calendar years from 1990 to 2019, the mortality and DALY rates of children younger than 1-year-old were significantly higher than in the other age groups of 0-14 years old. From 1990 to 2019, the prevalence rate of cardiomyopathy aged 0-14 years old gradually increased, with EAPC of 0.82 (95%CI: 0.71-0.93); mortality rate and DALY rate decreased [EAPC = -2.32 (95%CI: -2.59 to -2.05)].ConclusionFrom 1990 to 2019, the disease burden of cardiomyopathy in children of China aged 0-14 years was heterogeneous; the burden of male children was higher than females; and the burden of cardiomyopathy in children younger than 1 year old needs more attention.
| S-EPMC10436593 | biostudies-literature
Project description:To meet the SDG requirement of spatial disaggregation of indicators, several methods have been developed to generate estimates of under-five mortality at the sub-national level. The reliability of sub-national mortality estimates in children aged 5-14 with the available survey data has not been evaluated so far. We generate Admin-1 sub-national estimates of the risk of dying in children aged less than five (5q0) and those aged 5 to 14 years old (10q5). We use 96 Demographic and Health Surveys (DHS) in 20 Sub-Saharan countries having at least 3 surveys designed to be representative at a sub-national level. The estimates account for the complex sample design of DHS and HIV-related biases in young children. A Bayesian space-time model previously developed for under-five mortality is used to smooth estimates across space and time in both age groups to reduce problems associated with data sparsity. The posterior distributions of the probability 10q5 are used to compute coefficients of variation and assess precision. Sufficiently precise estimates are retained to study the sub-national relationship between age-specific mortality rates (5q0 and 10q5), accounting for uncertainty in sub-national levels. Out of 1,132 space-time estimates, 62.3% are considered sufficiently precise with high heterogeneity across countries. Across all periods, sub-national estimates of mortality in children aged 0-4 are highly correlated with those in older children and young adolescents but this correlation is largely driven by the mortality decline. Within specific periods of time, it is often impossible to assess the relationship between mortality rates in the two age groups at the sub-national level, except in Nigeria, Ethiopia, Cameroon, Senegal and Zambia. As increased attention is devoted to survival after age 5, more research is needed to ensure that sub-national areas with specific interventions required for older children can be correctly identified.
| S-EPMC7815126 | biostudies-literature
Project description:Examination of host genome-wide changes upon encounters with pathogens provides insight into the pathogenesis of infection and disease. When performed comparatively, it may shed light on the mechanisms underlying host susceptibility. In this study, gene expression in the mouse colon was investigated in two cognate lines of mice that differ in their response to Citrobacter rodentium infection; susceptible inbred FVB/N (FVB) and resistant outbred Swiss Webster (SW) mice. Gene expression in the distal colon was investigated prior to infection and at 4 and 9 days post-inoculation using a whole mouse genome Affymetrix array. Computational analysis identified 462 (1%) probe sets differentially expressed by more than 2-fold between uninoculated SW and FVB mice. In response to C. rodentium infection, 5,123 probe sets (11.4%) were significantly modulated in one or both lines of mice. Microarray data were validated by quantitative real time RT-PCR on 35 selected genes (r = 0.87, p < 0.001) and were found to have a 94% concordance. Transcripts represented by 1,547 probe sets (3.4%), were differentially expressed between FVB and SW mice regardless of infection status (host effect). Genes associated with transport were over-represented to a greater extent than immune response-related genes (25% vs. 11% of enrichment, respectively). Electrolyte analysis revealed hypochloremia and hyponatremia in susceptible animals. The results support the hypothesis that mortality in C. rodentium-infected FVB mice is associated with impaired ion transport and development of fatal hypovolemia. These studies contribute to our understanding of the pathogenesis of C. rodentium and suggest novel strategies for the prevention and treatment of diarrhea associated with bacterial infections of the intestinal tract. Experiment Overall Design: Global gene expression analysis was performed on the distal colon with 2-3 mice per group. Because no difference for any parameters was observed in uninfected mice at 4 or 9 dpi, the animals were pooled into an uninoculated control groups for each line of mouse. The selection of representative samples for microarray analysis was based on known infection status and colonic lesions. The final number of biological replicates for each condition was n = 5 for uninoculated FVB mice (âFpâ group), n = 4 for uninoculated SW mice (âSpâ group), and n = 3 for infected animals from each line at each time point (âFi4â, âSi4â, âFi9â, and âSi9â respectively).
2008-06-15 | E-GEOD-8025 | biostudies-arrayexpress
Project description:BACKGROUND:Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in children aged <5 years. Zimbabwe introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose infant schedule with no booster dose or catch-up campaign. We evaluated the impact of PCV13 on pediatric pneumonia and meningitis. METHODS:We examined annual changes in the proportion of hospitalizations due to pneumonia and meningitis among children aged <5 years at Harare Central Hospital (HCH) pre-PCV13 (January 2010-June 2012) and post-PCV13 (July 2013-December 2016) using a negative binomial regression model, adjusting for seasonality. We also evaluated post-PCV13 changes in serotype distribution among children with confirmed pneumococcal meningitis at HCH and acute respiratory infection (ARI) trends using Ministry of Health outpatient data. RESULTS:Pneumonia hospitalizations among children aged <5 years steadily declined pre-PCV13; no significant change in annual decline was observed post-PCV13. Post-PCV13 introduction, meningitis hospitalization decreased 30% annually (95% confidence interval [CI], -42, -14) among children aged 12-59 months, and no change was observed among children aged 0-11 months. Pneumococcal meningitis caused by PCV13 serotypes decreased from 100% in 2011 to 50% in 2016. Annual severe and moderate outpatient ARI decreased by 30% (95% CI, -33, -26) and 7% (95% CI, -11, -2), respectively, post-PCV13 introduction. CONCLUSIONS:We observed declines in pediatric meningitis hospitalizations, PCV13-type pneumococcal meningitis, and severe and moderate ARI outpatient visits post-PCV13 introduction. Low specificity of discharge codes, changes in referral patterns, and improvements in human immunodeficiency virus care may have contributed to the lack of additional declines in pneumonia hospitalizations post-PCV13 introduction.
| S-EPMC6761317 | biostudies-literature
Project description:ImportanceFirearms caused more than 500 pediatric fatalities in 2017-a 50% increase from 2009. Laws regulating firearms are one approach to reducing pediatric firearm fatalities.ObjectiveTo evaluate the association between state child access prevention (CAP) firearm laws and pediatric firearm fatalities.Design, setting, and participantsA state-level, cross-sectional study of CAP firearm laws throughout the United States, 1991-2016, was conducted using negative binomial regression to analyze differences in state fatality rates in children aged 0 to 14 years. Data analysis was performed from November 21, 2018, to October 18, 2019.ExposuresImplementation of 2 categories of state CAP firearm laws: recklessness laws, which pertain to providing a firearm to a child, and negligence laws, which pertain to accessibility of a firearm within the home.Main outcomes and measuresRates of firearm fatalities across all intents and by specific intent (homicide, suicide, and unintentional) per 100 000 children aged 0 to 14 years.ResultsTwenty-five states passed CAP laws between 1989 and 2000. Between 1991 and 2016, 13 697 firearm fatalities occurred in children aged 0 to 14 years. Recklessness laws were not associated with changes in pediatric firearm fatality rates. Negligence laws overall were associated with significant reductions in firearm fatalities in children aged 0 to 14 years, with a 13% relative reduction in all firearm fatalities (95% CI, -18% to -7%), a 15% relative reduction in firearm homicides (95% CI, -22% to -7%), a 12% relative reduction in firearm suicides (95% CI, -20% to -2%), and a 13% relative reduction in unintentional firearm fatalities (95% CI, -24% to -1%). The most stringent negligence laws were associated with unintentional firearm fatality reductions of 59% (95% CI, -68% to -49%). A total of 3929 deaths (29% of all firearm deaths) were associated with states not having passed the most stringent form of negligence CAP laws.Conclusions and relevanceIn this study, negligence laws were associated with relative reductions in firearm fatality rates in children aged 0 to 14 years. The most stringent negligence laws were associated with the largest reductions in unintentional firearm fatalities. Recklessness laws were not associated with reduced firearm fatality rates. The passage of negligence CAP laws may have the potential to reduce firearm fatalities in children.
| S-EPMC7052788 | biostudies-literature