Child deaths due to injury in the four UK countries: a time trends study from 1980 to 2010.
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ABSTRACT: Background
Injuries are an increasingly important cause of death in children worldwide, yet injury mortality is highly preventable. Determining patterns and trends in child injury mortality can identify groups at particularly high risk. We compare trends in child deaths due to injury in four UK countries, between 1980 and 2010.Methods
We obtained information from death certificates on all deaths occurring between 1980 and 2010 in children aged 28 days to 18 years and resident in England, Scotland, Wales or Northern Ireland. Injury deaths were defined by an external cause code recorded as the underlying cause of death. Injury mortality rates were analysed by type of injury, country of residence, age group, sex and time period.Results
Child mortality due to injury has declined in all countries of the UK. England consistently experienced the lowest mortality rate throughout the study period. For children aged 10 to 18 years, differences between countries in mortality rates increased during the study period. Inter-country differences were largest for boys aged 10 to 18 years with mortality rate ratios of 1.38 (95% confidence interval 1.16, 1.64) for Wales, 1.68 (1.48, 1.91) for Scotland and 1.81 (1.50, 2.18) for Northern Ireland compared with England (the baseline) in 2006-10. The decline in mortality due to injury was accounted for by a decline in unintentional injuries. For older children, no declines were observed for deaths caused by self-harm, by assault or from undetermined intent in any UK country.Conclusion
Whilst child deaths from injury have declined in all four UK countries, substantial differences in mortality rates remain between countries, particularly for older boys. This group stands to gain most from policy interventions to reduce deaths from injury in children.
SUBMITTER: Hardelid P
PROVIDER: S-EPMC3707924 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Ischemic heart disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Risk Factors and Injuries 2010 Study estimated global and regional IHD mortality from 1980 to 2010.Sources for IHD mortality estimates were country-level surveillance, verbal autopsy, and vital registration data. Regional income, metabolic and nutritional risk factors, and other covariates were estimated from surveys and a systematic review. An estimation and validation process led to an ensemble model of IHD mortality for 21 world regions. Globally, age-standardized IHD mortality has declined since the 1980s, and high-income regions (especially Australasia, Western Europe, and North America) experienced the most remarkable declines. Age-standardized IHD mortality increased in former Soviet Union countries and South Asia in the 1990s and attenuated after 2000. In 2010, Eastern Europe and Central Asia had the highest age-standardized IHD mortality rates. More IHD deaths occurred in South Asia in 2010 than in any other region. On average, IHD deaths in South Asia, North Africa and the Middle East, and sub-Saharan Africa occurred at younger ages in comparison with most other regions.In most world regions, particularly in high-income regions, age-standardized IHD mortality rates have declined significantly since 1980. High age-standardized IHD mortality in Eastern Europe, Central Asia, and South Asia point to the need to prevent and control established risk factors in those regions and to research the unique behavioral and environmental determinants of higher IHD mortality.
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Project description:BackgroundFunding from external agencies for malaria control in Africa has increased dramatically over the past decade resulting in substantial increases in population coverage by effective malaria prevention interventions. This unprecedented effort to scale-up malaria interventions is likely improving child survival and will likely contribute to meeting Millennium Development Goal (MDG) 4 to reduce the < 5 mortality rate by two thirds between 1990 and 2015.MethodsThe Lives Saved Tool (LiST) model was used to quantify the likely impact that malaria prevention intervention scale-up has had on malaria mortality over the past decade (2001-2010) across 43 malaria endemic countries in sub-Saharan African. The likely impact of ITNs and malaria prevention interventions in pregnancy (intermittent preventive treatment [IPTp] and ITNs used during pregnancy) over this period was assessed.ResultsThe LiST model conservatively estimates that malaria prevention intervention scale-up over the past decade has prevented 842,800 (uncertainty: 562,800-1,364,645) child deaths due to malaria across 43 malaria-endemic countries in Africa, compared to a baseline of the year 2000. Over the entire decade, this represents an 8.2% decrease in the number of malaria-caused child deaths that would have occurred over this period had malaria prevention coverage remained unchanged since 2000. The biggest impact occurred in 2010 with a 24.4% decrease in malaria-caused child deaths compared to what would have happened had malaria prevention interventions not been scaled-up beyond 2000 coverage levels. ITNs accounted for 99% of the lives saved.ConclusionsThe results suggest that funding for malaria prevention in Africa over the past decade has had a substantial impact on decreasing child deaths due to malaria. Rapidly achieving and then maintaining universal coverage of these interventions should be an urgent priority for malaria control programmes in the future. Successful scale-up in many African countries will likely contribute substantially to meeting MDG 4, as well as succeed in meeting MDG 6 (Target 1) to halt and reverse malaria incidence by 2015.
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Project description:BackgroundInjuries result in substantial number of deaths among children globally. The burden across many settings is largely unknown. We estimated global and regional child deaths due to injuries from publicly available evidence.MethodsWe searched for community-based studies and nationally representative data reporting on child injury deaths published after year 1990 from CINAHL, EMBASE, IndMed, LILACS, Global Health, MEDLINE, SCOPUS, and Web of Science. Specific and all-cause mortality due to injuries were extracted for three age groups (0-11 months, 1-4 years, and 0-4 years). We conducted random-effects meta-analysis on extracted crude estimates, and developed a meta-regression model to determine the number of deaths due to injuries among children aged 0-4 years globally and across the World Health Organization (WHO) regions.ResultsTwenty-nine studies from 16 countries met the selection criteria. A total of 230 data-points on 15 causes of injury deaths were retrieved from all studies. Eighteen studies were rated as high quality, although heterogeneity was high (I2?=?99.7%, P?<?0.001) reflecting variable data sources and study designs. For children aged 0-11 months, the pooled crude injury mortality rate was 29.6 (95% confidence interval (CI)?=?21.1-38.1) per 100?000 child population, with asphyxiation being the leading cause of death (neonatal) at 189.1 (95% CI?=?142.7-235.4) per 100?000 followed by suffocation (post-neonatal) at 18.7 (95% CI?=?11.8-25.7) per 100?000. Among children aged 1-4 years, the pooled crude injury mortality rate was 32.7 (95% CI?=?27.3-38.1) per 100?000, with traffic injuries and drowning the leading causes of deaths at 10.8 (95% CI?=?8.9-12.8) and 8.8 (95% CI?=?7.5-10.2) per 100?000, respectively. Among children under five years, the pooled injury mortality rate was 37.7 (95% CI?=?32.7-42.7) per 100?000, with traffic injuries and drowning also the leading causes of deaths at 10.3 (95% CI?=?8.8-11.8) and 8.9 (95% CI?=?7.8-9.9) per 100?000 respectively. When crude mortality changes over age, WHO regions, and study period were accounted for in our model, we estimated that in 2015 there were 522?167 (95% CI?=?395?823-648?630) deaths among children aged 0-4 years, with South East Asia (SEARO) recording the highest number of deaths at 195?084 (95% CI?=?159476-230502), closely followed by the Africa region (AFRO) with 176523 (95% CI?=?115?040-237?831) deaths. Globally, traffic injuries and drowning were the leading causes of under-five injury fatalities in 2015 with 142?661 (22.0/100?000) and 123?270 (19.0/100?000) child deaths, respectively. The exception being burns in AFRO with 57?784 deaths (38.6/100?000).ConclusionsVarying study designs, case definitions, and particularly limited country representation from Africa and South-East Asia (where we reported higher estimates), imply a need for more studies for better population representative estimates. This study may have however provided improved understanding on child injury death profiles needed to guide further research, policy reforms and relevant strategies globally.
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Project description:ObjectiveLittle is known about whether levels of physical fitness, which is related to adiposity and physical activity (PA), have changed in children, particularly the progressive increase in childhood obesity levels. We aimed to examine the time trends in resting pulse rate (a marker of physical fitness) among UK children, in order to better understand the trends in levels of physical fitness in recent decades.Design and settingWe used a cross-sectional study design and included data on over 22 000 children aged 9-11 years (mean 10.3 years) from five population-based studies conducted in the UK between 1980 and 2008.Main outcome measuresResting pulse rate (bpm).ResultsObserved mean resting pulse rate was higher for girls than boys (82.2 bpm vs 78.7 bpm). During the study period mean pulse rate increased by 0.07 bpm/year (95% CI 0.04 to 0.09) among boys and to a lesser extent among girls, by 0.04 bpm/year (0.01 to 0.06) (p<0.05 for gender interaction). For boys, there was an indication that the trend was steeper after the mid-1990 s, compared to that prior to 1994 (annual increase 0.14 vs 0.04 bpm). The trends for Body Mass Index (BMI) accounted for only 13.8% (11.3% to 16.3%) of increase in pulse rate for boys and 17.2% (9.4% to 24.9%) for girls.ConclusionsIncreases in mean resting pulse rate have occurred during the period 1980-2008 in girls and especially in boys. The increase was not explained by increased BMI. The observed trends in children, though modest, could have important public health implications for future cardiovascular risk.
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Project description:Background: The field of child and adolescent psychiatry lags behind adult psychiatry significantly. In recent years, it has witnessed a significant increase in the publication of journals and articles. This study provides a detailed bibliometric analysis of articles published from 1980 to 2016, in the top seven journals of child and adolescent psychiatry. Methods: Using the Web of Science core collection, we selected 9,719 research papers published in seven psychiatric journals from 1980 to 2016. We utilized the Web of Science Analytics tool and Network Analysis Interface for Literature Studies (NAILS) Project scripts to delineate the general trends of publication in these journals. Then, co-citation analysis and hierarchical cluster analysis was performed using CiteSpace to map important papers, landmark theories and foci of research in child and adolescent psychiatry. Results: The field of child and adolescent psychiatry has experienced an increasing trend in research, which was reflected in the results of this study. Hierarchical cluster analysis revealed that the research foci in psychiatry were primarily studies related to the design of psychometric instruments, checklists, taxonomy, attention deficit hyperactivity disorder (ADHD), depression, PTSD, social phobia, and psychopharmacology. Moreover, several landmark studies, including the validation of a child behavior checklist, Ainsworth's empirical evidence of Bowlby's attachment theory, and adult outcomes of childhood dysregulation were published. This study also reports rapid expansion and innovation in research areas in the field of child and adolescent psychiatry from 1980-2016. Conclusions: Rapid expansion and innovation in research areas in the field of child and adolescent psychiatry has been observed, from 1980 to 2016.
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